Western Cape hospitals buckling under pressure of rising staff shortages
Cape Town – Health-care workers at key hospitals in the battle against the coronavirus are faltering under the pressure of staff shortages as the province pleads for R113 million in budget shortfalls.
Some health workers warn increasing Covid-19 infections among staff are putting a strain on those who have to carry the load. The province is forced to make use of agency staff to cover the gaps.
Provincial head of health, Keith Cloete, said the department was struggling to achieve the planned 135 critical care beds in the public sector mainly as a result of staff shortages linked to absenteeism from coronavirus infections, agency staff who refuse to work in Covid-19 areas and no significant assistance from other provinces as they experience increasing pressure.
Based on the new estimates, the province said it had 5 515 beds available from public, field and private hospitals as well as 400 beds in critical care.
The Brackengate facility can accommodate 338 patients and comes at a cost of R44m. The facility can accommodate eight patients on high-flow nasal oxygen.
The province has briefed President Cyril Ramaphosa on the need for an extra 5 272 workers who include, nurses, doctors and administrative workers, as it would only be able to supply 1 477 staff from its own sources.
But the provincial health department said the province’s new epidemiological predictions points to lower than the expected 5 000 staff shortages among health workers and support staff.
“When we were talking about the shortfall of staff, it was premised on us needing 7 800 beds for the peak, with the recalibration to 5 000 beds that we have already provisioned for. The staffing needs is significantly less,” said Cloete.
“What we are recalibrating is the 400/500 people for the Brackengate (field hospital) and in terms of our staff absenteeism we have built in a figure of 2 000.
"Our bigger challenge now is to make sure (to manage) the absenteeism rate, with people getting fatigued, that we have sufficient rotation and capacity.”
The Brackengate field hospital is expected to begin operation on Friday, with 300 beds for Covid-19 patients from hospitals struggling with capacity.
The National Education, Health and Allied Workers Union (Nehawu) visited several hospitals this week and said members had highlighted issues around the provision of personal protective equipment, strain from staff shortages as well as a lack of proper training.
Yesterday, the delegation visited Khayelitsha Hospital, where 140 workers have tested positive, of whom 15 are still under quarantine.
Khayelitsha’s clinical manager, Kitesh Moodley, said staffing had been a challenge as the facility’s Covid-19 ward was running at 100% capacity.
“We have had to focus on acquiring periodic contracts for nurses and doctors and agency staff whenever the need arises,” he said.
“The challenge, however, comes from support services, which does not have agencies but that’s where we utilise voluntary services. But any given time there is always someone who is absent due to Covid-19 and that poses a challenge.”
The province has more than 3 000 health-care workers who have tested positive in the public and private sector, of whom 28 have died.
“There is high disregard for the rights of workers, ill-preparedness from management in making sure we are prepared to protect the workers,” said Nehawu’s Michael Shingange.
“In hospitals like Groote Schuur the bed capacity is almost full, particularly the ICU, and in a few weeks we will have a big crisis. They have over 460 workers who tested positive while Tygerberg has had over 500.
“Public health service has always had high number of shortages, but with high number of workers having to self-isolate, this exacerbates the shortages and burdens those left behind.
“President Ramaphosa told the province not to let us get defeated because of issues like budgets and staff shortages; I hope the province is filling all vacant posts based on this.”
However, Premier Alan Winde said budgets continued to be a big concern for the province.
“When the president visited us we got confirmation that we really don’t need to worry about budgets, but when Tito Mboweni tabled his adjusted budget last week, it really showed us we have a really big issue with budgets,” he said.
“We have already spent R5.3 billion for preparedness expenditure for the health response, but this included education, public works response on field hospitals and then feeding on the social development side.
“And at the moment through the budget adjustment it looks like maybe R500m will be realised, but if you look at the big picture we are looking at a R113m shortfall. That excludes the R5bn already spent.”