RIGHT OF REPLY: Reducing the surgical and cancer treatment backlogs is an urgent priority

RIGHT OF REPLY: Reducing the surgical and cancer treatment backlogs is an urgent priorityMoney was made available in March to the Gauteng Health Department to outsource radiation oncology services and address surgical backlogs in the province. PHOTO: SECTION27 and Cancer Alliance
Comment & Analysis

Recently an opinion piece was published on this platform bemoaning what the author described as a “… lack of urgency” to tackle the backlog of cancer treatment in Gauteng, accusing the Gauteng Department of Health (GDoH) of sitting on the money “… earmarked to outsource urgent cancer treatment”.

There is no dispute over the fact that there is a need to act with urgency in attending to the backlog in surgical and oncology services.

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There is an acknowledgement that a number of factors such as shortages in both personnel and equipment, the knock-on effect of the COVID-19 pandemic that stretched the capacity of the healthcare system as a whole, and the unfortunate fire that broke out at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2021 has had a ripple effect when it comes to cancer treatment, not only for the province but for the country as a whole given the inter-dependence of the system.

The burnt section at the Charlotte Maxeka Hospital.
Charlotte Maxeke Hospital in Johannesburg. Despite millions being paid for security at Gauteng health facilities, theft of copper piping and cables persists, endangering the lives of patients and healthcare workers. PHOTO: Gauteng Health

It is within this context that the MEC for Health and Wellness, Nomantu Nkomo-Ralehoko when she tabled the department’s budget vote on 25 May this year specifically focused on the need to channel more resources toward oncology services.

Funding is a crucial factor for the success of any healthcare initiative. Understanding this, the Gauteng Provincial Treasury has demonstrated its support for this vital cause by allocating R784 million specifically to address the surgical backlog, including radiation oncology services. This financial backing represents a firm commitment to improving cancer care and provides us with the necessary resources to make this initiative a reality.

The MEC further announced that as part of expanding services to communities, oncology services will now be taken to cover township-based teaching hospitals namely Chris Hani Baragwanath Academic Hospital and Dr George Mukhari Academic Hospital. Currently, oncology services are provided through Charlotte Maxeke, Baragwanath, and Steve Biko Academic hospitals. We currently have 2 000 patients per month benefitting from oncology services at Charlotte Maxeke and Steve Biko hospitals.

Nomantu Nkomo-Ralehoko, MEC for Health in Gauteng
Nomantu Nkomo-Ralehoko, MEC for Health in Gauteng. PHOTO: GP Health and Wellness/Twitter

Furthermore, in order to ensure that patients requiring radiation oncology services are not disadvantaged, the provincial department through engagement with multiple stakeholders such as Cancer Alliance and SECTION27 has identified the need to appoint private sector providers to supply radiation oncology services for this financial year.

Outsourcing these services represents a strategic move aimed at harnessing the expertise and efficiencies of the private sector. This is expected to be instrumental in enhancing the quality of care and reducing waiting times for patients in need of radiation therapy. The outsourcing must be done within the confines of applicable legislative frameworks such as the Public Finance Management Act and supply chain management (SCM) processes.

The tender process is currently underway after the department completed specifications for the outsourcing of radiation oncology services for Charlotte Maxeke and Steve Biko Academic hospitals.

As part of exploring various options to expedite the outsourcing approach, the provincial department envisaged following a closed tender to invite a limited number of service providers to bid. However, the specifications to the technical proposal were divided into three categories – for the Professional/Specialist Radiation Oncologist, Technical Service/Oncology treating machine, and the radiation planning service. The market analysis conducted revealed that there are a number of service providers who can provide the needed services.

To prevent any irregularities in the tender process, the department decided to follow an open tender process with a shortened tender advert period of 14 days. This will allow specialist radiation oncologists and radiation planners to be availed the opportunity to tender as per categories 1 and 3.

activists during a march to charlotte maxeke hospital. poster reads cancer patients matter.
On 23 November 2021, Cancer Alliance and its partners SECTION27 and the Treatment Action Campaign held a protest at Charlotte Maxeke Johannesburg Academic Hospital and delivered a memorandum outlining their concerns. PHOTO: SECTION27 and Cancer Alliance

We recognise the urgency of the situation and want to assure the public that we are committed to handling the outsourcing of radiation oncology services diligently and are nearing implementation.

The anticipated impact of outsourcing radiation oncology services is expected to be far-reaching. By leveraging the capabilities and expertise of external service providers, we aim to improve the accessibility and quality of radiation therapy for cancer patients. This showcases a proactive and adaptive approach in response to the mounting challenges posed by the increasing prevalence of cancer.

Additionally, it is important to point out that we have advertised a tender for one Brachytherapy machine for Steve Biko Academic Hospital, which closed end of May. Specifications for one Linear Accelerator (Linac) machine for Charlotte Maxeke were done and the advertisement of the tender is underway. These machines are essential in the treatment of cancer and acquiring them is a significant step in improving the quality of cancer care.

sign for radiation oncology in Groote Schuur
PHOTO: Nasief Manie/Spotlight

The department has furthermore, procured four Linear Accelerator (Linac) machines, which are essential in the treatment of cancer. Two of these Linac machines are allocated for Chris Hani and two for Dr. George Mukhari Academic institutions.

The commissioning and operationalisation of the four Linac machines depend on the construction of special bunkers for the safe operation of radiation therapy equipment. The turnkey project to construct these bunkers at Baragwanath and Dr George Mukhari is envisaged to be completed within this financial year.

By strengthening our infrastructure and expanding our resources, we are positioning the department to provide better care for cancer patients.

As we forge ahead with these initiatives, we remain mindful of the tremendous responsibility we carry in the fight against cancer. Our actions today have the potential to bring hope and make a meaningful difference in the lives of countless individuals and families affected by this disease. Through continued investment, innovation, and strategic partnerships we strive to drastically reduce the surgical and radiation oncology backlogs.

*Mankupane is the Acting Head of Hospital Services at the Gauteng Department of Health.