Research by the Cancer Alliance into backlogs of people waiting for cancer treatment at state hospitals has uncovered evidence of widespread administrative failures, writes MedicalBrief.
The study, reported in Sunday Times, shows among other that Chris Hani Baragwanath Hospital in Soweto does not even have a list of whom, among its 53 breast cancer patients, is waiting for radiation.
The research, done by a medical consultant with assistance from doctors at Charlotte Maxeke Hospital, focused on the four major cancers affected by the backlog — prostate, breast, cervical and colorectal — and examined all patient file records in February.
The prostate unit records listed 2,087 patients, of whom only 819 could be accounted for. Of these, 343 were high-risk patients.
Of the 334 breast cancer patients at Charlotte Maxeke, 51 had been expedited, 123 were awaiting results, 17 were waiting to be called and 13 were recurrences. The rest were categorised as “miscellaneous” and “planning”.
A Sunday Times report in December revealed that two new cancer-treatment machines worth more than R100m, ordered more than a year ago, have been in storage since November.
The Linear Accelerator (Linac) machines, which deliver high-energy X-rays or electrons to destroy cancer cells while sparing the surrounding tissue, need to be housed in protective bunkers that haven’t yet been built; the Gauteng Health Department said construction would begin next month. Completion is due by the end of November, and “a task team is being set up to look at backlogs”.
Charlotte Maxeke is Gauteng’s main oncology hospital, but it has been outsourcing some treatments to surrounding hospitals since its devastating fire and resulting thefts and delays during refurbishment.
The research report has recommended that medical staff receive training in data management and that a “living” document be created where patients’ treatments can be updated and monitored. It also recommended that a checklist be added to patients’ files showing whether the necessary steps had been taken before radiotherapy, such as blood tests, X-rays and scans.
Louise Turner, COO of the Breast Health Foundation, said overly long delays in patients receiving radiation after completing chemotherapy resulted in some having to redo the chemo, or experiencing a recurrence of the cancer.
Cancer Alliance’s Salomé Meyer there had been a crisis for at least five years. The alliance represents 33 non-profit organisations and cancer advocates.
“Cancer incidence is on the increase nationally. Most patients in the public sector are diagnosed with late-stage disease that requires more complex treatments,” she told the Sunday Times. “The increase in the number of diagnosed cancer patients, however, does not come with an increase in the budget to accommodate new equipment and more appropriate health-care professionals.
“At Charlotte Maxeke, patient demands far exceed the supply of treatment equipment time and oncology professionals, resulting a backlog of several years. COVID-19 and the fire at Charlotte Maxeke have further pressurised an already stressed oncology service, negatively affecting treatment outcomes for patients.”
Earlier this month, Cancer Alliance shared the results of its research with acting deputy director-general of health Dr Freddy Kgongwana and several other Gauteng health officials, at a meeting where it was decided a task team would be set up. Health department spokesperson Kwara Kekana told the Sunday Times the task team was due to start work on 1 April.
CMJAH Rad Onc_V2 pdf
Sunday Times Pressreader article – Cancer care in crisis (Open access)
See more from MedicalBrief archives:
Cancer Alliance explores legal options to compel public/private treatment partnership
Johannesburg protest march over neglect of cancer patients
DA: Health MEC's reply highlights dire situation at Charlotte Maxeke cancer unit
Waiting times for cancer treatment worsen at Charlotte Maxeke
Gauteng cancer patients 'dying waiting for treatment'