Hon Ncamisile Nkwanyana, IFP Spokesperson On Health
At the outset the Inkatha Freedom Party would like to welcome the recently-appointed Head of Department, Dr Sifiso Mtshali and hopes that corruption and nepotism in the department will a eradicated and the department will serve the health needs of the people of KwaZulu-Natal. First and foremost he must outline his action plan on how he will turn things around in the department. We want to see him coming up with new strategies that will give hope to the staff at all levels in the Department of Health and the people of KZN. He must work hard to restore the negative image of the department due to poor leadership and bungling under Dr Sibongile Zungu.
The IFP is of the view that our health care system needs a complete overhaul if we are serious about delivering good health care to our people. We need substantial change, not just tinkering at the edges and fooling ourselves that we are making progress. The review should detail the radical reforms that will be required to move us from where we are now. The reforms that I speak about must be inclusive of infrastructure, personnel and material supply reforms. History is already littered with incremental, ad hoc and stop-gap measures that have not produced the desired results, and this is not what the people of KwaZulu-Natal should be subjected to. If we continue on this path, the implementation of the much-talked about National Health Insurance will continue to evade us.
We call on the MEC to establish a Provincial Health Commission to conduct a review of health services and programs which will look at existing health services and programs across all levels at health care facilities. It will examine the efficiency and effectiveness of services provided to people who do not receive good treatment at our health care facilities. Far too often our citizens face abuse and shoddy treatment at the hands of health care practitioners often leading a deterioration of their health or even death.
We further call for measures to make the sector more accountable, including setting targets and tracking progress in reform efforts. We appreciate that there are many very professional and caring health care workers in our province and we applaud them. But why is it that ambulance personnel who transport seriously ill patients to our hospitals are turned away from some hospitals and made to drive around in circles from one hospital to another in order to get the patient admitted? Why is it that we hear of nurses sitting in a union meeting while patients are being neglected? Why is that we heal of shortages of medical supplies and then blame is passed back and forth between the national department and the provincial department? These are some of the issues that must be addressed urgently and severe action must be taken against those who are found to be negligent.
KZN must overhaul its entire health care system and move towards primary health care. We need to launch a massive primary health care campaign in KZN. Patients from low-income communities should not have to contend with rude and unprofessional nursing personnel. For example, an advanced midwifery nurse from Mkhuze Clinic in KwaZulu-Natal has been suspended pending an inquiry into allegations that she failed to provide an acceptable level of care to an expectant mother. This follows the suspension of two doctors – one from Osindisweni Hospital and another from Mahatma Gandhi Memorial Hospital — and a nurse from Osindisweni Hospital following the death of a 19-year-old road accident victim who was allegedly refused treatment in both these institutions. Furthermore, nurses and security guards were caught sleeping at Prince Mshiyeni Hospital. These are just a few examples of reported cases – how many more of our people are dying because of negligence and unprofessional conduct?
The IFP is of the view that one of the main problems is that many nurses lack public relations skills. They embarrass patients in public and also reveal personal information about patients. Some nurses are so arrogant because they know that patients are at their mercy and so they treat them badly. Nurses are supposed to feel for patients and empathise with them, but that is not the case. When you visit the clinic or the hospital you spend almost the whole day in a queue waiting to receive attention while the nurses loiter around and with no sense of urgency.
It is not fair to paint all nurses with the same brush, as some really try their best to care for patients. Nurses are also human and they make mistakes and also come from various backgrounds that may determine their behaviour. But as professionals they should conduct themselves as such and display good public relations skills. We condemn rude and uncaring behaviour by the nurses at hospitals and clinics as this is a violation of patient’s rights.
The IFP calls on the MEC to urgently do an evaluation on the working conditions at our health care facilities. We believe that frustration on the part of health care workers could stem from poor working conditions and a lack of medical supplies. The salaries paid to all in the health care sector including general assistants and security staff needs to be revisited as this could be a factor contributing to low morale.
We need to take a number of different steps that will improve patient care and improve how we spot bad practice. Never again will we allow sub-standard care, cruelty or neglect to go unnoticed and unpunished. This is not about a hospital worker who makes a mistake, but specific cases where a patient has been neglected or ill-treated. Such offences are unacceptable and those who are found to be guilty must feel the full force of the law.
The IFP is concerned about the lack of clear programs to cater for those with mental health problems. Our hospitals do not have appropriate accommodation for people with mental health problems and they are very often placed in the same wards as people with general health problems thereby endangering both staff and other patients. The reforms that I am talking about must urgently look into providing facilities at hospitals that will be appropriate for mentally challenged patients. If one walks in our streets, one will find people with mental health problems loitering around but the Department is doing nothing to identify and help those people to get medication.
Education about mental illness needs to start early, reaching deliberately into classrooms to teach the next generation about positive mental health and how to recognize and seek help when problems first start, especially since symptoms often first appear in childhood. This requires a mental-health curriculum in every school. With mental health, however, it is essential to catch our youngest patients long before they fall ill. Not only is there a right to safe, affordable accommodation but it should be a centrepiece of mental-health treatment.
The recent reported shortages of medication in hospitals is a cause for concern. It is essential to monitor the drug supply in order to be able to minimize or prevent harm to patients arising from a lack of continuous treatment. We are convinced that there is lack of proper control and monitoring of supplies. The National Department of Health is on record as having stated that it is not responsible for the shortage of medication as it has made the provisions but that the problem lies with supply chain processes at provincial level. The HOD and his senior staff must get to the bottom of the problems that plague supply chain processes and ensure that there is an uninterrupted supply of medication and put an end to passing the buck.
I don't believe that this government is really interested in trying to tackle this issue by directly confronting the drug companies and do anything significant about it. There has to be strong leadership starting with the MEC and the HOD in order to solve this problem.
It is a common phenomenon to observe long queues and over-crowding of patients at state hospitals and clinics. Normally, working patients who visit state hospitals and clinics do spend a day or two at such health institutions, waiting to be attended to and or get treatment. This practice is not helpful to the patients and it is another clear demonstration of a failing KZN government in terms of service delivery in the public health care sector.
Apart from the academic and professional training that personnel in the health sector received, they need motivation, encouragement and refresher courses to keep them breast of the trends. But most importantly, they need a great deal of understanding of service delivery as compared to the current clumsy and poor service many of them give to the patients.
At this juncture, allow me to unravel some of the bottlenecks which cause delays which lead to poor service delivery:
- Health personnel. Some personnel, particularly those at the points of registration, card searching and fee payment, are often ill-prepared with poor understanding of the importance of time, customer care and patient service. One wonders whether they were ever told that patients have other commitments after having been seen by the doctors.
- Language barrier. The IFP observed with great concern that sometimes a lot of time is being wasted while patients and doctors are struggling with the language and communication difficulties. Staffing according to languages spoken will not only lessen the communication barrier, but will also assist to correctly pinpoint the ailment and provide appropriate treatment. The primary concern must be to communicate correctly and speedily in order for the patients to move on to the next stage of medical care.
- Stock shortages. Another matter which had been observed which hampers service delivery in the health sector, is the shortages of medical supplies. Under these circumstances, anything can happen to the health of patients. Furthermore, overcrowding at the hospitals pharmacies and at general entry points do not bode well for the health sector and long term solutions must be found. How the MEC of Health allows over-crowding at clinics and hospitals is unthinkable, considering the dangers and risks of communicable diseases.
- Security. Hospitals and clinics must become safe environments for patients, health care workers as well as the general public. Far too often we hear of staff as well as patients being assaulted at hospitals. There have been many cases of suicides that have occurred at health care facilities. Reports of medical supplies going missing have also been reported during our oversight visits. It is therefore imperative that security at health care facilities are tightened up.
The MEC of Health must admit that the health sector has deteriorated. Areas of training and re-training must be identified with the view to improve service delivery. Excuses will not do anything to improve the situation and will only let rot to worsen.
The objective must be to shorten the waiting time at points of entry so that patients can receive treatment as quickly as possible. Health service must be quickly delivered so that people can move on to other commitments. We should not allow poor service delivery to be the acceptable benchmark in KZN. Professional health provision ought to be second to none.
I thank you
Contact: Mrs Ncamisile Nkwanyana MPL, 078 302 3991