PE Hospital Turmoil: CEO Leaves, Nurses Snore in Patient Beds
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IZINDABA PE hospital turmoil: CEO leaves, nurses snore in patient beds Longstanding critical staff shortages in her post. The probe findings, which would no replacement of Medical officer posts that the maternity unit at Port Elizabeth’s Dora lead either to her return to her post or the have been vacated in order for them to take Nginza Hospital came to a head in mid- continuation of her temporary replacement, up funded registrar posts – this has placed February with a 3-day nurses’ strike, the Dr Bawinile Ndlovu, were due at the unbearable strain in the system.’ Pepeta went enforced departure of the CEO, and nearly end of February. All the worker unions on to cite post-community service officers burnt-out doctors being prevented from involved (the National Education, Health who wanted to remain in the hospital doing ward rounds by strikers. and Allied Workers’ Union (NEHAWU), complex not being absorbed. Official documents in the possession the Health & Other Services Personnel of Izindaba reveal doctor allegations of Trade Union of South Africa (HOSPERSA) Hospital accreditation in leadership autocracy, major staff shortages, and the Democratic Nursing Organisation danger, chief warns non-appointment of consultants to available of South Africa (DENOSA)) called for Pepeta warned that with a Health Prof- posts, outstanding overtime payments, lack of Quangule’s sacking after a high-level essions Council of South Africa training academic support and burn-out. Combined, Bisho delegation and a local parliamentary accreditation inspection due in Feb ruary, the doctors claim, these conditions have led portfolio committee visited the hospital, several departments, including cardio- to patient care being compromised, which promising to rectify matters with a detailed thoracic surgery, obstetrics and gynaecology was aggravated by the nurses’ strike from 10 plan of action. Quangule was then advised and psychiatry, stood to lose their training to 12 February. At least one pregnant woman to stay away for her own safety. status. He expressed shock at the ‘ongoing died during the strike, although Izindaba notion by the provincial leadership’ that could not establish whether or not this specialist numbers were sufficient, when was due to strike-compromised care. Eight Factors contributing to the in fact they were worse than the doctor- doctors per shift were covering a 60-bed hospital crisis included the population ratios of several low-income antenatal ward, a 70-bed postnatal ward, inefficient use of staff and a African countries. One estimate puts the a 43-bed gynaecological ward, an 18-bed recent major growth in services. Eastern Cape doctor/patient ratio at one high-care unit, a 9-bed labour ward, a 4-bed The latter was prompted by a doctor per 10 000 people (ten times less observation ward and a teeming outpatient new system decanting patients than the World Bank prescription of 1/1 000 clinic – around the clock. The unresolved from other districts to Dora people). Speaking to Izindaba, a spokesman issues led to major differences between the Nginza Hospital before a for the provincial health department, Siyanda maternity unit chief Dr Mfundo Mabenge, Manana, denied that any moratorium on a member of the National Committee for new staffing plan could be filling posts existed, saying the procedure the Confidential Enquiries into Maternal implemented. was to identify a critical post and then Deaths (the ‘Saving Mothers, Saving Babies’ write a motivation to the Cost Containment committee), and his CEO, Dr Nthombi Committee, which sat weekly. He stressed Quangule. These came to a head, said Izindaba doctor sources said the stalled that the post needed already to have had Izindaba sources in both Bisho (the provincial appointment of senior doctors in the obstet- funding allocated to it. The CEO, Quangule, health department head office) and at the rics and gynaecology unit was leading to could not be blamed for this, he added. hospital, when Quangule sent an ambulance senior doctors being overburdened because Factors contributing to the hospital crisis to fetch Mabenge from his home after he they had to perform all the caesarean included the inefficient use of staff and a took a few days off to relieve burn-out. sections (junior doctors may not operate recent major growth in services. The latter independently). On average, 800 babies are was prompted by a new system decanting Surprise visit catches born at the hospital each month. The doctors patients from other districts to Dora Nginza nurses asleep in ward said that plans for training, and better Hospital before a new staffing plan could beds equipment at clinic level, were abandoned be implemented. Everything possible would Then, just days before the strike, Quangule, owing to budget constraints. Izindaba is in be done to retain longstanding and highly in an unannounced late-night medical ward possession of a letter, dated 4 January 2015, valued staff, he added. inspection, surprised eight nurses – the from Dr Lungile Pepeta, paediatrics chief at Union spokespersons declined to com- entire complement for the ward – asleep Dora Nginza Hospital, and addressed to the ment until the probe and disciplinary hear- in unoccupied patient beds. A disciplinary entire provincial health leadership. In it he ing were completed. hearing was pending at the time of going said that the Port Elizabeth Hospital Complex to print, Bisho confirmed. The Eastern was being prevented from replacing medical Chris Bateman Cape health department also began a probe staff who had left the department during [email protected] into Quangule’s ‘autocratic’ behaviour the previous 3 months. ‘The department has and her alleged lack of response to doctor issued circulars stating that the appointment S Afr Med J 2016;106(4):320. complaints, temporarily relieving her of of staff will be centralised and that there will DOI:10.7196/SAMJ.2016.v106i4.10763 320 April 2016, Vol. 106, No. 4.