Mitchells Plain Hospital needs R300 million to properly function and alleviate critical service problems including bed and staff.
A recent report identified the challenges at Mitchells Plain and Khayalitsha district hospitals following an oversight visit from the provincial legislature’s Standing Committee on Health.
The visits followed reports about patients forced to sleep on the floor and in chairs due to bed shortages, as well as alleged patient abuse and neglect at Mitchells Plain.
Listed among Mitchells Plain’s main challenges were:
* Staff shortages including no family physician and the need for occupational therapists, social workers, and psychologists.
* No ICU and Care Ward. Patients who need ICU services are referred to the Groote Schuur Hospital. During the visit, 202 patients were waiting for a referral.
* An increase in psychiatric patients, while The hospital isn’t equipped to assist the increase of psychiatric patients who are only meant to be held for 72 hours, but end up staying for up to 14 days.
* The hospital had a 120-bed capacity but 139 patients were admitted at the time of the visit.
* The closure of the GF Jooste Hospital meant that patients from the Klipfontein sub-district received treatment at Mitchells Plain, further exacerbating the problems.
* High absenteeism among doctors.
* The hospital overspent its R30m budget annually on agency staff and overtime for nursing staff. As such, it would need R300m to address its needs.
Khayelitsha hospital was also buckling under service pressures and bed capacity challenges.
Both of the hospitals have, as part of the report’s recommendations, asked to be turned into regional hospitals.
The ANC’s Western Cape spokesperson on health Rachel Windvogel called on the Department of Health to urgently address the challenges facing both facilities.
“The severe service pressures are caused, in part, by the department's refusal to allocate additional funds required to alleviate the pressures.
“Rapid population growth, immigration and development of new informal settlements have all contributed to the severe service pressures.”
“The department has already identified the need for a regional hospital to service the Khayelitsha, Mitchells Plain and the Klipfontein region.
“Due to the provincial government's failures and delays, the building of the Klipfontein Regional Hospital will only be completed after 2031.
“People cannot wait until then. It is for that reason that we continue to make the calls for one of the existing two district hospitals to be converted into a regional hospital.”
The department appeared before the Health Portfolio Committee earlier this week to unpack its annual report.
Windvogel said Khayelitsha hadn’t been given the R150m requested because the head of department, Dr Keith Cloete, said there was no money.
Provincial secretary at Democratic Nursing Organisation of South Africa (Denosa), Jaco van Heerden, said under-staffing at the two hospitals was a concern.
“Because of the pressure of the catchment area being high but the resources not matching the health demand, by default service delivery gets compromised unintentionally but because of the material conditions.
“Nurses migrate to the private sector or to Europe.”
Van Heerden said there should be political will to allocate more resources to the health budget.
“(There needs to be) an understanding that when spending money on health, it is an investment not an expenditure.
“We must push for medical staff (doctors, nurses etc) population ratio to be legislated – this will also enable unions and civil society to take the government to court and make them accountable to improve service delivery and quality of health care offered to citizens.”
Mark van der Heever, spokesperson for the Western Cape Health Department, acknowledged that both hospitals were experiencing higher demand for services.
“The social determinants facing Khayelitsha and Mitchells Plain, in particular violence and safety, drug abuse, unemployment, limited economic opportunity, and other factors further contributes to the pressure on the health system,” he said.
“This has been evident for a while now and we have communicated the emergency pressures as a result of these societal ills, and interpersonal violence trauma cases.”
He added there had been a noticeable increase in the number of mental health admissions.
“The health system is experiencing mental health pressures at all levels. The department is putting plans in place to relieve pressures at district hospital level by strengthening specialised referral systems and community and primary health care mental health services.”
Van der Heever said the department, on average, uses the equivalent of 3% of its compensation of employees budget to supplement its workforce capacity.
“The key drivers behind this need are natural attrition of staff resulting in vacancies that cannot always be filled quickly, capacity shortfall due to staff leave (annual, sick, maternity etc) and workload spikes.
“The department will always have a need for agency personnel to supplement its capacity due the reasons highlighted above.”