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Delays for patients as Charlotte Maxeke left without angio suite

Staff at the beleaguered Charlotte Maxeke Academic Hospital have slammed a badly planned decommissioning process of a specialised angiogram machine, causing a three-month delay in potentially life-saving vascular imaging and surgery before the new replacement can be installed.

In Spotlight, Ufrieda Ho writes that staff had been given short notice that the old angio suite system was being retired at the beginning of August, and that there would not be adequate contingency support. They said there had not been a satisfactory explanation for the haste to decommission and remove the old machine – as the two newly acquired replacement angio suite systems can only be brought on-stream in three months’.

The angio suite is a multi-million-rand piece of equipment used for cardiovascular imaging of blocked arteries and is vital for guided vascular surgery. The procedure is critical to save lives or to prevent the loss of limbs in patients with vascular disease.

Short notice

At the beginning of August, staff from the radiology and surgical departments were suddenly told the machine would be decommissioned within a week. “We were expected to just inform patients – who were expecting their procedure in the upcoming weeks – that they would not be getting their surgeries, which means they could die. We are talking about a serious threat to life, but management never takes responsibility,” one said.

“It makes no logical sense to decommission the machine at this point because there’s no proper contingency in place. You can’t help but think there is something fishy going on or that this is just irrational planning.”

By “fishy”, she said there are questions about who has benefitted from the sale of the old machine and why the buyer was allowed to take possession when it was still in use and the new machines had not yet been installed.

The angio suite, which had already reached its 10-year lifespan in 2018, had long been flagged for replacement.

The machine limped along but was working until it was decommissioned. Another three months of working with an old machine rather than having no machine at all would have been the obvious way forward, under the circumstances, she said.

There are also concerns about how the acquisition and installation process of the two new machines was done. The total cost for the two is just under R44.5m.

But the hospital told Spotlight the machines cannot be brought on-stream immediately because it first needed to find an additional R2.8m for room alterations and renovations at the two sites where the new angio suites would be used. This work is now being carried out.

The explanation has left staff flummoxed. “Why would you spend R44.5m on the machines and then not have R2.8m to get the theatres ready?”

‘Patients diverted’

The hospital’s communications officer Tabudi Madisha said the three-month delay to complete the renovations “is being managed”, with patients currently being diverted to Chris Hani Baragwanath and Steve Biko Academic hospitals.

He added that a CEO-to-CEO agreement was in place between Charlotte Maxeke and Baragwanath.

A memo from Charlotte Maxeke (seen by Spotlight) states that operational details are still to be finalised between clinical heads of surgery and the head of clinical units, and that emergency cases will be discussed case by case between doctors from the two hospitals.

Some doctors at Charlotte Maxeke are sceptical this will work in practice. One said that in his informal discussions with his counterparts at another hospital, he had been told “it will be impossible and impractical” to take on Charlotee Maxeke’s patients.

“Management may be saying everything will be up and running within three months, which we know from experience will probably be closer to six months. But even at three months, at least 80 patients will be affected,” he said.

Sold for scrap

Madisha said maintenance of the old machine was done “according to the tender specification and the manufacturer’s maintenance plan”. However, he did not disclose the name of the buyer of the old machine. “As far as we know, it was not sold for use, but for scrap. It will be removed by the successful bidder who has bought it as scrap.”

However, said one staffer, “If it is indeed being sold for scrap, then surely it can wait – why the rush?”

Madisha said replacement of the old machine was part of the hospital’s annual procurement plan, and that the successful bidder for the two new machines is Midrand-based company Tecmed, which has provided the two pieces of equipment at a total price of R44.43m.

“The registration of need is done by the hospital but the tender process is the function of head office (the Gauteng Department of Health),” he added.

The Department of Health did not respond to questions about the value of the old machine and to whom it was sold.

Spotlight article – Surgeries delayed at Charlotte Maxeke as key machine decommissioned before replacements are ready (Creative Commons Licence)

 

See more from MedicalBrief archives:

 

Charlotte Maxeke elective surgeries cancelled

 

Gauteng Premier’s Office admits ‘possible corruption’ in Charlotte Maxeke repairs

 

Gauteng surrenders R215m to Treasury after delays in fixing hospitals

 

Non-payment of contractor delays completion of psychiatric ward at Charlotte Maxeke

 

 

 

 

 

 

 

 

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