SA’s health system steadily healing
Earlier this week your newspaper ran a front-page story regarding the deployment of the SA Military Health Service (SAMHS) at Chris Hani Baragwanath Hospital’s maternity unit (“SANDF steps in to help at Bara”).
Let me perhaps start off by stating the obvious. Health-care delivery in the public sector is facing a number of challenges that can be summarised briefly as follows:
l Critical shortages in the area of both doctors and nurses.
l The burden of disease (including injuries) that has been increasing over the past years (including pre-1994).
l Old infrastructure requiring urgent refurbishing and replacement.
The challenges confronting Bara can be understood within these three areas. The same can be said for all other hospitals (and primary health-care facilities) throughout the country. It is with this understanding that the ANC took a decision to prioritise health, a decision that gave birth to what has become known as the 10 Point Plan – our road map towards addressing the many challenges confronting health care in our country. It’s not only in the public health sector where problems exist – the private sector is facing problems of its own, including exorbitant pricing.
It is however unfortunate that National Health Insurance has overshadowed everything else that’s contained in the plan.
Since his appointment in 2009, Health Minister Dr Aaron Motsoaledi has consulted virtually all key stakeholders in our society to see how this plan can best be implemented.
In April last year the minister hosted the successful Nursing Summit which culminated in the Nursing Compact, which outlines in precise terms how nursing as the backbone of every health sector can be revitalised in our country.
A lot of work has since been done in this regard, also since last year’s State of the Nation address. But a lot more still needs to be done.
It’s a known fact that our country has lost a lot of nurses to foreign countries and this has been made worse by the fact that long before 1994 some “wise” men and women took a decision to change the training of nurses in our country. Contrary to popular view, matters started going wrong in the training of nurses long before 1994.
At the Nursing Summit last April, all delegates agreed that the training of nurses in our country must go back to basics. Nursing must be the bed-side experience that it used to be years ago.
Equally important is that crucial work is being done towards the revamping of 122 nursing colleges so that we are, in the near future, able to produce the necessary numbers of good, well-trained professional nurses with good foundations when it comes to patient care.
Once again, this is something that no one, however hardworking, can do overnight. What then can be done when the situation is this urgent?
Folding hands and hoping for miracles is not an option – not with Motsoaledi.
Decisions have to be taken and they have to be taken fast, especially when it comes to our premier facilities like Chris Hani Baragwanath Hospital.
On any given day, thousands of patients with varying needs go through the doors of Bara for their health-care needs.
It is with this understanding that everything must be done to ensure that as far as is practically possible, our patients receive the best clinical care when they visit this facility.
Apart from the SAMHS intervention, more is being done to improve the situation at Bara. The Department of Health has commenced with a process of hiring at least 40 foreign qualified nurses. In line with our requirements, these nurses must go through the necessary requirements of the SA Nursing Council so that they are ultimately ready for placement in this facility.
This is something we are confident can and should be done in a relatively short period of time.
In the meantime, the SAMHS personnel will continue to provide the much-needed nursing service at this important facility.
But it’s not only in the area of nursing where we are encountering shortages. It is a well-known fact there is this worrying shortage of doctors (including specialists) in our facilities.
Just as in the case with nurses, a lot of our doctors left for overseas countries due to a range of factors, some of which are beyond anyone’s control. This problem is even more acute when dealing with hospitals in rural areas, as very few doctors want to go and work there. This is despite various attempts made by the government to provide attractive incentives.
Why do we find ourselves in this situation? The simple explanation is provided above – we have seen a lot of our doctors including specialists migrate overseas for a variety of reasons, some of which are beyond any government’s control.
Second, and perhaps a bit complex, it’s true that our medical schools have been producing the same number of doctors (1 200) for many years, despite the increasing population and the increasing burden of disease complicated by HIV/Aids, TB and non-communicable diseases such as cancers and diabetes.
The key to our future lies partly in addressing this problem. The minister has over the past few months consulted with the deans of medical schools with a view to getting them to absorb more students in line with our plan to increase our output from the current 1 200.
It’s quite encouraging that virtually all of them are willing to hold our hand towards this common goal, and one university has already started with absorbing an extra 40 students with others in various states of readiness.
So, despite what some might choose to dismiss as a hopeless situation, for us a lot is happening. A baby is being born, it’s not an easy birth, and it’s going to take longer.
l Fidel Hadebe is the spokesman for the Ministry and Department of Health