Adam Habib. Picture: AFP
Adam Habib. Picture: AFP

Wits vice-chancellor Adam Habib has challenged Gauteng premier David Makhura’s call for the health department to finance the province’s debt-ridden teaching hospitals, saying centralising their funding without fixing their deep-seated administrative and governance challenges won’t give patients a better deal.

Gauteng is home to four of SA’s 10 central hospitals, which provide specialised care for complicated cases and train healthcare professionals in partnership with university-based medical schools, including Wits. These four facilities — Charlotte Makexe, Steve Biko, Chris Hani Baragwanath and Dr George Mukhari — are grappling with growing waiting lists, staff and equipment shortages, and poor working conditions.

“The whole system needs to be fixed,” said Habib.

In an interview with Business Day on Wednesday night, he said centralising the funding of the four central hospitals will not solve their managerial weaknesses. Nor will it resolve the long-standing tension created by the “joint appointment” of clinical staff, who are jointly employed by the provincial health department and universities.

A joint appointment requires a clinician to dedicate a set amount of their time to training and research at a university, and the rest providing clinical services at a hospital. Wits has 2,500 staff members, who are jointly appointed to its faculty of health sciences and public hospitals, including Charlotte Maxeke and Chris Hani Baragwanath.

Habib was responding to a statement issued by Makhura on Tuesday in which he called on the national health department to finance these hospitals directly, saying that they were under-funded for their role and collectively owed R1.4bn to suppliers. The central hospitals receive ring-fenced conditional grants that are overseen by the national health department, as well as an allocation from the provincial health budget.

He said central hospitals should be overseen by an independent board, which would appoint the CEO, and the facilities should employ clinicians directly. At present, hospital CEOs are appointed by the provincial health department.

Effective distance

An arms-length relationship between the hospital board and the provincial health department would limit political interference, and clinicians could be managed more effectively if they served one master rather than two, habib said. “Hospital CEOs see a clinicians job as to treat, the university sees it as training.” 

Questions posed by the DA’s Jack Bloom in the provincial legislature over the past few months have revealed that prostate cancer patients face a three-year wait for treatment at Charlotte Maxeke, and more than 6,000 patients at Chris Hani Baragwanath have been waiting more than six months for surgery. Those waiting for hip or knee surgery at Chris Hani Baragwanath can expect to wait up to five years.

On Thursday, Bloom issued a statement saying none of the hospitals in the province comply with the standards set out in the Occupational Health and Safety Act, and that Dr George Mukhari hospital is among the worst offenders.

“I am dismayed that occupational safety has been so neglected at Gauteng hospitals and clinics, endangering staff and patients. We were lucky that no lives were lost when there was a fire at the Bheki Mlangeni Hospital earlier this year, but safety measures need to be stepped up at all hospitals.

“It highlights once again how grossly unprepared the provincial health department is for the planned National Health Insurance (NHI) which requires properly accredited high quality health facilities.”