Health Systems

Western Cape: state of health

– Western Cape state of health report published

The Western Cape health system is failing the people who rely on it. People dread to attend overcrowded and under-resourced clinics. They wait for hours or days to be seen by a nurse or doctor. Sometimes without any privacy from others waiting. People without appointments are turned away. Pregnant women are shouted at to stop pushing while in labour, causing long term health complications or the death of their babies. State of the art hospitals look impressive on the outside, yet on the inside patients lie without dignity on the floor. Overstretched nurses get security guards to give out patient files. Ambulances are delayed, too afraid to respond without police presence, or they never arrive at all. This is the reality facing people who depend on free health services in the Western Cape.

20 years ago, the first TAC branch was born in Khayelitsha. We began campaigning to ensure access to HIV treatment for all. Today, TAC Western Cape continues to fight for the rights of the poor and marginalised. Now as well as people living with HIV and TB, we represent all people who use the public healthcare system. We campaign on critical issues related to the quality of and access to healthcare. There are now 36 branches across the province in Cape Town Metro, Eden, Overberg, and West Coast. 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 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 OHSC1. According to the OHSC report, facilities should score at least 80% to claim an acceptable level of care – yet in the Western Cape of 65 clinics inspected by the OHSC (not necessarily the same facilities as monitored by TAC) only 22% of the clinics are performing at 50% or above, only 4% of the clinics at 60% and above, and none above 70%.

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.

TAC Western Cape demands provincial leadership and accountability in order to develop a turnaround strategy to address the crisis in the province’s broken public health system. This report outlines a set of detailed concerns and demands. We urge the MEC of Health Nomafrench Mbombo, Premier Helen Zille, and the provincial Department of Health to deliver on your Constitutional mandate and to urgently address these issues with the seriousness they deserve.




For more information contact:

Provincial Chairperson | Vuyani Macotha | | 081 887 8130

Provincial Manager | Mary-Jane Matsolo | | 079 802 2686

(National media enquiries |Lotti Rutter | | 081 818 8493)