31 January 2013

South Africa: Report On Baby Deaths Released

It has been a bad start to the year for the department of health in Limpopo. Earlier this week four babies died at Limpopo's hospital, George Masebe. ... ( Resource: SA Health Ministry Revising Public Healthcare Doctor Ratio )

Pretoria — The death of four babies at the George Masebe Hospital in Limpopo was not due to a shortage of doctors at the hospital, but a shortage of personnel on duty at the time of the deaths.

This was revealed in a report by the task team appointed by Health Minister Dr Aaron Motsoaledi to investigate the circumstances surrounding the deaths of the children at the hospital on 4 January 2013.

Motsoaledi presented the report in Pretoria on Thursday, which highlighted that the claims of a shortage of doctors were incorrect.

According to the report, the critical factor underlying the deaths of the four children was the inadequate control of and unprofessional conduct by members of the medical staff in the hospital, resulting in poor clinical care.

"Review data indicates that a staff complement of 10 doctors is sufficient for the hospital. There is no shortage of medical staff in the hospital but there was a shortage of personnel on duty at the time of these deaths.

"This shortage was due to the poor management and control of existing staff and the unprofessional conduct of many of the doctors employed in the hospital," the report revealed.

George Masebe Hospital is one of the seven district hospitals in the Waterberg District of Limpopo, with a population of 677 477, including 78 069 children below the age of five.

The hospital has 10 full time and seven sessional doctors, who are supported by 197 nurses and a full spectrum of allied health professionals.

One full time doctor is allocated to each ward, three to the outpatient department and one to the wellness clinic, which oversees the care of HIV infected individuals.

Two doctors are on call after hours, with the first call covering casualty and the wards, and the second call assisting with theatre or if the workload is too heavy for the first call alone.

The sessional doctors assist with the afterhours cover over a weekend, which means that the full time staff do an average of four calls a month, including one for two first calls.

"Although there is an attendance register for doctors, they do not sign in or out. Nursing staff in the wards report that general doctors report on duty at 9am and depart when all patients have been seen.

"Leave is not well managed and there is little planning around leave as doctors hand in leave forms the day before [it] is due to start and depart before the leave is recommended by the senor clinical manager even approved," the task team discovered during the investigation.

It further noted that whilst the infrastructure in all the three components of the hospital where the children died is poor and needs to be corrected, this was a secondary concern as it did not appear to have contributed to the deaths.

The report recommended that the acting CEO, who has been acting for over two years, should be relieved of her responsibilities and a permanent CEO with suitable qualifications and skills be appointed as a matter of urgency.

The CEO was moved following complaints from organised labour that she was too strict.

"Patient reviews and staff development activities, such as the continuing professional development of medical staff, suggest that the management was more functional prior to December 2012."

Motsoaledi, who visited the hospital on Wednesday, said he would reserve his observations until a more appropriate time.

He, however, said that he had submitted the list of doctors who acted unethically to the Health Professions Council of South Africa and all responsible staff members would undergo a disciplinary hearing.

Motsoaledi noted that as government, they would try their best to implement the recommendations of the report, especially those that point to the weakness in the overall healthcare system, such as the provision of equipment and infrastructure. This would be done despite the report having clearly stated that the deaths of the babies were not a direct result of these particular factors.

"It is important that we do so as part of goal four of the negotiated service delivery agreement, which states that we must improve the effectiveness and efficiency of the healthcare system," he said.

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