By Bonginkosi Dhlamini
The poor state of Gauteng’s public health facilities is once again under the spotlight for all the wrong reasons.
This comes after a video recording of poor service at the Rahima Moosa Mother and Child Hospital in Johannesburg went viral. It shows several heavily pregnant women sitting on chairs and others sleeping on the floor allegedly without being attended to for over three days,.
In an interview on Radio 702 this week, the hospital CEO Dr Nozuko Mkabayi explained that the facility was “overwhelmed” with expectant mothers seeking treatment, which had resulted in a shortage of beds in the antenatal ward.
She said the Health Act policy compelled hospitals to admit all patients in need of health care services. It also compels them to ensure that all admitted patients are given adequate and respectful care, especially in a hospital dedicated to maternal and neonatal care.
The CEO openly admitted that it was normal for maternity patients to sit and wait for over 24 hours just to get access to a hospital bed.
The cynic in me is tempted to say that was, perhaps, an admission about the state of dysfunction at the hospital. Neither the hospital CEO nor the Gauteng health department have taken accountability for the apparent negligent treatment of patients involved in this case.
The focus on the dysfunction at the Rahima Moosa hospital has become more ambiguous as some politicians have suggested that the real reason for the lack of beds was the excess demand for healthcare services by people coming from other provinces, linking it to poor immigration control. I argue that this could not be further from the truth.
Whether the hospital is burdened with caring for excess patients or not is a moot point. There is no excuse for the undignified and inhumane treatment of patients in our hospitals. This must be condemned because it is against our Constitution and its foundational principle of Ubuntu.
The National Department of Health’s 2016 Guidelines for Maternity in Care stipulates that: “workers administering care to pregnant women must demonstrate respect and a genuine interest in their clients, and avoid an arrogant, rude or judgmental attitude.
This applies even in the context of a “poor working environment”. In this instance, the staff at Rahima Moosa Hospital and the health department’s poor management dismally failed to administer dignified care. Collectively their negligent care has precipitated the dysfunctional situation where it is normal for maternal patients to sit in chairs or lie on the floor for over 24 hours. The hospital management must take accountability for this violation.
The IFP in Gauteng fully understands that overcrowding in our public hospitals is a true and prevalent challenge. However, this is not a new challenge caused by excess patients seeking care at our hospitals and any attempt to present the latter as fact is misleading.
The fact is that our public health systems and institutions have been failing for a long time because of poor financial planning and bad management. Just a few weeks ago the Gauteng Provincial Legislature Finance Portfolio Committee was presented with a report detailing the health department’s debt of over R3 billion that is owed to essential goods and services suppliers in some of the province’s major hospitals.
Notwithstanding issues of budget constraints, this is also a result of a continuous state of dysfunctionality within the health department which lost billions of public funds through mismanagement and corruption.
This effectively means that the delivery of proper and adequate healthcare services is compromised, notwithstanding that these provincial hospitals play a key role in fulfilling the constitutional mandate to uphold the right to access healthcare.
The challenges plaguing the health department are not insurmountable, but they do require ethical leadership that serves the public better and fosters a culture of good governance.
This view is shared by governance scholar, Professor William Gumede, who in his book Restless Nation writes that leadership plays a key role in improving the performance of State institutions and strengthening them, especially in times of crisis. This is pertinent to the case of the health department beset with dysfunctional and absent leadership.
Therefore, we must insist that our public health institutions are led by highly competent, ethical, and honest people. This is vital for the wellbeing of the vulnerable and poor citizens of Gauteng who have no choice but to rely on the decrepit public health system.
*Bonginkosi Dhlamini is a Member of the Gauteng Provincial Legislature and IFP Gauteng Provincial Chairperson.