Gauteng is the economic heart of South Africa. While South Africa’s smallest province, it has a population of over 13 million people (roughly a quarter of the population of South Africa). With lots of money around and most of the population relatively close to urban hubs, delivering quality healthcare services in Gauteng should be easier than in most of South Africa’s other provinces.
Yet health issues continue to be a major challenge in the province. Ongoing human resource shortages, overworked staff, unreliable ambulance services, staff who don’t treat patients with dignity, medical negligence cases, and a lack of beds. This is the reality on the ground that continues to put people’s health, dignity and lives at risk.
In addition, a tangled web of social failings impact on the healthcare challenges. There’s high unemployment and competition for scarce resources. Public works shortfalls mean infrastructure in hospitals and clinics is not renovated or maintained. And the high cost of commuting, or lack of proper roads in new developments, represent very real barriers to accessing healthcare for many patients. It is a most distressing trend that already weak healthcare standards are slipping further and that there are clear losses in areas where gains had previously been achieved1.
The Treatment Action Campaign (TAC) has been working in Gauteng since the early 2000s and continues to represent users of the public healthcare system and campaign on critical issues related to the quality of and access to healthcare. We currently have a network of 24 branches in all five districts in the province. Through these branches we monitor service delivery at a number of clinics and hospitals. Our members are the people who need the public health system to work, so they are the first to notice when it does not.
Each of our branches in the province has adopted a primary healthcare facility local to them and have been monitoring the state of services at these facilities since November 2017. The results highlight a number of critical concerns with regard to the state of services at clinics and community healthcare centres. A summary of the results of data collected to date is provided below.
The monitoring tool used has 24 questions based on the services and quality of service that a primary healthcare facility should offer. The questions, developed in consultation with TAC members, are designed to address the key concerns for users of the public healthcare system – and as such should be seen as complimentary to the more systematic and operational monitoring conducted by the Office of Health Standards Compliance (OHSC). The monitoring was conducted by TAC members trained in the use of the tool. In addition to monitoring facilities, TAC branches engage with members of the community to understand the challenges and collect testimonies and complaints that relate to these concerns.
The data collected by our branches corresponds to the worrying picture of our public healthcare system painted by reports published last year by the OHSC. According to the OHSC report, facilities should score at least 80% to claim an acceptable level of care – yet in Gauteng of 52 clinics inspected by the OHSC (not necessarily the same facilities as monitored by TAC) only 12% of the clinics are performing at 50% or above. Only one clinic performed above the required standard to claim an acceptable level of care.
In addition to monitoring facilities, TAC branches engage with members of the community to understand the challenges and collect testimonies and complaints that relate to these concerns. We also conduct ongoing investigations into the state of a number of hospitals in the province, the results of which are shared in our report.
Overall, the persistent and severe challenges outlined in this new report result in people who depend on the public healthcare system receiving inadequate, poor quality and undignified healthcare. The Gauteng healthcare system is broken. This dysfunction impacts disproportionately on the poorest and those in rural communities. The broken health system also impedes on the success of the provincial HIV and TB response. It needs an urgent turnaround strategy to clean the dirt in the system and to get rid of all the corruption and mismanagement that continue to deprive public healthcare users of their Constitutional right to access quality healthcare services. The report has been sent to the Gauteng MEC of Health.
Our members and members of our communities have had enough of the decay in our public healthcare system. We will hold politicians accountable for their indifference to the suffering of other human beings. We will not accept the way our dignity is being trampled on by the corrupt and the politically connected.
For more information contact:
Provincial Chairperson | Fikile Mtsweni | firstname.lastname@example.org | 076 529 7631
Provincial Manager | Stephen Ngcobo | Stephen.email@example.com | 073 846 0910
(National media enquiries |Lotti Rutter | firstname.lastname@example.org | 081 818 8493)