The Eastern Cape health department is forging ahead with the closure of two of the three TB hospitals in Nelson Mandela Bay and transforming them into a district hospital and psychiatric facility.
The move comes as the department ramps up its service delivery optimisation strategy for better services in the province.
During her 2022/2023 budget speech in the Bhisho legislature on Tuesday, health MEC Nomakhosazana Meth said the low levels of hospital admission for tuberculosis, coupled with a lack of psychiatric facilities in the region, was the rationale behind the decision.
“In a region like Nelson Mandela Bay, there are three TB hospitals, and yet there are only 118 patients requiring hospitalisation in the region,” she said.
“[But] there is no district hospital and no psychiatric facility.”
Empilweni TB Hospital in Kwaford will become a district hospital while the Orsmond TB Hospital in Kariega will be converted into a psychiatric facility.
The Jose Pearson TB Hospital in Bethelsdorp will remain.
“During Covid-19 there was a desperate need for beds at a lower level of care and Empilweni Hospital was allocated to take on stable patients who did not require specialist care.
“This provided enormous relief at the regional and tertiary hospitals, making beds available for patients who needed specialist care,” Meth said.
Healthcare workers, stakeholders and residents were up in arms in February when they discovered plans were already afoot to transfer nurses and patients from Orsmond Hospital to Jose Pearson TB Hospital.
Concerned parties have cited fears that healthcare workers at various clinics across the Bay would be unable to properly assist TB patients as key TB hospitals were now closed.
They said should Jose Pearson become the only TB hospital in the metro, there was a possibility of cross-contamination taking place as patients with multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) would all be accommodated under one roof with patients who had less severe strains.
However, before the plans were finalised, Meth said meaningful consultation was required with stakeholders to explain the rationale of the proposed plan.
“We need to prevail on our stakeholders to reach consensus on solutions that will promote affordable, quality care through consolidation and equitable redistribution of health resources.”
Meth said SA recorded 34,587 teenagers giving birth in the 2020/2021 financial year.
She said between July and December, 9,396 girls aged 15-19 gave birth at Eastern Cape facilities, as well as 319 children aged between 10 and 14.
“This is of grave concern because children should not be having children. We are calling upon children to abstain from having sex until they are over 21 years old.
“In cases where they are already sexually active, we advocate the use of condoms.
“The department provides condoms free of charge at our facilities.”
She said a multipronged approach had started to mitigate against the increase in teenage pregnancies.
Meth set aside R115m in the midterm economic framework (MTEF) for the establishment of rehabilitation centres.
Dora Ngiza will be one of three centres of excellence in the province for cerebral palsy patients.
“This will enhance the current rehabilitation services already provided at these three facilities.
“Rehabilitation services are an important part of the integrated medico-legal strategy and form the cornerstone of our public health defence.
“In this defence, the department is making a case that the public sector can provide good quality rehabilitation services for children with cerebral palsy and where we are unable to do so, we undertake to either procure or reimburse the custodian of children with cerebral palsy for such agreed services or rehabilitative items,” Meth said.
Medico-legal claims have bogged down the provincial health department for years, with Bhisho having forked out more than R3bn in claims over a six-year period.
Construction work is under way at the Sir Henry Elliot facility in Mthatha while Dora Nginza and the Mdantsane-based Cecilia Makiwane hospitals are still in the planning phases.
The department received a R27bn allocation for 2021/2022, the second-biggest slice in the provincial budget.
Meth said 11 of the 84 Emergency Medical Services bases were found to be non-compliant with industry standards, essentially with wash bays and minor infrastructure requirements.
“The department has allocated R137m to address the ambulance wash bays and general upgrading of facilities in the strategic period ahead.”
DA MPL Jane Cowley said Meth’s address made no mention of the “elephant in the room”, which was the contingent liability standing at R40bn.
“This is almost completely made up of medico-legal claims against the department stemming from cerebral palsy cases.
“These claims will not all be successful, but [such claims] have resulted in huge annual payments to successful claimants, which have crippled the department,” Cowley said.
“Nothing was said about the R4.5bn in accruals and payables to service providers.
“This effectively reduces the new budget from R27.3bn to R22.8bn once these are settled.”
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