Public hospitals in Gauteng notched up 7 117 cases of unintended harm inflicted on patients – serious adverse events (SAEs) – last year and amid crippling staff shortages countrywide.
The personnel crisis is unlikely to be remedied any time soon, according to Health Minister Aaron Motsoaledi, responding to a parliamentary question from ActionSA MP Kgosi Letlape. Motsoaledi said that in the Free State alone, there was a 22.4% vacancy rate for doctors – and a 28% nurse vacancy rate – followed by Mpumalanga with 18.5% and Limpopo with 17.6%.
News24 reports that the Northern Cape has a 21% nurse vacancy rate and the North West one of 14%. In the Northern Cape, there was a 44% vacancy rate for senior management, followed by KwaZulu-Natal with 27.7% and Mpumalanga at 24.6%.
Motsoaledi said the major challenge was the budget cuts imposed by Treasury, and that additionally, there were “availability” issues in some categories, particularly for specialists in areas like ophthalmology and psychiatry, as well as theatre and intensive care unit nursing.
Letlape, a former president of the Health Professions Council of SA (HPCSA), said a consequence of the high vacancy rate was the quality of care “undoubtedly” being undermined, the latest SAE statistics being a case in point, staff burnout, low retention, and a surge in medical malpractice lawsuits.
“The reality is that overworked and under-resourced hospitals are paying the price, with nearly R24bn having been paid out in medical-legal claims since 2020,” he said.
National Education, Health and Allied Workers’ Union (Nehawu) spokesperson Lwazi Nkolonzi said the union had been calling for the department to implement its 2030 Human Resource Strategy for Health more rapidly to deal with the shortages.
“The strategy states that the prevailing … challenges are a result of continued underinvestment, limited strategic planning and management capacity, and gaps in governance, stewardship, accountability, co-ordination and implementation of key health workforce policy interventions for the delivery of quality services,” he said.
He added that National Treasury should “do away with its austerity measures programme” that has had a particular impact the delivery of health services, with the increasing numbers of serious adverse events indicative of this.
Bara tops the list
In Gauteng alone, last year, Chris Hani Baragwanath recorded the highest number of SAEs, with 1 169 incidents, followed by Dr George Mukhari Academic Hospital in Ga-Rankuwa with 613 cases, Steve Biko Academic Hospital in Pretoria at 552 cases and Charlotte Maxeke with 447 cases.
Tembisa Hospital led the tertiary hospitals with 437 cases, followed by Kalafong Hospital in Atteridgeville with 307 incidents, and then Helen Joseph Hospital in Auckland Park, which recorded 153 cases.
Leratong Hospital in the West Rand topped the list among regional hospitals with 499 cases, followed by Pholosong Hospital in Tsakane with 325 incidents, Thelle Mogoerane Hospital in Vosloorus with 318 cases, and then Rahima Moosa Mother and Child Hospital with 239 cases.
The remaining regional hospitals each registered fewer than 200 SAEs, with Sebokeng Hospital reporting the lowest at 72.
Figures for district hospitals show that Bheki Mlangeni Hospital in Jabulani, Soweto, was the only one to report more than 100 SAEs, with a total of 119.
DA MP and party health spokesperson Jack Bloom said that the figures were alarming.
“Notably concerning are the 452 SAEs reported at Weskoppies Psychiatric Hospital,” he said. “These incidents arise from various factors, but they are frequently linked to substandard hospital conditions and medical negligence. There is a worrying uptrend as there were 6 910 SAEs recorded in 2021, up from 4 701 SAEs in 2020, and 4 170 in 2019.”
He added that only 29 officials across nine hospitals faced disciplinary action last year.
“If the rise in SAEs is not curbed, patient suffering will persist, and the financial burden of medical negligence cases will escalate. The DA will push for better hospital management, prompt filling of staff vacancies, provision of essential equipment, and robust training and disciplinary measures to address poor performance that leads to patient harm.”
See more from MedicalBrief archives:
3 832 die in Gauteng’s public hospitals from ‘negligent’ SAEs
2 000 patients died from severe adverse events at Gauteng Hospitals last year
Serious Adverse Events on the rise in Gauteng’s worst hospitals
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