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Mediclinic News : Revealed: SA's health crisis

Title

Revealed: SA's health crisis

Date

2016-11-25

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News Description

BUSINESS DAY Previously unpublished government records paint a grim picture of a failing public health system, a worrying lack of disclosure about its shortcomings, and an oversight mechanism that has done little to raise standards. Data obtained from the Office of Health Standards Compliance (OHSC), based on inspections it conducted in the four years to March 31 2016, show that only 89 of the 1,427 public hospitals and clinics had met the office’s 70% pass mark. And of the 320 facilities that were subjected to repeat inspections, the vast majority failed to improve in any significant way between visits. The office used 13 metrics, ranging from the availability of medicines to operational management, to rank the facilities, and each of those comprised several components that were weighted according to the gravity of the threat they posed to patient safety. Umhlanga Clinic in KwaZulu-Natal, which scored just 18% when it was inspected in 2014 and failed to meet the 70% compliance threshold for a single metric, fared worst in the rankings. Hundreds of other clinics fared little better. While the data clearly highlights a crisis, it also contains a number of anomalies. Only two of the 149 clinics evaluated by the OHSC in the Western Cape, generally considered to have a well-run health administration, scored 70% or more in the most recent inspection. In Tshwane, 16 of 47 clinics made the grade. Steve Biko Hospital in Gauteng was the top-ranked facility, scoring 96%. However, the DA’s Jack Bloom recently highlighted complaints about the state of its casualty department and outstanding repairs. The OHSC data also appear to be out of kilter with the provincial variations in maternal mortality rates — a proxy indicator for how well a health system is functioning and closely monitored by the government. Business Day calculated a weighted average for the hospital scores in each province, using bed numbers. Gauteng, North West and KwaZulu-Natal get virtually the same weighted average quality scores for their hospitals (72.23, 73.57 and 71.25 respectively) as the Western Cape’s (74.52), yet their maternal mortality ratios are much higher at 141, 179 and 185 per 100,000 live births respectively than the Western Cape’s 77 per 100,000 live births. Until now, details of the OHSC’s investigations have been kept under wraps, impeding efforts to hold facilities and provincial health departments to account. The lack of disclosure has also made it impossible to gauge whether the office is doing its job effectively, or ascertain whether patients are likely to get quality care. The OHSC’s failure to publish its findings is perplexing given that it lacks the legal muscle to enforce standards: in March it complained to Parliament that it could not take action against hospitals and clinics because regulations giving it the power to do so were still in the pipeline. Business Day accessed the OHSC’s high-level inspection data using the Promotion of Access to Information Act (PAIA) after the body repeatedly rebuffed requests for information. And then it relinquished the bare minimum — only the final scores — and declined to answer follow-up questions or respond to a request for more details. A second PAIA application was filed to obtain the 13 composite scores. Despite agreeing to this second application, the OHSC provided an incomplete data set, omitting component scores for the 2015-16 fiscal year despite having given a written undertaking to do so.
Created at 2016/11/29 10:40 AM by Mediclinic
Last modified at 2016/11/29 10:40 AM by Mediclinic