Surgical backlogs continue to rise countrywide, as reduced budgets and staffing shortages eat away at public healthcare capacity, and institutions and medical professionals feel the pinch while patients suffer.
In the Western Cape, says Health MEC Mireille Wenger, more than 10 500 surgical procedures are now overdue.
“Emerging from Covid-19 had its own unique dynamics, and there was a large backlog at that stage, which we were actually able to eradicate quite soon after lockdown was lifted,” she told News24.
“But now, as a direct consequence of the budget cuts and not being able to meet the full wage deal demands, we have another backlog again.”
The MEC added that the province was looking at partnerships with the private sector to alleviate the situation.
“Next week I’m going to Beaufort West, where we have a private-public partnership with academia, NGOs and ourselves for cataract operations. We will be able to clear the cataract surgical backlog in that week, so partnerships are key,” she said.
National Health Department spokesperson Foster Mohale said that a contributor to the backlog was the limited number of skilled specialists in public hospitals.
“These backlogs are pronounced in provinces where there are no medical schools, like North West, Northern Cape and Mpumalanga,” he said. The types of surgeries with backlogs include orthopaedics, general surgery, urology, ophthalmology, maxillofacial, cataract, ear nose and throat, neurosurgery, and gynaecology.
Gauteng Department of Health spokesperson Motalatale Modiba said the province had cleared its backlog.
“Currently, the ‘surgical marathon’ intervention focuses on fast-tracking operations for people on the waiting list. As of 31 July this year, 5 000 patients were awaiting surgeries. However, this is a dynamic figure as it fluctuates as and when new patients are registered on the waiting list and when surgeries are performed.”
Between 1 April and 31 July 2024, 26 000 surgeries were carried out.
SA Medical Association member and primary healthcare specialist Angelique Coetzee said: “The backlog is a critical issue and reflects a multi-factorial challenge, including resource constraints, staffing shortages, and systemic inefficiencies.
“A lack of adequately equipped operating rooms, medical supplies and essential infrastructure has strained capacity, including not enough surgeons, support staff, and burnout of staff. And then …many facilities also face issues with managing patient lists and optimising their operations.
“So, we are seeing a lot of issues, which unfortunately, have serious implications for the patient. Surgical delays lead to the progression of illnesses, complicating the cases that could have been simple to manage.
“We propose immediate actions, like establishing a social security system and establishing a task team to address the backlog in high-priority areas, such as orthopaedics, oncology and paediatrics, and see why it happens.
“Where can we improve the situation? Looking at public-private partnerships to use these facilities, looking at extended hours, running operating theatres during evenings and weekends, with adequate staff incentives, and then shift less complex procedures to the districts or smaller hospitals, to reduce pressure on tertiary institutions.
“And maybe it’s time to expand surgical training programmes and retention strategies to address these human resource gaps. Also, invest more in operating theatres and critical care facilities to match the population’s demands. We don’t do that.
“There's also a need to implement advanced scheduling and tracking systems under a digital solutions programme. And advocate for better resources for these patients going forward.”
News24 article – Cape surgery backlogs rise as billions slashed from budget (Restricted access)
See more from MedicalBrief archives:
Eastern Cape hospitals flounder under surgical backlogs and massive debts
Huge strides by Cape hospital in reducing surgical backlogs
Critical need for national strategy to address chronic surgical backlog