Crisis at Joburg hospital cancer unit puts lives at risk

31 May 2021

The cancer unit at Charlotte Maxeke Johannesburg Hospital (CMJH) is short of 71 staff, has frequent chemotherapy drugs out of stock, and has broken and out-of-date radiation machines.

This is revealed by Gauteng Health MEC Nomathemba Mokgethi in a written reply to my questions in the Gauteng Legislature.

It shows the dire situation for 1300 cancer patients even before the recent fire at the hospital closed the unit and made things even worse for them.

According to Mokgethi, the unit needs 175 staff to provide a proper service, but has only 104 staff. The shortages include the following:

16 Specialist oncologists
15 Radiation Therapists
9 Specialists in training
9 Medical Physics Interns
6 Registered Nurses
5 Staff Nurses
3 Oncology trained pharmacists
2 Medical Registrars
2 Medical Officers

The problems at Medical Oncology include:

- recurrent chemotherapy drug shortages delaying patient treatments.

- insufficient number of nursing staff for inpatient volume which falls below the international recommended 1 to 4 nurse to patient ratio.

- insufficient nursing staff for volume of infusions in the outpatient unit.

At Radiation Oncology there are:

insufficient number of linear accelerators for patient volume.

50% of equipment is old and needs replacing, causing regular breakdowns and treatment delays.

two cobalt units have not been working for two years. These need to be replaced with two small linear accelerators.

a brachytherapy unit and a north voltage unit have been broken since March this year.

The worst waiting list is for prostate cancer patients - 700 patients are on hormonal therapy and will wait from 3 to 5 years for radiotherapy.

The recurrent chemotherapy drug shortages lead to delays or switching of treatment midway, which results in “suboptimal response rates” and impacts on the overall survival of patients.

Insufficient nursing staff below the internationally recommended 1 to 4 nurse to patient ratio “increases the risk of administration errors which can result in poorer outcomes, fatalities and treatment delays.”

The lack of cutting-edge technology such as an MRI-Linear accelerator means that patients with tumours such as pancreatic cancers are not getting optimal radiotherapy.

Efforts are being made to resolve a salary dispute which is causing Radiotherapists to leave, taking valuable intellectual capital with them.

All these problems predated the closure of the cancer unit after the fire six weeks ago. The alternative arrangements to treat cancer patients at the Chris Hani Baragwanath and Steve Biko hospitals are woefully inadequate, and the treatment delays are getting worse.

The one ray of light is that there are discussions with the Netcare Hospital Group who are putting together a Private Public Partnership for cancer treatment.

This proposal should be speeded up, as well the reopening of the CMJH unit with extra staff and new machines.

Issued by Jack Bloom, DA Gauteng Shadow MEC for Health, 31 May 2021