Depending upon where you live, the wait for cancer treatment at a public facility can be more of a death sentence than the disease itself.
In KwaZulu-Natal, for instance, there are 791 patients on a waiting list of six to eight weeks for radiation treatment at public hospitals, whereas in Gauteng, thousands of patients are awaiting treatment at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital.
Some have been waiting more than a year for the lifesaving care.
The Gauteng Health Department is now bracing itself for a court battle after SECTION27, the Cancer Alliance and the Treatment Action Campaign took the fight for better treatment of state cancer patients to the High Court.
In 2017, there was a similar battle in KZN when the provincial Health Department came under fire for failing patients as a result of non-functioning machines, leading to the death of hundreds of cancer sufferers.
TimesLIVE reports that at the time, nearly 100 patients were on a waiting list of at least eight months.
Seven years later the provincial Health Department said there are 827 radiation treatment slots available between the three facilities and that each is able to put 40 patients on radiation per day, with each patient undergoing radiation for up to six weeks.
Treatment is done at Grey’s Hospital in Pietermaritzburg and Inkosi Albert Luthuli Academic Hospital and Addington Hospital in Durban.
KwaZulu-Natal Health Department spokesperson Ntokozo Maphisa told TimesLIVE Premium the province has six fully-functional radiation machines, and the seventh one is at an advanced stage of commissioning.
“Significantly, the department is in the process of building a new oncology unit at Ngwelezana Hospital in the north of the province. A chemotherapy unit has already been opened at this hospital, with a full-time radiation oncologist already appointed.”
Maphisa said the prevalence of cancer globally and in South Africa has increased in recent years.
“Concurrent with this increase has been a growing number of patients who require cancer treatment, both in the private and public sectors.”
DA Chief whip in the KZN legislature, Imran Keeka, told a different story in his response to the state of the province address last week.
“Waiting times… are worrying, and even scandalous. In KwaZulu-Natal, it can take six weeks for fractures to be repaired, six months to see a cardiologist for heart problems and up to six years to see a urologist. Cancer patients have to wait between three weeks and several months before they are seen. Their cancers don’t wait,” he said.
Cancer Association of South Africa (Cansa) head of advocacy Zodwa Sithole said the association was unaware of any current backlogs in KwaZulu-Natal, however, there were “occasional” patients who contacted the association to report long waiting periods.
“We then escalate the information with that oncology department to assist the patients.”
Sithole added that Cansa did not have the number of cancer patients receiving treatment at public hospitals in KZN.
“A new initiative was launched in 2023 to assist cancer patients at state facilities, where our information and support desks are staffed by our trained volunteers who provide information and help with referrals to Cansa support groups, tele-counselling and other services.”
Cansa has an information and support desk at Inkosi Albert Luthuli Hospital plus another five in other provinces: Charlotte Maxeke, Steve Biko, National Hospital in Bloemfontein, East London’s Frere Hospital, and Robert Sobukwe Hospital in Kimberley.
In the Western Cape, Professor Jeannette Parkes, head of radiation oncology at Groote Schuur Hospital and the University of Cape Town, said there were “adequate facilities in our two state academic hospitals to treat all patients”.
“We have four radiotherapy machines at each academic hospital with brachytherapy facilities and multidisciplinary clinics. But we have human resource shortages – we struggle with this, with the retention of radiation oncology staff, medical physics staff and therapy radiographers, as well as anaesthetists and nurses.”
Parkes said there was no standard waiting time for patients to receive radiation treatment.
“This is different in every hospital and province. Cancer management and radiotherapy provision in particular is a complex and expensive service. Adequate infrastructure, equipment and staffing all depend on a complex interplay between national and provincial Health Departments.”
She said while health budgets were the responsibility of the provincial Treasury, high-cost items like radiotherapy machines are sometimes procured through national funding.
Other considerations include hospital procurement and supply chain support as well as the experience of senior clinicians and medical physicists, and human resource policies.
“Western Cape is fortunate in the support offered to the oncology department, compared with other provinces. It is also different for different disease clinics. Waiting times for staging radiology scans, and oncology surgery, also part of our multidisciplinary team metrics, have recently lengthened considerably and are a far greater risk for our cancer patients currently than radiotherapy.”
TimesLIVE article – How KZN and WC compare to Gauteng in cancer treatment (Restricted access)
See more from MedicalBrief archives:
Cancer services failing throughout SA
Gauteng Health accuses Cancer Alliance of interference as case postponed
Gauteng partners with private sector to reduce cancer backlog
Gauteng Health sued over unspent cancer millions
KZN wants oncology maintenance contract set aside and R9m repayment