Port Alfred Hospital has made significant progress in addressing its equipment shortages, Department of Health spokesperson Mkhululi Ndamase says. He responded to questions from Talk of the Town after DA shadow health MEC Jane Cowley flagged several concerns at the public health faciilty.
Following a recent oversight visit, Cowley said staffing, equipment shortages, emergency medical services, stockouts, infrastructure and safety were concerns. Talk of the Town spoke to Cowley both on site earlier this month, as well as by phone this week.
Staffing
“Port Alfred Hospital is grappling with a severe staff shortage as vacant, funded posts remain unfilled due to governmental cost-cutting measures in the Eastern Cape,” Cowley said.
She later clarified in response to Talk of the Town’s questions: “The provincial cost management team sent out a directive called Memo 49 which has effectively frozen all posts- so no vacancies can be filled. They will then ringfence the money tied to these posts (because they are funded posts) and use the money to pay their creditors.”
The recent departure of six nurses had had a serious impact on Port Alfred Hospital’s workforce, and the pharmacy manager position remained vacant, Cowley noted during her on-site visit earlier this month.
“There are not only shortages of operations managers but a whole range of posts,” Cowley said. “The pressure on the remaining staff is unsustainable.”
Equipment Shortages
On-site, Cowley said, “Essential medical equipment is not available or not working optimally. The hospital is awaiting the installation of an X-ray machine, while transport issues hinder its operations. The hospital is short of anaesthetic equipment, vital signs monitoring equipment and wheelchairs. A donated incubator is awaiting a ventilator, and the current Oxy log [a type of ventilator] is not working or user-friendly.”
Cowley said critical life-saving non-negotiable vitals (NNVs) such as automated electronic defibrillators, which are mandatory and can save lives, must be supplied immediately to meet the hospital’s operational needs.
Emergency Medical Services (EMS)
This vital service was stretched to breaking point, Cowley said. Patients often faced lengthy waits of six to eight hours for ambulances from distant locations such as Makhanda, Gqeberha or East London.
Pharmaceutical Challenges
Essential medications and supplies were frequently out of stock, Cowley said.
“Contrary to initial reports, the total budget allocation for Pharmacy and Stores [at Port Alfred Hospital] is R970,000, Cowley told Talk of the Town this week. “However, by the time of our visit, expenditures had already surpassed R1.2 million, revealing a significant shortfall in funding. If current trends persist, projected spending is expected to reach approximately R2.4 million by the end of the financial year, underscoring the dire need for increased budgetary support.”
Infrastructure
The hospital’s ageing buildings required urgent repairs and abandoned buildings had become home to drug addicts, Cowley said. However, escalating costs had pushed these renovations to the back burner.
“Despite efforts to address these issues, the hospital continues to operate with limited resources,” Cowley said. “But the community is expressing growing concern about the hospital’s ability to provide adequate healthcare services,” Cowley said.
“The situation is particularly dire for mental health patients, who need 72-hour observations.”
Cowley said she had written to the Premier, urgently requesting that the filling of vacant funded posts be prioritised, particularly in primary healthcare facilities like Port Alfred Hospital. She said she would call for increased investment in essential medical equipment to ensure hospitals across the province could deliver effective care.
“The ripple effect of [province-wide] cost-cutting measures extends beyond Port Alfred Hospital,” Cowley said. “Patients across the province are increasingly forced to seek treatment at tertiary hospitals, such as Frere and Livingstone, for illnesses that should be handled at primary healthcare facilities.
“This not only places further strain on the already stretched tertiary hospitals but also exacerbates costs as treating patients in these settings is significantly more expensive.”
Significant progress
Health department spokesperson Ndamase said the Port Alfred Hospital had made significant progress in addressing its equipment shortages.
“The new X-ray machine is up and running, and all other machines, including the CTG machine received four months ago, are functioning properly. The hospital has also serviced all machines over four months ago, ensuring they remain in good working condition,” Ndamase said.
The department had ordered an additional anaesthesia machine, which was awaiting delivery.
“However, the current machine remains fully functional, providing uninterrupted service,” Ndamase said.
Regarding staffing, the department was working to fill vacant positions, including the operations manager and pharmacy manager, within the available budget.
“Medicine stock-outs are promptly addressed through orders from the depot, ensuring life-saving medication remains available,” Ndamase said.
“Plans are under way to upgrade the 72-hour observation unit to meet minimum standards. While budget constraints have delayed hospital renovations this financial year, the department also acknowledges the infrastructure needs and strives to improve service quality for the people of Port Alfred and the Eastern Cape.”
“This is testament to the department’s commitment to delivering quality care despite challenges,” he said.
What the MEC said
EMS
In her budget and policy speech delivered earlier this year, MEC Ntandokazi Capa said the Eastern Cape Department of Health had been allocated R30 106 843 for the 2024/25 financial year. Of this, R1 562 632 is allocated to emergency medical services (EMS).
“We endeavour to get to the scene of the call in less than 30 minutes in urban areas and under 60 minutes in rural areas. Over the past financial year, we have managed to achieve these target times in 55% of calls in urban areas and in 65% of these calls in rural areas, respectively. The major challenges include the state of the road infrastructure in rural areas and the impact of rains and other natural events on access to certain communities.”
Capa said the next financial year would see further improvements in their response times to life threatening events.
“We are making improvements in our service by recruiting registered paramedics, especially for rural areas, within available budgets,” Capa said.
Medicines
She said medicine availability had been under strain, due to internal and external constraints, including that global supply chains had not stabilised since the COVID-19 pandemic. In addition, the import of pharmaceutical ingredients had been disrupted by the wars in European countries (Russia and Ukraine; and most recently Israel/ Palestine).
Capa said the departmental cash flow constraints due to the impact of historic medico-legal settlements had also made it difficult for the department to pay suppliers of essential medicines on time, resulting in them suspending the departmental accounts.
Mental health facilities
Of mental health facilities, Capa said the province had inappropriate 72-hour observation capability and lacked access to acute beds for admissions to mental health facilities.
Infrastructure
Capa said in the past 30 years, the Eastern Cape Department of Health had invested over R30 billion to improve infrastructure across the province.
District health services are set to be funded to the tune of R15 568 003 in the 2024/2025 financial year and health facilities management across the province has a budget of R1 306 528.
- Additional reporting by Sue Maclennan
- This article was first published in Talk of the Town, October 31, 2024. The newspaper serving the communities of Ndlambe and the Sunshine Coast, with a weekly wrap of Makhanda news, is available at stores from early on Thursdays.
