Load shedding, introduced in South Africa 15 years ago, continues to create serious challenges for the medical profession, write Dr Volker Hitzeroth, medico-legal consultant, and Dr Tony Behrman, medical business consultant, at Medical Protection Society.
A recent Medical Protection Society (MPS) survey of more than 660 South African doctors found that 86% believe load shedding poses a threat to patient safety.
Respondents reported concerns about delayed tests, surgeries and prescriptions, unreliable systems, machinery and phones lines, and even treating patients in the darkness when back-up power fails.
One doctor described the “perpetual anxiety” created by load shedding when treating patients. Another was “always scared” that the medical machinery would fail them due to load shedding.
In addition to the threat to patient safety, 63% of respondents also said loadshedding was having serious financial implications at their place of work.
Unlike doctors in private hospitals, few private stand-alone doctors can afford generators, which in any event have their own hazards and are extremely noisy: most use inverters.
A 6KV inverter, however, costs more than R60 000 to power a private stand-alone surgery today.
Without inverters, when power resumes there is often a surge that can cause sensitive pieces of equipment to burn out or become damaged beyond repair. Adding to the concern is the fact many insurance companies are now excluding power surge-induced damage from their policies.
Some electrical sub-stations, meanwhile, have caught alight, leaving entire neighbourhoods without power for days. This can then create localised health issues through problems with food degradation and water purification, which doctors ultimately have to treat.
It also results in vulnerability to patients, their families, doctors and staff as regular power interruptions damage the electronic systems supplying power to computers, alarms and panic buttons as well as various access control systems, lifts and escalators.
These challenges are clearly taking their toll on the medical profession, with three-quarters (75%) saying that load shedding is having a negative impact on their mental well-being.
Meanwhile, of the doctors who are considering leaving South Africa to practise in another country, nine in 10 (90%) cited load shedding as an influence for their decision.
Our survey found that 80% believe the government could do more to prevent all healthcare facilities from being affected by load shedding.
Power outages are challenging enough for any South African business or household, but for healthcare practitioners, the challenges are compounded.
The effect – of not being able to provide safe patient care – on a doctor’s mental well-being cannot be overstated. When patient safety is at risk, doctors also feel vulnerable to complaints, regulatory investigations, claims in clinical negligence and even criminal charges.
This pressure, in addition to the financial burden placed on healthcare facilities to function during power outages, is clearly taking its toll and may be tipping the balance for those who are already struggling to cope with the many other challenges faced by doctors daily.
When mental well-being is poor, it is worrying for the individual practitioner, but can also jeopardise patient care.
With load shedding forecast to continue well into 2024 (and possibly beyond) it is apparent that more needs to be done to enable healthcare practitioners to focus on treating patients without worrying about the safety, medico-legal and financial implications thereof.
At MPS our focus remains on advising our members on steps which may help to prevent foreseeable risks and problems due to load-shedding.
We also provide a 24/7 independent counselling service as a benefit of membership for those who need mental well-being support.
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