Free State orthopaedic services in ‘a state of collapse’

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Orthopaedic services in the Free State are in a state of collapse, with a surgery waiting list at Pelonomi Hospital of more than 130 patients on most days. Spotlight reports that whistle-blowers say patients with broken legs, arms and other serious orthopaedic conditions are being sent home because the buckling health system is simply unable to cope with the numbers. Health workers are told there is no money to bring in outside help to reduce the waiting lists.

Recently, the report says when a team of outside health workers were paid to work a weekend at Bloemfontein’s Pelonomi Hospital in an attempt to reduce the waiting list, at least 40 patients were sent home because there was simply no capacity to get to them.
“Imagine this: for six weeks these patients have been lying in hospital beds with well-meaning doctors assuring them that their surgery was imminent, only to be told that you will no longer be operated on and that this means you bones will not re-attach properly or that your ankle will remain partially dislocated,” said a health worker, who asked to remain anonymous for fear of reprisals.

The report says what was more disturbing for the health workers was the fact that in 2016 there was millions to run a dodgy, illegal stem cell practice in the Pelonomi orthopaedics department, but there was no money to bring in extra health workers to reduce the waiting list. “It simply cannot continue like this; patients wait for 40 days for simple, straightforward treatment for fractures. Their lives are destroyed, it is an untenable situation,” said a doctor.

According to the report, towards the end of last year an illegal stem cell experimental treatment was being provided at Pelonomi Hospital. Shortly after Section27 and the Treatment Action Campaign brought details of the ReGenesis project to the attention of the national director-general of health, Precious Matsoso, the Medicines Control Council (MCC) suspended the unlawful stem cell experimentation at Pelonomi.

The report says at the same time the Free State Department of Health cancelled its contract with the stem cell company, ReGenesis Biotechnologies following a list of questions sent in connection with the involvement of controversial Health MEC Dr Benny Malakoane. Before the exposé, the Free State Department of Health was set to spend tens of millions of rand on unproven and potentially dangerous stem cell therapies for the treatment of musculoskeletal diseases in its orthopaedic knee patients at two hospitals.

The report says a service level contract between the Free State Department of Health and ReGenesis Biotechnologies indicated that the service would be provided in Pelonomi Hospital and Boitumelo Hospital in Kroonstad. The department would pay R30,000 per client, with a guaranteed supply of 1,000 patients per year. This adds up to R30m per year and R90m over the three years of the contract.

The report says MCC chair Professor Helen Rees confirmed at the time that inspectors had been to the Pelonomi site: “Our concern was that the service level agreement made reference to medicines, injections and therapeutic research.” She said the informed consent documents referred to the patients giving permission for stem cell therapy, permission for stem cells to be removed, concentrated and re-injected and for their stem cells to be given to another person.

Days after the revelations Free State Premier Ace Magashule reshuffled his Cabinet and Malakoane was shifted from health. Since then, the report says, questions have been sent to the MEC’s spokespeople and the Premier’s people. All these attempts have elicited a zero response.

The report says it is crucial to understand where this case is, has there been an investigation, what are the findings, will anyone be charged, was Malakoane due to benefit from this contract, were proper tender procedures followed, and so on. A well-placed source in the Free State has shared a list of names of relevant people who need to be investigated. They include hospital CEOs who allegedly participated in the scheme, hospital managers who requested the waiting lists and who contacted the patients, doctors and their secretaries who played a key role in running this scheme, a doctor who reportedly gave instructions for the order forms to go through, an individual who gave the financial permissions and two heads at Bophelo House (health department head office) who were involved.

A Bloemfontein doctor claimed to be aware of patients who suffered due to this treatment, with reports of some dying. Registrar of medicines, Dr Joey Gouws, recently confirmed that Department of Health inspectors have laid criminal charges against Dr Wian Stander, the controversial owner of Regenesis, “for the sale of unregistered medicine and/ or conduct of a clinical trial without obtaining the necessary authorisation from the MCC”. Gouws said they were in no position to advise on the status of the police investigation.

The report says she also confirmed that the MCC had reported Stander to the Health Professions Council of South Africa (HPCSA). At the time of going to print, the HPCSA had not responded to queries requesting an update on the charges.

 

The report says this is not the first time the province has faced this problem. In the past the province has been able to reduce the waiting lists significantly by buying in locums at a cost of about R6m per annum. The domino effect of long waiting lists for orthopaedics is more complications, septic bed sores for the elderly, children left disabled and adults losing their jobs. A doctor explained that Pelonomi is facing increasing pressure as peripheral hospitals no longer have skilled specialists to perform the surgery. The hospital is also taking in referrals from the Northern Cape and Lesotho.

Sources allege that the hospital CEO is not disclosing the current state of affairs to the provincial government for fear of reprisals, the report says. “Hospital management are misleading their heads who in turn mislead the national director-general, who because of incorrect information misleads the national health minister,” a health worker added.

Spotlight report

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