Tertiary hospitals in the Eastern Cape are facing yet another medical crisis, having run out of syringe needles while battling a dire lack of other equipment – and having to borrow from rural hospitals.
Staff at Livingstone Hospital in Nelson Mandela Bay been unable to draw blood, struggling to resuscitate patients because they have no syringes, and being unable to use medicine in ampoules.
There is also a shortage of nappies, nebuliser masks, adult oxygen masks, oxygen regulators, special plasters, ECG electrodes and ECG paper.
New Health MEC Ntandokazi Capa’s office confirmed the problem, attributing it to a “provincial challenge relating … to suppliers not able to fulfil our order on time”, but some sources blamed the shortages on payment delays.
One department staffer said some suppliers are not paid within the stipulated 30 days after delivery.
According to Capa’s spokesperson, Sizwe Kupelo, however, the shortages were also due to some “import challenges as some of these items are imported by contracted suppliers”.
“The department is working with counterparts in the national department and neighbouring provinces to find a lasting solution.”
He confirmed hospital managers were “borrowing” needles from rural hospitals, reports Daily Maverick.
“In the meantime, the department is redistributing stock from those facilities with low consumption to the high-consumption facilities. In addition, small quantities are procured on a quotations basis from alternative suppliers, but unfortunately they also do not have the full line … and cannot fulfil the quantities we require.”
Kupelo confirmed this was the case in some of the contracts, but that it was due to administrative issues, not a shortage of funds.
“The reasons vary … Some suppliers are citing delays in payment – payment after 30 days of delivery… it is less about availability of money, more about the administrative process that takes long.”
The department is “in a comfortable position in terms of budget to pay suppliers”, so this “cannot be blamed on suppliers being owed money”, he added.
In a document setting out cost containment measures for the department, published in June, management stressed that money for medicines, patient meals, lab services, medical supplies, property payments, emergency services, contractors, chemicals, fuel, oil, gas, wood and coal, consumable supplies, fleet services (including government motor transport) had to be protected at all cost and the bills for these services must be covered.
The hospital – which is spread over two facilities, Livingstone Hospital and Port Elizabeth Provincial Hospital – has not had a permanent CEO since 2018 when unions ran high-performing CEO Thulane Madonsela out of the facility.
At least five times in the past two years the Department of Health has said a CEO appointment was “imminent”, but it hasn’t happened yet.
The department itself also has an acting HoD since the highly acclaimed Dr Rolene Wagner was moved to the Office of the Premier. Neither does it have a chief financial officer or even an acting HR director.
Last month, Premier Oscar Mabuyane said that fixing the Health Department would be one of his top priorities, but Daily Maverick has seen documents proving that the shortage of gloves at the hospital is caused by delays at the Provincial Cost Containment Committee linked to Mabuyane’s office.
At the peak of the Covid-19 pandemic, the department had to send senior personnel to rescue Livingstone Hospital from collapse. Then, Mtandeki Xamlashe – the acting CEO, now the director of hospital services in the department – said the situation had been allowed to deteriorate to such an extent that it would take five years to recover.
In July 2020, at the height of the first wave of coronavirus infections in Nelson Mandela Bay, desperate doctors temporarily closed the hospital’s casualty unit after it had not been cleaned for days because of labour disputes.
Health and safety inspectors found a warehouse full of rotting linen that had not been washed for weeks.
“Facilities management had collapsed. There were areas of serious incompetence. This began to demoralise the clinicians who did their best under the circumstances,” Xamlashe said at the time.
After Wagner’s appointment the situation stabilised, but it is now deteriorating fast.
Doctors said they were told to be “innovative”, after complaining about the lack of consumables.
“The office of the MEC takes this matter seriously and has asked top management to find an urgent solution,” Kupelo said, adding that the MEC will visit Livingstone Hospital “soon”.
See more from MedicalBrief archives:
Eastern Cape hospitals flounder under surgical backlogs and massive debts
Interns caught in crossfire of ‘broken’ Port Elizabeth Hospital system
Doctors urge crisis management as Eastern Cape Hospitals collapse