Kirsten Whitworth says Health Minister Aaron Motsoaledi took decisive action on the issue of empty beds in Gauteng hospitals, but more needs to be done to fix the province’s healthcare crisis.
Johannesburg - It’s no secret that the public healthcare system in Gauteng is in crisis. The former MEC for health, Hope Papo, himself described a crisis in the province, and it cannot be solved quickly. It demands a sustained, systemic and long-term approach. That said, there are times when a small and direct intervention may be possible to address needs and bring immediate relief.
In southern Gauteng, three public hospitals, Helen Joseph, Sebokeng and Charlotte Maxeke, have wards that reserve beds for insured, fee-paying patients. These wards are called Folateng wards. Folateng means “place of healing”. The Folateng system was started about 12 years ago but by early this year, in at least two of these hospitals, namely Helen Joseph (40 beds) and Sebokeng (36 beds), almost all the beds in these wards stood empty.
Meanwhile, some patients at Chris Hani Baragwanath Academic hospital in Soweto, the third largest hospital in the world, are forced to share beds, to lie on mattresses on the floor, to spend hours on benches or chairs and, in the worst cases, are turned away.
Given that for many, Chris Hani Baragwanath is a hospital of last resort, those turned away inevitably face a quiet death. The situation at Baragwanath is so dire Professor Ken Huddle, together with several other clinicians, wrote a public letter published in the May issue of the South African Medical Journal.
The letter called for the closure of the Folateng wards and their re-opening for use by public sector patients. It also called for the re-opening of hospitals that have closed, including Hillbrow, Kempton Park and Lenasia South.
This story has generated significant media interest. The thought of very sick people having to share beds at one public hospital while, in the same city, beds are reserved in other public hospitals for those who can pay for them, is unsettling.
On April 10, Eusebius McKaiser hosted a discussion on Power FM between Huddle, Minister of Health Dr Aaron Motsoaledi and myself in which the Folateng units were brought to the attention of the public. It has been our experience that the minister is eager to engage constructively and this debate was no exception.
Huddle highlighted his concern at the lack of beds for extremely ill patients while public beds were privatised. I noted that economic apartheid is alive and well when a two-tier system is allowed in a public health system.
The minister shared his dismay that any patient might be turned away when there were empty beds available and undertook to look into the matter. He said he was dead against the two-tier system, but was unable to commit to a timeframe within which steps would be taken. The story was carried by this newspaper and others.
The minister was quoted as saying: “You can’t provide private medical care inside a public institution. We are working round the clock to abolish that. It’s wrong.”
Motsoaledi was also quoted as having told the Gauteng Department of Health: “It’s actually illegal to tell somebody they can’t use a bed in a public hospital because it’s reserved for somebody with a medical aid.”
On April 23, Wits Centre for Applied Legal Studies’ director Professor Bonita Meyersfeld and Huddle appeared on SABC’s AM Live to discuss the Folateng issue. The minister of health appeared on the show later in the broadcast. He announced that under no circumstances could individuals be turned away where there were beds available for private health-care patients or otherwise. This would be a violation of the law and section 27 of the constitution. We applaud the minister’s robust position.
It is easy to become disheartened in the face of a crisis. It is important that this does not lead to inaction. Although it will take years to address the crisis, the Folateng issue presented the minister with the opportunity for a discrete intervention. He took decisive action and, as a result, beds that were lying empty may be freed up to assist with the burden on the hospitals in southern Gauteng.