Johannesburg - Increased mortality, growing waiting lists and unfilled vacancies. This is the picture painted of the Port Elizabeth Health Complex by its top doctors.
In a damning statement endorsed by all 30 specialists in the complex, the doctors are calling for action as staff shortages inhibit their ability to provide adequate health care.
They allege the health complex - which comprises three large provincial hospitals: Dora Nginza, Livingstone and Port Elizabeth - has lost 47 doctors this year, with no advertisements calling for replacements published and only “a handful” of positions refilled.
Furthermore, three heads of department - in surgery, urology, and plastic surgery and burns - have resigned, “almost entirely due to the critical staff shortages”.
Another two heads of department, in neurosurgery and cardiology, have not had their contracts renewed.
Numbers provided show a drastic increase in infant and child-mortality rates in the past year, with growing surgery waiting lists in every other department.
“We feel it our duty to inform the public that there are certain, essential tertiary services that cannot be rendered effectively, and we believe that the Eastern Cape Department of Health, which has done very little to avert this crisis, must take full responsibility for the increased mortality and morbidity which will inevitably flow from this catastrophic situation,” reads the statement.
But the province’s health department has dismissed the statement.
Spokesman Sizwe Kupelo called it “grandstanding” and “nothing but a dereliction of duty”. He said a list of 17 new doctors was waiting on approval from the Treasury, while requests had been submitted for a further 15.
He added that if there were vacancies in hospitals, it was the specialists’ duty to notify the department to advertise that position. He said doctors were not doing so.
The department was doing “everything in its power” to get doctors. But once filled, it was also up to specialists to ensure the posts stayed filled, he said.
“We have a situation where these specialists are the most senior people in the hospital,” Kupelo said.
“They are expected to mentor young recruits. They have failed to do that. This is grandstanding. They are politicising service delivery.
“This is why we’re paying specialists millions and millions... They don’t do what they’re paid to do. They sit and complain and complain and complain until Jesus comes… We have an issue that instead of sitting around a table, these people go public.”
This is the second time the health complex has taken its grievances to the media.
In June, representatives held a media conference airing the same woes. Several senior staff members were threatened with disciplinary action for going public. And now they say that, if anything, their problems have only become worse.
“My contract expired on November 30,” said head of cardiology Dr Basil Brown.
“My application for renewal, I’m told, is still being considered. I’m working for nothing.”
He said the doctors were prepared to face the consequences of their statement.
“The public needs to be made aware of this situation.”
According to Section27, the province’s health department was facing a shortfall of between R2.5 billion and R3 billion at the end of the last financial year - a shortfall that would have had to have been funded out of the 2012/2013 budget.
“Given the 2012/13 budget is already considered to be insufficient to meet the needs of the department and has in fact declined in real terms, this is likely to severely exacerbate their weak financial position,” says the social justice group.
“This is likely to impact on service delivery in the province.”
What’s ailing in health care:
The department has lost a third of its staff, but, after “numerous applications”, none of the posts have been filled. It has stopped rural outreach, which has led to more mother and baby deaths in these rural areas.
“The situation is a disaster as, without anaesthetics, no surgery may be performed,” says the statement.
Four of the unit’s five doctors have left without being replaced. The remaining doctor is now only accepting referrals of patients with burns over more than 20 percent of their bodies, or 15 percent for children.
By the end of the year, only one of the department’s three medical officers will still be at the hospital.
“If no replacements are appointed, the clinic and in-patient services will have to be severely curtailed,” says the statement.
With only two full-time specialists and one junior doctor, the department’s waiting list for open-heart surgery is greater than six months, with a year’s wait for child patients.
“A number of candidates have applied for positions in the department but could not be appointed due to financial problems,” the statement claims.
There has been no full-time ENT specialist at the PHEC for 10 years. A South African surgeon who was head-hunted in Australia to fill the post arrived, only to be told that his appointment had not been approved.
As such, no major surgeries can be performed in Port Elizabeth and emergencies have to be transferred to East London.
With no junior staff available to man the ICU next month, the unit is expecting to close the adult department of critical care on January 2.
Because of severe staff shortages, only emergency referrals will be accepted as of January 1.
With only one neaurosurgeon remaining, the waiting list for surgery patients is at least 60. Of the two junior doctors in the department, one is leaving at the end of the year.