Getting the system to work

Getting the system to workNo sign of improving, a sign flippantly tells patients that their long waiting times means “they’re not dying”

By Ufrieda Ho

Staff shortages remain a massive challenge for the public health service.

The Gauteng Department of Health earlier this year released information in response to questions

Patients are left in hospital corridors for long periods.
Patients are left in hospital corridors for long periods.

from the Democratic Alliance. The Department reported that state hospitals need 1,151 Grade 1 medical officers, 110 medical registrars, 78 community service medical officers, 160 Grade 1 medical specialists, and 58 intern medical officers. There are 17 clinical unit and department head vacancies and a dire shortage of nurses. The report noted 1,184 vacancies for Grade 1 nursing assistants, 1,340 Grade 1 professional nurses, 141 speciality nurses and 88 primary health clinical nurses.


The pressure of getting doctors and nurses into the system is complicated by the lure of private

sector salaries and employment conditions. This year, the system has come under additional significant strain as student protests rock the higher education institutions. If interns and qualified doctors are prevented from entering the system it will severely compromise the service offered at the province’s academic teaching hospitals.

In October, however, the Gauteng Department of Health announced that it had seen a ‛net gain of 2,227 nurses by the end of August, and 1029 medical professionals’. Earlier in the year, the Department also announced that 25 Cuban doctors would start working in the province. The Cuban doctors will focus on maternal, infant and child care. Infant mortality and maternal deaths remain a priority even in the country’s economically dominant province. Meanwhile, currently, there are 400 South African medical students being trained in Cuba as part of government’s initiative to plug the gap of doctors in South African public health care.

In June, the MEC for Health, Qedani Mahlangu, said a new double-storey paediatric unit at Chris Hani Baragwanath hospital should be completed next year. The unit will cater for children under the age of 10 and the target is to treat 3,000 inpatients and 2,000 outpatients a month at this facility.

The Gauteng Department for Emergency Medical Services budget has increased to R1,2 billion for

No sign of improving, a sign flippantly tells patients that their long waiting times means “they’re not dying”
No sign of improving, a sign flippantly tells patients that their long waiting times means “they’re not dying”

the current financial year. This amount will go towards the procurement of an additional 150 ambulances, 25 primary response vehicles, 11 rescue vehicles and five mobile emergency communications and command vehicles.

The provincial government has shown some positive initiatives, though the long term test lies in ensuring that good projects and recruitment drives are sustainable, adaptive and have the commitment of properly trained staff, to make them effective.

According to Mahlangu’s 2016-17 budget speech, recent successes include the Stock Visibility System (SVS). This is a phone app-driven system that allows nurses and staff to scan medicine barcodes to track stock levels of ARVs, TB medicines and vaccines, to be entered into a stock levels database. By the middle of this year 110 clinic should have been connected to the SVS system, with a roll out to all primary health clinics to be completed by the last quarter of this year, the Department reported.

The Gauteng provincial government’s own scorecard of its districts, meanwhile, identifies Tshwane as the best performing district in the country this year, with Laudium and Calcot Dhlephu clinics rated as Gauteng’s top clinics.

Furthermore, the Department said some of their facilities improved their national core standards rating, with Steve Biko Academic Hospital scoring 96 percent, Kalafong Hospital 81 percent and Mamelodi Hospital 73 percent. Declines in performance were noted at Charlotte Maxeke and George Mukhari Hospitals.