Print article   email story

Justine Reisinger

PATIENTS awaiting knee and hip operations and those waiting for simple cataract surgery at Johannesburg Hospital share one depressing reality: they’ll be confined to wheelchairs or temporarily blind for about 12 months.

Almost 2 800 patients are on the surgery waiting list at Johannesburg Hospital, 100 of them children. Another 100 are waiting for cardiac surgery, while more than 400 people await knee and hip operations. The 1 320 patients waiting for cataract surgery make up nearly half the waiting list.

In April 2006, the Gauteng health department announced a major drop in surgery backlog. The waiting time for knee and hip surgery was only two to three months and only one month for cataracts.

Two years later, the waiting time is back up to 12 months.

“These waiting lists never go down,” says DA Gauteng spokesperson on health Jack Bloom.

“I’ve been monitoring them for years and they are just getting worse. We don’t see any improvement; we’re not getting extra resources to cope with this.”

Sagie Pillay, chief executive of Johannesburg Hospital, doesn’t see the backlog as an uncommon problem.

“A surgical backlog is a feature of the health system everywhere,” Pillay says.

“The patients on the waiting list are of semi-urgent or non-urgent surgical status.

“All our emergencies are dealt with immediately.”

Health MEC Brian Hlongwa cites increased patient loads and the high number of emergency surgeries as the cause of long waiting lists.

He says patients don’t face serious risks while on the waiting list. Individuals whose conditions worsen are immediately prioritised once they hit emergency-status.

Bloom disagrees, viewing the system as a vicious cycle that may leave some behind.

“Every time there’s an emergency, the hospital pushes that forward, which is why the waiting list never goes down,” Bloom says.

“Tragically, some of these lists get shorter because these people die waiting for operations.”

Bloom does not believe there will be change without outside resources, either in the form of help from the private sector or a “big push” from the hospital and health department to reduce the backlog.

Pillay’s hospital isn’t the only one suffering from lack of resources and mismanagement by the health department.

A medicine shortage has led doctors to prescribe aspirin to cancer patients at Joburg’s Helen Joseph Hospital, where life-saving equipment such as electrocardiogram machines is also scarce.

Medical professionals have been attacked while working but Hlongwa has yet to fulfil his promise to beef up security by May.

While Pillay acknowledges the waiting time is inconvenient for patients, there is not much that can be done without money.

“Surgeons and anaesthetists are a scarce commodity because they make so much more money in the private sector,” Pillay says. “We just don’t have enough skills.”

The ongoing campaign to attract health professionals back to the public sector has received a positive response, according to Pillay.

New salary packages are being considered for doctors. A similar increase in the salaries of nurses helped eradicate many vacancies last year.

The Gauteng health department initiated a surgical backlog reduction programme three years ago that gave more money to the hospital in addition to the normal budget for orthopedic and cataract surgeries.

An additional R6 million was allocated to reduce the backlogs. Beds were added to the intensive care unit for post-operation patient care.

Patients requiring minor surgeries were sent to smaller hospitals to reserve space and skills for more complex surgeries.

But Bloom remains sceptical.

“I hear this every year, that the health department has a reduction programme but it never seems to make a dent,” he says. “We never seem to win. The waiting lists just get longer and longer.”

Subscribe to the print edition of City Press