Province’s health facilities under pressure

Theuns Botha, Minister of Health

Western Cape Government

Western Cape Health Minister, Theuns Botha, says that the current pressures at Western Cape health facilities across the service platform, not only at hospitals and emergency centres, are real. “It is true that public health services are under pressure at various facilities and varying times. The burden on our health facilities is much larger than they were designed for. We are looking at a way forward. We are hoping and will be making a representation to National Health and Treasury that the province will be compensated adequately in the equitable share allocation of the budget for the significant increase in population growth of the province.”

There is always a tension between the escalating demand for services and the available resources. Shortage of beds is always relative to the demands on the service. The emergency centres are the entry point into the public hospitals and therefore face the brunt of the pressure. For this reason the health department has in the past few years systematically improved the infrastructure within emergency centres – New Somerset Hospital, Khayelitsha Hospital and the new Mitchell’s Plain Hospital are cases in point. The emergency centre at Mitchell’s Plain Hospital will open on 1 November. Emergency medicine specialists have been permanently placed in emergency centres to strengthen clinical governance and quality of care.

Our challenge is not shortages of medical equipment, but shortages of specialist doctors and nurses. This problem is not only in our province, but a world-wide problem, given the brain drain from developing countries to developed countries. In the province, the funded vacancy rates for doctors generally for the last financial year was 2,6% and for nurses 3,7%, which is relatively low in comparison to other provinces. Minister Botha says: “My information is that the vacancy rates in other provinces are average 40%.”

Minister Botha says: “The condition of the patients coming through the doors of the emergency centres are a direct result of the burden of disease within the larger population which in itself is a function of upstream factors  such inter-personal violence, road traffic accidents, risk factors for chronic diseases such as smoking, alcohol abuse, lack of exercise and unhealthy diets, substance  abuse, lack of proper housing and overcrowding. It is for this reason that the Western Cape Government’s strategic objective to create a healthier society is a high priority. We need to reduce illness and increase wellness.  

“We also know that the Western Cape is one the largest recipients of in migration from other provinces and beyond. This has been confirmed by the Census 2011. We are also informed by staff that there are an increasing proportion of foreign speaking patients attending facilities, although this is not quantified. It is difficult to quantify this challenge owing to the fact that patients provide local addresses.  The growth from 2001 to 2011 for WC is 28,7% and is only second to Gauteng.”

Western Cape Government Health does not have a single average waiting time for patients waiting for beds at a hospital, as this varies within a hospital at different times and between facilities. We are currently developing tools to measure this more systematically. The department has embarked on numerous initiatives to address this matter including as follows:

•          Upgrading the infrastructure and medical equipment of emergency centres

•          Started a patient flow collaborative that has engaged with teams of staff working at Hospitals to address patient flow.

The participating hospitals include Groote Schuur Hospital, Khayelitsha Hospital, GF Jooste Hospital, Eersteriver Hospital and Worcester Hospital. This project has just started and it’s still too early to measure the impact. Each of the teams are being creative in addressing specific aspects of the emergency centres and related functions.