A Free State hospital is in the headlines again, this time for allegedly leaving corpses lying on beds for hours while letting one man die under suspicious circumstances.
According to a News24 report, one of the people whose body was left on a bed at Dihlabeng Regional Hospital in Bethlehem was Frik Balanco, a 65-year-old man who was hospitalised in December last year when he experienced pains in his chest and stomach. And a day after he died on 29 January, his wife Maritsa recounted to the Mail & Guardian how Balanco’s body had to be carried down four flights of stairs because the hospital lifts weren’t working.
The report says doctors have also complained about rats in the hospital, which were drawn there because waste removal had stopped after the removal company had not been paid.
In July last year, Dihlabeng made headlines when a critically ill woman was denied a bed in ICU because provincial ANC officials had ordered that a high-ranking office bearer be admitted to the ward. It was reported at the time that the woman later died in a general ward.
The Treatment Action Campaign (TAC) has reacted to a letter from doctors in the Free State listing what it calls a “credible” number of specific and very serious allegations relating to the collapse of the Free State healthcare system and the “disappointingly evasive” response from the current management of the Free State Health system in a statement on Politicsweb.
The TAC statement reads: “We are disappointed that the response from the Provincial Department of Health does not address any of the specific concerns raised in the whistle-blower letter (eg broken elevators and the 300 person long waiting list for spectacles at Dihlabeng hospital). While the response does state that the department takes note of the specific issues and will look into them, it then goes on to suggest that the allegations are ‘gross exaggeration’ and ‘deliberate orchestrations’. This is not the way to respond when doctors in your province call for help.
“The department alleges that: ‘Amongst other challenges the department and the Free State has not been getting the right kinds of allocations as per the national formula of the equitable share.’ We will write to National Treasury to investigate these allegations. We do however note that the finances of the Free State Department of Health was in such a poor state last year that it had to be taken over by Treasury. We find it unlikely that insufficient allocations are the root cause of the collapse of the province’s healthcare system.
“We find a number of the statistics quoted in the statement to lack credibility. For example the claim that ‘the prevention of mother to child transmission of HIV improved from 1.8% in 2013/14 to 0.09% in the first quarter of 2014/15’ or the claim that ‘all multi-drug resistant TB confirmed patients have been initiated on treatment’. In both these cases we are asked to believe that the Free State is doing dramatically better than other provinces. We request that the Free State government make the sources of these statistics available for public scrutiny.
“We note the claim that the department has employed 40 new doctors. We request that the department share information regarding how and from where these doctors were recruited. We also request aggregate figures showing both how many new doctors were recruited over the last year and how many resigned or were dismissed.
“We are disappointed that the department blame amongst others the ‘legacy of the past’ and the ‘general ineptitude of some professionals who are clearly not committed at times to sustaining non-racial provision of health services’. Excuses like these are red herrings and an insult to the many courageous healthcare workers who continue to serve in the public sector despite often very difficult working conditions.
“As users of, and workers in, the public healthcare system we know that the Free State healthcare system has been mismanaged for many years. We know at first hand that under MEC Malakoane things are not getting any better. We know that fixing the Free State healthcare system is the responsibility of the current ANC led administration… We stress that TAC is independent of all political parties. We do not campaign for or against any political parties. However, where a party acts contrary to the public interest we will point this out. Our obligation is to our members, not to political parties.
“In their letter the whistle-blower doctors write: ‘What we report and allege here should be investigated and reported. In particular we appeal to the SA Human Rights Commission to take our allegations seriously because what we report is a violation of rights to health, dignity and equality.’ As TAC we fully endorse this call on the SAHRC to launch an investigation.
“We call on all progressive civil society organisations, unions, and other partner organisations to heed the call of patients and healthcare workers in the Free State. We also thank all organisations and individuals who have shown solidarity with the people in the Free State.”
In an editorial the Mail&Guardian writes that doctors, health activists and policymakers are starting to lose faith in health minister Aaron Motsoaledi’s ability to fix South Africa’s dilapidated public healthcare system. They believe he has a “lack of political influence” in his dealings with provincial health departments – which are falling apart.
The paper reports that it visited Dihlabeng Regional Hospital in Bethlehem in the Free State and found that the hospital has only a third of the number of doctors it had in 2012. The report says nurses are resigning in droves because of horrific working conditions and the bodies of patients who have died are left for hours in hospital beds, because there is not enough staff to remove them.
Ironically, the report notes, Dihlabeng is situated in one of Motsoaledi’s National Health Insurance (NHI) pilot districts, which benefit from a special fund to improve infrastructure and health services. But a group of Dihlabeng’s doctors warned: “The Free State Health Department is killing the minister’s dream of an NHI. We are concerned that he doesn’t have a clue of what is happening here. We haven’t seen any of the money.”
Last year, the Free State Health Department was placed under the administration of the provincial treasury because it was no longer considered fit to manage its own budget. But, the report says, it doesn’t stop with the Free State. From 2013 to 2015 the Limpopo Health Department was under national administration, because suppliers had not been paid. From 2012 to early 2014, the Eastern Cape Health Department was under the partial administration of the provincial treasury department for the same reason.
The Constitution doesn’t allow Motsoaledi to give health MECs direct instructions. Yet, argue activists and policymakers, “political influence” would help a great deal. “If the health minister had enough political clout to negotiate with the premiers of provinces to replace MECs who fail to perform their duties properly, and assist them with new appointments, there would be a considerable improvement in health services,” one activist said. “All that he does is to send in short-term national health department task teams.”
The report says Motsoaledi is a rare breed: a minister with exceptional vision. But unless he drastically intervenes in the health systems of provinces, his vision will be undermined and ultimately paralysed by incompetent administrators who will make his long-awaited NHI no more than a piece of paper.