Call to boost local health capacity

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We are in the midst of a pandemic – now if ever, is the time to work together to find solutions to serious healthcare threats facing residents of this area.

Two weeks after Grocott’s Mail reported on the call by doctors to open up an additional 32 beds at Settlers Hospital, Nalithemba Hospitals have confirmed that their former private facility is now in the control of the Department of Health. However, the former Netcare wards and offices remain firmly locked and as this region experiences a sharp spike in Covid-19 cases, public service watchdog PSAM has called for speedy action to expand health services to residents.

Doctors early last week reported unusually long waiting periods for patients with Covid symptoms to be examined at Settlers Hospital and difficulty in securing beds for private patients in neighbouring metros.

Since the lifting of lockdown restrictions to level 3, confirmed cases in the Makana municipal area have climbed rapidly towards last Sunday’s total of 620. Last week, doctors and Department of Health officials reported unprecedented pressure on local resources, and some private practitioners said they had tried in vain to have patients admitted to private facilities in neighbouring metros.

“It doesn’t matter who you are, or how good your medical aid is,” one GP said. “We are battling to get private beds for our patients.”

On 3 July, Grocott’s Mail reported on the urgent call by health professionals for the former Netcare private 32-bed ward at Settlers to be re-opened and utilised as a Covid-19 facility. Both the Department of Health and Netcare said they were in negotiations to this end; however, two weeks later, sources confirm that the former Netcare wards and offices remain firmly locked.

Netcare/ Nalithemba, which managed the private sections of the public-private partnerships at state hospitals Settlers and Port Alfred, closed their facilities there on 6 December. At the time, the Department of Health said there had been no formal agreement to terminate the relationship and that the matter of Netcare’s withdrawal had not been finalised.

The Department of Health had been in a public-private partnership with consortium Nalithemba at the two hospitals since 2009. Netcare is a 50% shareholder in Nalithemba and operated the private facilities at those hospitals. Settlers had 32 private beds (of 251) and Port Alfred 31 (of 60). These were the only private facilities operated by Nalithemba Hospitals.

Last week, as the demand on local resources grew, Department of Health spokesperson Siyanda Manana said, “We have the pressure now of Covid and our focus is to make sure that pressure is relieved.

“We don’t see anything that precludes us from using [the former Netcare private ward],” Manana said last week. “Right now we are going to see that it opens. This is an urgent issue we are engaging with.”

On Tuesday 14 July Dr Chris Smith, consultant to the Nalithemba board, said in reply to a follow-up query from Grocott’s Mail, “Nalithemba is able to confirm that the private facilities at both Settlers and Port Alfred hospitals have been transferred to the Eastern Cape Department of Health (EC DoH).  As such the EC DoH have taken control of these areas and shall decide how these areas can be optimised to meet their requirements going forwards.”

However, as of Tuesday, the 32-bed former private ward remained firmly locked, with none of the wards or offices in use, sources confirmed.

Commenting ahead of today’s statement by Nalithemba, Public Service Accountability Monitor Director Jay Kruuse called on Netcare/ Nalithemba and the Department of Health to act quickly for the benefit of the public.

“The PSAM are aware that Netcare and the Eastern Cape Health Department have been in discussion for some time, in order to determine whether agreement can be reached to re-open the 32-bed section of Settlers Hospital,” Kruuse said. “This currently unused section of the Hospital, was previously operated by Netcare in accordance with a public private partnership with the Department.

“The PSAM calls upon the leadership in both Netcare and the Department to act swiftly in the public interest to expand health services to residents of the Makana Municipality.

“We are in the midst of a pandemic – now if ever, is the time to work together to find solutions to serious healthcare threats facing residents of this area. Reaching agreement on the re-opening of this section of Settler’s Hospital will also help reduce the need for referrals to hospitals in East London and Port Elizabeth that are increasingly unable to accommodate the influx of patients from further afield.”

CONCERN ABOUT CAPACITY AT SETTLERS HOSPITAL 

Doctors last Monday expressed concern about an unprecedented situation that day, with ambulances not accepting ill patients due to the Casualty section at Settlers Hospital being “full”.

Sources explained that within the (public) emergency medical services, a specific ambulance is designated for the transport of confirmed or suspected Covid cases.

Because Casualty filled up quickly last Monday (not exclusively Covid-related cases), the “Covid” ambulance which had arrived there with a patient had to remain outside with the patient for around four hours before they could be examined in a Covid-designated area.

Manana later confirmed this and elaborated.

“It is not true that Settlers was full,” Manana said. “Those waiting to come in were PUIs [persons under investigation for suspected Covid-19].

“The hospital must prepare an area for PUIs so they have no contact with others in Casualty.”

Only ambulance staff may take a PUI through to the isolation area, Manana said.

“An isolation area was being prepared for positive people. EMS must take them directly to the isolation area.”

Manana said more areas were being cleared for PUIs.

They are not turning people away.

WHAT DOH SAID ABOUT THE 32 FORMER PRIVATE BEDS

When Manana said the hospital was preparing more areas, Grocott’s Mail asked whether this included the 32-bed former Netcare/Nalithemba private section.

“We don’t see anything that precludes us from using [the former Netcare/Nalithemba private section],” Manana said. “Right now we are going to see that it opens. This is an urgent issue we are engaging with,” he said last week.

“We have the pressure now of Covid and our focus now is making sure that pressure is relieved.”

Asked whether doctors would be able to treat private patients in that facility, Manana said, “Private and public patients will be treated there. We will just bill the private doctors for treating their patients in the public facility.

“This is the case in the field hospital in Port Elizabeth: it is accepting private patients who could not get into St George’s or Greenacres. They are not turning people away.”

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