While hospitals in the Northern Cape manage to cope under the double strain of Covid-19 and an under-resourced health system, this is thanks to the many dedicated facility managers, health professionals and hospital staff who, through exceptionally hard work, as opposed to a well-managed health system, are keeping health care services in the province afloat.
These were the observations of the Democratic Alliance (DA) during an oversight inspection to three Northern Cape hospitals yesterday by myself, the DA’s national shadow minister of health, Siviwe Gwarube, and DA provincial health spokesperson, Dr Isak Fritz (see pics here, here and here).
In respect of all three facilities visited, namely the Robert Mangaliso Sobukwe Hospital and the new mental hospital in Kimberley, as well as the Prof ZK Matthews Hospital in Barkley West, the biggest underlying challenge to the provision of health care, alongside the pandemic, is the dire shortage of staff.
At RMS Hospital, the Chief Executive Officer is still awaiting the transfer of Human Resource delegations back to him. In the meantime, he cannot appoint anyone, not even a cleaner, and he has to wait up to five months for submissions to get signed off at the head office. In effect, the facility continues to lose potential health professionals, who eventually seek employment in other provinces.
The Covid-19 positive diagnoses of 146 hospital employees at the hospital has placed an added burden on staff, who have to work harder and longer to make up for absent colleagues. The hospital has increased the overtime limit from 30% to 40%, but even that is not enough. The hospital needs respite. At the end of the day, it is no wonder that only emergency surgical procedures can take place, as the backlog for operations grows to 985. While concerning, it is also not surprising that the Covid section of the RMS hospital, which must service the entire province, has only six ICU beds, of which five were already occupied.
The lack of staffing has a similar effect in the other facilities too.
The new mental hospital, whilst completed and equipped to deliver a full package of services, is still only moving past phase 1, regarding the phasing in of services. This is despite the facility having become operationalised a year ago already. Due to a lack of clinical capacity, overburdened staff also have to fulfill dual roles as a result of pandemic protocols. For example, psychiatrists have to serve as doctors and health and safety officers. This has been further aggravated by the 16 staff members who tested positive for Covid-19. In effect, some state patients are still accommodated in prison and child admissions have yet to commence. At the same time, there is the looming threat of security for state patients, given that the private security contract comes to an end next month, leaving the under-capacitated internal security unit to take over this role.
At Prof ZK Matthews hospital, the staff shortages are further aggravated by the shortage of ambulances and fleet vehicles, which significantly affect outreach services to the outlying communities, as well as emergency services, given that limited staff and vehicles are more often than not used for referrals to Kimberley, leaving Barkley West residents in the lurch.
The DA is calling on health MEC Maruping Lekwene to relinquish HR delegations to some facilities, and to do even more to grow the field of health professionals. Our hospital staff, whom we thank from the bottom of our hearts, can only work so much. They cannot carry the burden of a poorly resourced health system indefinitely. Action must be taken before their load gets too heavy and health services crumble.
Delmaine Christians / DA