Health faces R10,5 bln claims

2017-04-20 14:11
KZN Health MEC Dr Sibongiseni Dhlomo gave his annual budget vote at the KZN Legislature on Wednesday, revealing many new projects and plans, but also admitting that many areas are in dire straits.

KZN Health MEC Dr Sibongiseni Dhlomo gave his annual budget vote at the KZN Legislature on Wednesday, revealing many new projects and plans, but also admitting that many areas are in dire straits. (File Image)

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With a staggering R10,5 billion in outstanding medical claims, broken oncology machines and only six state oncologists in the province, officials from the KwaZulu-Natal Health Department say they are trying their best with the little money they have.

KZN Health MEC Dr Sibongiseni Dhlomo gave his annual budget vote at the KZN Legislature on Wednesday, revealing many new projects and plans, but also admitting that many areas are in dire straits.

Dhlomo revealed that the province had coughed up R240 million for medico­legal claims in the 2016/2017 financial year.

With claims most common in obstetrics, paediatrics, and radiology, among others, he said people were now unwilling to specialise in those areas.

Dhlomo said the problem extended to the private sector too.

He described the claims as “a challenge” and said the department had found lawyers had been touting for clients outside hospitals and clinics to pursue medical negligence cases.

He said some lawyers were even touting at schools, approaching parents of children with cerebral palsy and other similar conditions and encouraging them to open cases because a medical negligence claim can date back 21 years.

He said the claims coming through to the department were not new, but were rather claims that could have been filed years ago, but were only being opened now.

Another issue the department is dealing with is that the province only has six state oncologists, one each at the Addington and Inkosi Albert Luthuli hospitals in eThekwini, and four at Grey’s Hospital in Pietermaritzburg.

Dhlomo admitted that the department was facing challenges and said despite receiving one of the highest budgets in the province, second only to the Education Department, more money was needed from the national department to adequately address certain issues within the public health sector.

Dhlomo said there was a plan to look at partnering with the private sector’s oncologists and using their machines to fast-track cancer diagnoses and treatment.

He said the private sector in KZN had 50 oncologists and around 30 oncology machines that could be used to treat state patients as part of the proposed collaboration.

Dhlomo added that there was one oncology machine at Addington Hospital that could treat 10 patients a day, but that there would be 50 waiting in a queue for treatment that they would not be able to afford in the private sector.

He said there was no time to service and fix the machines and buying more would eat into their already tight budget.

“It is probably our own fault. We are aware of the impacts this will have,” admitted Dhlomo.

He said women were being diagnosed with cancer, particularly breast and cervical cancer at a younger age, as early as 35 years old, in KZN.

“We realise the system must compensate by either servicing or getting more machines.”

KZN Health head of department Dr Sifiso Mtshali said oncologists were only staying in the public sector for a year or so before moving to the private sector.

Dhlomo added that the department was trying to “manage the budget size with all the pressures”.

Dhlomo said he realised interns in hospitals were working long hours but that would not change.

He said it was part of the curriculum to work long hours and that instead of “going home or to a wedding or funeral” they should go to the doctors’ room on the hospital premises and sleep for a few hours.

Dhlomo also addressed the resignation of health-care professionals whose posts were not being filled.

He said due to cost-cutting, when a nurse resigned, the post would not be filled immediately and that the other nurses would have to do more work than usual.

He said the department was trying to get more money to address all these problems, but for the moment could not fill the vacant positions as the money was needed elsewhere.

‘Drastic changes needed in KZN’s health-care system’

In response to the KwaZulu-Natal health budget speech, Democratic Alliance MP Dr Imran Keeka said the province’s health system “is like a patient with progressive gangrene and failure to operate will only allow the situation to get worse”.

Keeka said in a statement that despite all the department’s plans, initiatives and promises, the department just did not have the money.

“While the department has admittedly had to face the brunt of budget cuts as a result of the Izinduna payments [payments to lower echelon traditional leaders] and other economic factors, the reality is it is equally to blame for the situation it finds itself in.

“Other contributing factors include its own R260 million medicolegal bill ...”

Keeka said the province had a critical shortage of doctors, only 129 functional ambulances despite needing 1 057 for its population size, broken radiotherapy machines and a crumbling oncology service.

Inkatha Freedom Party MP Ncamisile Nkwanyana said in her response to the health budget vote that the budget allocation of R39,5 billion is grossly inadequate to meet the spending challenges being faced by this department.

“It is common knowledge that this department overspends its budget every year and seems to be getting itself deeper into debt,” Nkwanyana said in a statement on Wednesday.

She said the department needs to do all within its power to reduce the amount of money that is spent on purchasing services from private hospitals.

“If the public sector has its house in order and is providing adequate health-care services in well-equipped hospitals, there will be no need to waste money on buying services such as oncology services from private hospitals,” she said.

“The freezing of medical and nursing posts affects service delivery, deepens staff shortages, and prevents staff retention and professional development.

“Drastic changes are needed within this department and our health-care system if the aim of promoting the health of all of our citizens is to be reached,” she said.

THE South African Medical Association (Sama) recently released a statement saying their KwaZulu-Natal coastal branch would be calling on doctors and specialists to march on May 5.

Sama KZN coastal branch chairperson Dr Mvuyisi Mzukwa said the march is aimed at creating public awareness “of the poor state of public health care in the province”.

He said the organisation hoped the march would raise awareness and raise support from the public as they “demand an end to the rapidly deteriorating delivery of health care services in our province”.

Mzukwa said the branch is alarmed by the department’s decision to change the conditions of employment of all doctors by freezing critical posts, creating unfunded posts, keeping some doctors unemployed, and introducing a new overtime policy without adequate consultation.

“Subsequent to the introduction of the new policy, the doctors held a number of meetings with health officials demanding changes.

“A consultative process began with the national department, but the provincial department betrayed the process by commencing threatening workshops to enforce the implementation of the new policy.”

He said he had noticed a sharp deterioration in health care at hospitals and clinics in the province over the years. “Indications of this include shortages of medicines, collapsing infrastructure, broken equipment, and inadequate provision of staff,” he said.

Dr Mzukwa said there was a total collapse in the departments of oncology, ENT (ear, nose and throat), urology, and, lately, anaesthetics. He said members of Sama are reporting a variety of problems on a daily basis including burnout, mass resignations, and the relocation of doctors to other provinces.

At yesterday’s budget speech, KZN Health head of department Dr Sifiso Mtshali said he had met with Sama last week and had spent an entire afternoon briefing them on the department’s plans and initiatives.

He said it was not true that the provincial department would not speak with them and said talks over help from the public sector were discussed. He did not go into more detail. — Witness Reporter.

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