The crises at Chris Hani Baragwanath Academic Hospital, the world’s third-largest hospital, could result in hundreds of thousands of patients who rely on the public hospital being unable to access much-needed health care.
The hospital has been in the news for all the wrong reasons recently, with Gauteng health MEC Nomathemba Mokgethi telling the provincial legislature that 870 operations had been cancelled due to maintenance and equipment problems, overbooking and linen shortages.
In March, nurses and doctors had to pool funds to buy patients bread after a declining food supply at the tertiary hospital.
In June, a fire broke out at the hospital in an open space near tents used for Covid-19 testing but no-one was injured.
While the provincial health department has a budget of R59.4bn for 2022/2023, its infrastructure counterpart was allocated more than R36bn over the next three years to refurbish hospitals including Chris Hani Baragwanath, Leratong and Edenvale hospitals.
Chris Hani Baragwanath is the biggest hospital in the southern hemisphere, with a staff of about 6,000 and around 3,200 beds.
The specialist hospital sees about 150,000 inpatients and 500,000 outpatients annually, while 50,000 and 60,000 patients are treated at the hospital’s ophthalmology and maternity departments each year.
DA Gauteng health spokesperson Jack Bloom said the cancellation of medical procedures at the hospital causes great distress to staff and patients.
“Surgeons are hugely frustrated when an operation cannot proceed because of a linen shortage or another avoidable reason. Some patients have waited years for operations, only to be disappointed at the last moment when their surgery is cancelled,” he said.
“Every effort should be made to avoid the cancellation of operations as the surgery backlogs are alarmingly high and patients suffer from long waits.”
Bloom said hospital CEOs should be given more powers to do maintenance, which is currently done by the “dysfunctional Gauteng infrastructure development department”.
Poor maintenance
He said Chris Hani Baragwanath was a specialist hospital that was burdened with staff shortages. “The hospital is not for Gauteng only, it’s also for surrounding provinces. It’s very stressful for everybody. There is a lot of in-migration from other provinces, people are referred there for heart surgeries,” he said.
Bloom said because the health care facility was an old hospital — it was opened in the 1940s — it suffered poor maintenance including generator and air-conditioning failures and a shortage of linen.
“No hospital should have a shortage of linen. The hospital has had to cancel nearly 800 surgeries this year, and it’s a combination of factors: lack of surgery equipment and laundry. If, for instance, the air-con is not working you can’t go ahead with surgery. These power failures are really ruinous. There is a massive backlog of surgeries at Bara. The hospital is suffering from mismanagement at the provincial department of health which is deeply rooted,” Bloom said.
Asked what should be done to address the crises at the facility, Bloom said the hospital needed to fill critical vacancies and do proper maintenance of infrastructure and ensure there was enough linen.
“This is the largest hospital in SA. Public patients from other provinces depend on it for life-saving specialist care. The waiting list is so long that people will lose their lives (while on the waiting list). You can wait for up to five years for a hip operation at the hospital,” he said.
Young Nurses Indaba Trade Union general secretary Lerato Mthunzi said: “The crises at Bara are not new, they move from [officials] not being able to do their jobs properly due to red tape. Bara is your last port of call when it comes to referrals, but we feel it has not been given the budget due to it to operate efficiently.”
Mthunzi said the hospital was subjected to volumes of bureaucratic delays where managers needed approval for basic things such as buying bread for patients right up to infrastructure approvals.
Mthunzi, who has worked at Bara, said the infrastructure at the hospital is “aged to the core”, while the official lines of getting things authorised “are slim to none”.
“Managers have no power at all. What should happen is decentralisation of power so as to enable the hospital, and other big tertiary hospitals out there, to not be subjected to the current red tape they have to encounter. Government must put systems in place to make sure that those appointed in leadership positions do their jobs without hindrance,” she said.
“When you chat to the CEO [Nkele Lesia] you get the feeling that she is still waiting for someone to give approval. The hospital is remote-controlled and not managed properly. This is a disaster waiting to happen. Bara is facing crisis after crisis. Managers are forever chasing the tail. Politicians must stop meddling in the affairs of the hospital,” Mthunzi said.
National Education, Health and Allied Workers Union (Nehawu) Gauteng secretary Mzikayise Tshontshi, and Simphiwe Gada, Gauteng chair of the Democratic Nursing Organisation of SA (Denosa), were not immediately available for comment.
Lesia, explaining the cancellations last week Monday, said the facility had 43 theatres and “our patient load is quite heavy. We strive to prioritise emergency surgical procedures.”
“We don’t cancel any emergency cases and the reasons for cancellations are many — some of them are patient-related, which we are not in control of. For example, if the person is not fit for surgery.”
TimesLIVE reported that some operations were deferred because of time — doctors could only perform a limited number of operations a day.
“However, what is avoidable is the issue of this infrastructure challenge. For example, there was no clean linen at the hospital,” Lesia said, speaking during a visit to the hospital by the SA Human Rights Commission (SAHRC). “The reason was that the boilers were not functioning and at the same time the laundry equipment was not functioning.”
The commission conducted an oversight visit following reports about the cancelled surgeries.
Buang Jones, head of the SAHRC in Gauteng, said the commission planned to meet the heads of the departments of health, Treasury and infrastructure development on July 13 to discuss challenges in the provincial health care sector.
The purpose of the commission’s visit was to examine factors such as infrastructure, the quality of health care services, equipment and human resources, said Jones.
“We will await formal reports within a week. The commission intends to convene a meeting with the heads of departments to see how we can attend to these challenges and resolve them in a manner that upholds, respects and promotes the right of access to health care services.”
With TimesLIVE
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