KZN cancer rescue op
Private doctors to pick up slack in state oncology units
ONCOLOGISTS and radiotherapists from the private sector will provide oncology services at public health facilities, while the Department of Health is recruiting replacements to treat cancer patients.
This is according to department spokesperson Sam Mkhwanazi after questions posed by the Daily News on the mass exodus of oncologists from state-owned medical facilities to private practice.
Currently, there are only two oncologists left at Grey’s Hospital in Pietermaritzburg, while there are none Durban.
Last week, the last oncologist based at Inkosi Albert Luthuli Central Hospital resigned. This hospital sees, on average, at least 80% of the province’s cancer patients.
“The head of the clinical unit at Grey’s Hospital’s oncology unit will oversee the management of patients at this hospital, as well as at Inkosi Albert Luthuli Central Hospital.
“In addition to this, other private oncologists and radiotherapists from the Hopelands Oncology Clinic will assist with planning through a connection that has been established between their clinic and the hospital. The department has already advertised posts to fill vacancies,” he said.
The Cancer Association of South Africa (Cansa) will be hardest hit by the shortage. The association, which offers emotional support and accommodation for cancer patients, relies heavily on oncologists to administer their medication.
Dr Melissa Wallace, Cansa head of research and advocacy, said along with Cancer Alliance and the Medical Rights Advocacy Network, they were engaging with the Department of Health, both on a provincial and national level, to assist in finding solutions to the ongoing problem.
“Access to treatment for cancer patients is of considerable concern to Cansa and a high priority advocacy issue for us. We are aware of significant challenges around treatment in the province and other areas nationally, including the lack of functioning radiotherapy equipment as well as the dearth of oncologists in the public sector in this province,” said Wallace.
“We have evidence to support the fact that these failures in the system are resulting in poorer prognoses and in some cases, death, for patients awaiting treatment and specialist care. We are unrelenting in our pursuit of improvements in this area and will maintain this as a high priority until this matter is adequately addressed,” she said.
Lisa Strydom, Cansa divisional manager in KZN, said although they were not directly involved with the treatment of cancer, they ran a number of screening clinics in Durban, Pietermaritzburg, Empangeni and, occasionally, in Port Shepstone. They offered a mobile clinic service that travelled throughout the province offering screenings to mainly remote rural areas.
Issues
“When we pick up any issues, we refer people for the appropriate follow-up and treatment. There is a real crisis because the public health sector is not able to cope with these referrals. Even before the last few doctors left the public sector, patients were waiting up to eight months for treatment.
“The situation now is going to be even worse. This leaves us with a dilemma – do we as Cansa continue to screen people if we know they are not going to get the required treatment?” she asked.
Strydom said they ran a care home in Durban which provided accommodation, meals and transport for out-oftown patients for the duration of their ( mainly radiation) treatment. “The unavailability of doctors means our existing patients are at risk of having their treatment disrupted,” she said.
Strydom explained that while oncologists did not provide services to Cansa, they treated patients who would otherwise not be able to afford care.
According to Noel Desfontaines, the Health and Other Service Personnel Trade Union of South Africa general secretary, hordes of doctors were leaving because of poor working conditions, critical staff shortages and machines not being properly maintained.
“The cancer crisis in the KZN public health institutions has been on the brink of despair for years and it is no surprise that more and more oncologists are opting to work in the private sector.
“Day- to- day challenges include non-maintenance of equipment, corruption scandals on the procurement of machinery and the critical shortage of staff resulting in oncologists being overworked. These mass resignations could be the straw that breaks the camel’s back,” said Desfontaines.
Dr Ziad Seedat, managing director of The Hopelands Group, said while he was not in a position to comment on the specific frustrations and challenges that have faced oncologists who had recently resigned from Inkosi Albert Luthuli Central Hospital, at Hopelands they had oncologists join them because they had not been offered positions in the public sector after qualifying.
“This has likely contributed to the depletion of skills in the public sector.
“As the largest group of oncologists in private practice in KZN, we have volunteered our time and knowledge to offer solutions to overcome the unacceptable delays in treatment that patients have been experiencing.
“We are confident that through greater co-operation with our colleagues in the public sector, we can achieve greater efficiency and improve the quality of care provided to cancer patients across our province,” Seedat said.
Lorraine Govender, Cansa national advocacy co-ordinator, said while they welcomed the interim plan, they were hopeful the government would find a long-term solution to address staff shortage and other problems.