Gauteng central hospitals operating beyond capacity to treat cancer

Gauteng, with a population exceeding 15 million, faces the highest burden of cancer care in the country and the province’s central hospitals were not originally designed to handle the current patient load.

The central hospitals are operating beyond their capacity in providing both cancer treatment and overall healthcare services.

These are the findings of a detailed evaluation of oncology services in Gauteng, undertaken by the Health and Wellness Portfolio Committee.

The Health and Wellness Portfolio Committee, consisting of members from various political parties in the provincial legislature, recently conducted a focused study to assess the pressure points and operational efficiency of oncology services throughout Gauteng.

The visits conducted this week included Dr George Mukhari Academic, Steve Biko Academic, Charlotte Maxeke Johannesburg Academic, and Nelson Mandela Children’s Hospital.

According to the committee, this initiative provided a deeper understanding of the complex challenges involved in delivering cancer treatment and care within the public healthcare sector. 

“Contrary to perceptions, oncology services require sophisticated coordination, far beyond what is often assumed,” the statement read. 

The committee said oncology services at these central hospitals extend not only beyond the province but also across national borders, offering highly specialised care that is difficult to replicate at tertiary and district hospitals, which often lack essential surgical, diagnostic, and pathological capabilities. 

“Consequently, these hospitals face a high volume of referrals from other provinces, such as North West, Limpopo, and Mpumalanga, further straining an already overburdened system.” 

The team also found the bed allocation becomes increasingly complex as they accommodate patients from outside Gauteng.
Additionally, the backlog is exacerbated by the significant number of foreign nationals seeking cancer treatment and other healthcare services in these facilities. 

According to the statement, Charlotte Maxeke Academic Hospital currently owes over R700 million, while Steve Biko Academic Hospital has a bill exceeding R400 million for the treatment of foreign nationals. 

This situation further intensifies the financial strain on the system.

Human resource planning

The committee also observed that the human resource planning for oncology services is outdated and does not meet the growing demands of Gauteng’s population. 

“This mismatch has led to significant pressure on healthcare professionals, with unfavourable staff-to-patient ratios affecting service delivery.”

In addition, there is a critical shortage of oncology, radiology, and other specialised healthcare workers, compounded by the private sector’s ability to offer more competitive compensation for these sought-after skills. 

They also discovered that there was a shortage of specialised nurses in the operating theatres and intensive care units (ICU).
“These nurses play a crucial role in the value chain of cancer treatment and care.”

The team has since urged the National Department of Health to fast-track the approval and implementation of revised staffing plans, already proposed by hospitals, to address these shortages.

“While the committee recognises the budget constraints caused by austerity measures, addressing the critical need for specialised personnel must remain a top priority to meet growing healthcare demands.” 

Infrastructure needs 

Gauteng historically had only two main radiology centres. However, the committee said they were encouraged that Dr George Mukhari Hospital is advancing plans to construct an additional oncology facility. 

The committee believes that once the facility is completed, it will relieve pressure on existing services and enhance treatment capacity for cancer patients. 

“However, it is essential to ensure that infrastructure expansions are matched by an increase in specialised personnel to operate the facility effectively.” 

The committee stated that they will closely monitor the project’s progress to ensure it meets deadlines and improves access to care.

“The committee now fully understands the multi-faceted factors contributing to the backlog in oncology services. The entire value chain – from diagnosis to treatment – requires a coordinated approach, guided by clinical guidelines.” 

As the National Health Insurance (NHI) implementation progresses, they said it was expected that greater cooperation and system improvements would help address some of the current challenges in the healthcare sector.

“We remain committed to supporting Gauteng’s healthcare system and will continue working with the Department of Health to tackle these challenges. 

“Our goal is to enhance oncology services, ensuring all patients receive the high-quality care they deserve, despite the complexities involved in providing such specialized treatment,” said Health and Wellness Portfolio Committee Chairperson, Advocate Ezra Letsoalo. – SAnews.gov.za
 

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