Frustrated and angry doctors said an electricity maintenance shutdown at Pretoria’s Steve Biko Academic Hospital at the weekend came without any warning, resulting in emergency services scrambling to get critically ill patients to nearby hospitals.
Two floors housing critical services were evacuated so work could be done on failing electrical systems, reports Daily Maverick, adding that there are also unconfirmed reports that three patients died during the upheaval.
The emergency, intensive care and high care units were all out of service during the shutdown, as was the National Health Laboratory Service lab based at the hospital.
One insider told Daily Maverick: “What it meant was that 135 beds were no longer available over the weekend. The casualty department became a makeshift unit inside one ward on another floor. There were no patients apart from a few walk-ins. No CT scanning could be done either. Staff said they had no idea about the shutdown and why they had been moved.”
The casualty department, usually frenetic at weekends, was unable to function and fell eerily silent.
Less than three months ago, President Cyril Ramaphosa visited the hospital and lauded it as “the future”, saying it was NHI-ready.
The insider said the hospital was placed on a divert notice during the shutdown, which kept being extended. Emergency services struggled to get critically ill patients to nearby hospitals, including Tshwane and Mamelodi hospitals.
Tshwane Hospital, less than a kilometre away, bore the brunt of the disorganisation as it tried to accommodate patients it was not equipped to handle.
Staff at Steve Biko said they had only found out belatedly about the shutdown, so no adequate preparation or contingency could be done as the crisis unfolded.
Overburdened
One doctor, who became aware of the situation only after arriving on shift, said ICU patients were “just not getting sufficient care, and we had to phone around to other hospitals that were also overburdened and also not equipped to deal with patients needing specialised care”. He said he believed patient care was compromised.
“A critically ill patient had to be intubated and ventilated throughout the night, but she should have been at Steve Biko in a high-care or ICU bed.”
Colleagues told him three patients had died during the shutdown weekend. “I can say it is because they didn’t get the care they should have got.
“You cannot shut down an entire emergency unit, have no proper communication and contingencies, and call that a maintenance plan.
“For this kind of thing to go on day after day in some form or another is disheartening. And the administrators and middle management won’t acknowledge this is not normal. They don’t care about patients.
“Our seniors, like our consultants and other clinicians, are terrified by these administrators. They’re too scared to stand up to tell them … that things are failing.
“There is also an odd culture of pitting hospitals against each other instead of having a system for co-operation. And there’s a culture of bullying – it’s a very toxic system,” he said.
The switch from having medical superintendents running hospitals to putting CEOs – with or without a medical background – at the helm came about in 2013 under Health Minister Aaron Motsoaledi’s first tenure. It was meant to professionalise the public health service and initiate stronger management strategies, but its critics, including the doctor who spoke to Daily Maverick, say it’s had the opposite effect.
“Now you can’t change a lightbulb in a hospital without a tender,” he said. “And you have tendering systems that are open to corruption, meaning everything is costing the taxpayers more. Meanwhile, we are told there’s no money to employ more doctors, so we have fewer doctors trying to help more patients.
“Health workers and clinicians who understand patients’ need to be part of the picture of decision-making.”
Ireen Manyuha from the Gauteng Department of Health said: “The electrical system at the hospital was outdated, and the changeover system upgrade (involving repairs to a generator) for the power sources was necessary to ensure continuity of services during periods of power supply interruptions.
“Safety measures have been confirmed after the upgrade was successful and power supply was restored on Saturday, with patients returned to the wards …between Sunday and Monday.”
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