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The Citizen
2 days ago
- Health
- The Citizen
‘I could die before surgery': Cancer patient lost in Gauteng hospitals backlog
Over 34 000 patients are waiting to undergo surgery in various Gauteng public hospitals. A man from Gauteng, who is suffering from skin cancer and living in pain, has been told he may have to wait up to eight months for surgery at the Charlotte Maxeke Johannesburg Academic Hospital. But he doesn't have eight months. He could be dead before then. There are probably many more like him who are low down on the waiting list for surgery at Gauteng's government hospitals and who may die before they are admitted to theatre. Thousands trapped in growing surgical backlog There are more than 34 000 patients waiting, said Gauteng health MEC Nomantu Nkomo-Ralehoko in a written reply to questions by the DA's shadow health MEC Jack Bloom in the Gauteng Legislature. The man has developed a lump on his cheek, making it difficult for him to eat and speak. Early this year, he was diagnosed with skin cancer known as squamous cell carcinoma which has the potential to spread all over the body if left untreated. He is one of the 3 315 patients who has been on the surgery waiting list at Charlotte Maxeke Johannesburg Academic Hospital. Patient faces starvation and suffocation risk 'The cancer has begun to spread to other body parts causing considerable pain and swelling,' said the patient in a statement. He was scheduled to have a feeding tube and stent inserted yesterday, but the appointment has been moved again to the following week. 'The hospital cannot perform the primary procedure due to a backlog of patients. The growth must be removed, along with reconstructive surgery on my jawline,' said the patient. 'We were told I might have to wait for another six to eight months.' Hospital resources stretched beyond limits Cancer Alliance director Salomé Meyer said the man was turned away from hospital yesterday morning. She said the patient requires a feeding tube and a stent to allow him to breathe and to eat. ALSO READ: Health minister defends nearly R10 million legal spend on NHI court battles 'If that is not emergency surgery then what is? He was told to come back next week as the surgeon is now attending another hospital. 'The hospital has only one operating theatre and one intensive care unit. Patients with trauma from car accidents or gunshot wounds take precedence. 'We are now actively seeking to raise funds to facilitate the removal of the growth before it spreads further and completely blocks his airways.' Meyer said the man first required emergency surgery but his surgery was cancelled. 'If he does not get this surgery as soon as possible, he will starve to death and possibly suffocate,' she said. Budget shortfalls and misused funds deepen crisis Meyer said in 2023-24, a portion of the R784 million that was made available for backlogs was also to be allocated to surgery, but 'we did not get any feedback from the department of health. What we know is that they did not use R250 million of the ringfenced cancer money and now are spending the remaining money on the cancer backlog for radiation,' she said. 'So where is the money for surgical backlogs? The problem is all of the affected hospitals have had staff cuts.' Meyer said it would not be surprising cancer patients were the majority requiring surgery as many of them can 'wait' as their operations are not regarded as emergency or life-saving. She added the budget cuts were affecting all the hospitals. 'Gauteng is particularly affected because of the backlogs. We need to realise that health in SA is in the emergency room – and we do not have blood, or even staff to attend to this crisis,' she said. Patients could wait years Nkomo-Ralehoko said the largest waiting list is 6 764 patients at the Steve Biko Hospital in Pretoria, followed by the Chris Hani Baragwanath Hospital in Soweto (6 232), Dr George Mukhari Hospital in GaRankuwa (5 354), and 3315 patients at the Charlotte Maxeke Hospital. ALSO READ: Gauteng hospital security bill soars to R2.54bn amid patient care crisis Bloom said: 'Furthermore, figures are only given for 17 out of 37 hospitals in Gauteng. 'Waiting times differ for certain types of surgery; for instance, it is only one to two months for a cataract removal at Leratong Hospital, but two years at the Mamelodi and Yusuf Dadoo hospitals. 'While patients at Kalafong Hospital in Atteridgeville wait five years for hip surgery. They will only wait three to six months at Dr George Mukhari Hospital.' He added: 'The MEC blames the long waiting times on the high turnover of patients to Gauteng and the burden of trauma that takes preference over elective cases. She also admits that load shedding and water shortages lead to cancellations and postponements of surgeries. 'In May last year, the MEC claimed that the surgical waiting lists had been reduced from 38 000 to 24 000, so this progress has been reversed. I estimate the real waiting list for all 37 hospitals is probably about 40 000 as the budget cuts and staffing shortages have worsened the situation.' Bloom said while surgical blitzes can temporarily bring the number down, the DA is pushing for effective use of the R66 billion budget to permanently reduce the waiting lists. Health department denies backlog as crisis escalates Gauteng department of health spokesperson Motalatale Modiba conceded there were 34 528 patients recorded on surgical waiting lists at public hospitals in the province, but denied there is a backlog. 'The waiting lists includes patients across key specialties such as cataract, general surgery, paediatrics and others. However, it is important to differentiate between surgical backlogs and waiting lists. 'The waiting list is a dynamic figure as it fluctuates as and when new patients are registered on the waiting list and when surgeries are performed – it is therefore a moving target.' ALSO READ: Mother accuses Mpumalanga hospital of sabotage in medical negligence case Other hospitals with long waiting lists
News24
08-05-2025
- Health
- News24
Forceful ruling in Gauteng cancer case has far-reaching implications
A new ruling against the Gauteng Department of Health makes use of a supervisory interdict. This sets a precedent for future cases, empowering courts to step in when government entities fail to fulfil their constitutional duties, write Helen Michael, Slade van Rooyen and Farah Yassin of Werksmans Attorneys. For more financial news, visit the News24 Business front page. In a decisive move that underscores the judiciary's role in safeguarding constitutional rights, the Gauteng Local Division of the High Court, Johannesburg, recently issued an urgent interim relief order against the Gauteng Department of Health (GDoH). This order, stemming from the case of Cancer Alliance v Member of Executive Council for Health Gauteng Province and Others, mandated the GDoH to immediately formulate and implement a plan to address the growing backlog in radiation oncology services at two of its key hospitals. This ruling isn't merely a legal decision; it's a stark reminder of the critical intersection between public administration, budgetary allocation, and the fundamental right to healthcare. The heart of the issue lay in the GDoH's apparent failure to utilise allocated funds effectively. In March 2023, the Gauteng Provincial Treasury earmarked R784 million to bolster surgical and radiation oncology services, with a significant R250 million specifically designated for outsourcing radiation oncology. Shockingly, these designated funds for outsourcing were not used and were eventually returned to the Treasury at the end of the fiscal year. This inaction became the focal point for Cancer Alliance, a collective of non-profit organisations and advocates who brought the matter to court. They argued that the GDoH's dereliction not only squandered allocated resources, but also directly violated several constitutional provisions. The case brought to the forefront critical constitutional sections that underpin the state's responsibility to its citizens. Section 7(2) mandates the state to protect and fulfil the rights enshrined in the Bill of Rights, while section 27 assures everyone the right to access healthcare services. Additionally, the argument hinged on section 33, which ensures just administrative action, and section 195(1), which outlines principles for efficient public administration, including the prudent use of resources. Cancer Alliance contended that the GDoH's inaction breached all these sections, leading to a severe crisis in cancer care. Forceful The court's judgment was forceful and unambiguous. It recognised the urgent need for intervention, noting the grave circumstances where patients were 'deprived of radiation oncological treatment for so long that repeated surgeries and repeated chemotherapy virtually became routine and early death at times became inevitable.' This observation drove home the devastating real-world impact of administrative delays and bureaucratic missteps. The judge found that the GDoH had unjustifiably ignored the patients' right to receive outsourced radiation oncology, especially when funds had been specifically allocated for that purpose. Furthermore, the GDoH had sidestepped attempts by Cancer Alliance to engage in discussions about the tender process and to follow established regulatory procedures. This lack of engagement was seen as a direct violation of section 195 of the Constitution, which emphasises accountability and transparency in public administration. Van Nieuwenhuizen AJ, who presided over the case, was particularly critical of the GDoH's lack of accountability. He highlighted the failure to maintain professional ethics, promote efficient use of resources, provide services impartially, and respond to patients' needs adequately. The court emphasised the gravity of the situation, noting that the patients on the backlog list were facing life-threatening illnesses. Without timely treatment, their health would inevitably deteriorate, potentially leading to premature deaths. This scenario, according to the court, constituted actual and ongoing irreparable harm, demanding immediate action. The GDoH's argument that the issues would be addressed in a future review application was dismissed as 'insensitive and dismissive' of the patients' suffering. Ultimately, the court held that a 'compelling need' existed to ensure the GDoH was held accountable. It found that officials within the department had essentially acted independently, failing to recognise their obligation to the public interest. To rectify this, the court issued a supervisory interdict, effectively forcing the GDoH to take concrete steps. Within 45 days, the department was ordered to update the backlog list of cancer patients awaiting radiation oncology. It was also mandated to take all necessary actions to provide these services at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital. Finally, the GDoH must submit a report within three months detailing the steps taken and outlining a long-term plan for providing radiation oncology services. This ruling has far-reaching implications. Firstly, it reinforces the state's undeniable constitutional obligation to provide access to healthcare. The judgment makes it clear that merely allocating funds is insufficient; the state must actively ensure those funds are used to deliver essential services. Secondly, it shines a light on the critical importance of accountability and transparency in public administration. The court's findings underscore that delays and inefficiencies in processes like tendering can have life-or-death consequences. Lastly, the use of a supervisory interdict sets a precedent for future cases. It empowers courts to step in when government entities fail to fulfil their constitutional duties, providing a powerful tool for ensuring compliance and safeguarding citizens' rights. Powerful reminder In conclusion, the Cancer Alliance case is more than just a legal victory; it's a powerful reminder of the human element in public service. It reasserts the vital role of the judiciary in ensuring that the state meets its constitutional obligations, particularly in areas as fundamental as healthcare. It stands as a crucial checkpoint for how public resources are managed and highlights that inaction has a cost – often a human one. The judgment underscores that administrative functions must be carried out with ethical integrity, transparency, and a steadfast commitment to the needs of the public they serve. This week, the Gauteng health department announced that it would appeal the ruling. Helen Michael is a director, while Slade van Rooyen and Farah Yassin are candidate attorneys at Werksmans Attorneys.
The Citizen
08-05-2025
- Health
- The Citizen
Gauteng Health to appeal judgment to clear Cancer treatment backlog
More than 3 000 cancer patients have been waiting up to three years for treatment. A blood donor donates blood at the Netcare Olivedale Hospital, 10 March 2022, at a special patient care day to celebrate cancer survivors and patients. Picture: Michel Bega The Gauteng Department of Health has welcomed a decision by the Johannesburg High Court granting it leave to appeal a judgment relating to the provision of radiation oncology services. In March, the Gauteng High Court in Johannesburg declared the province's health department's failure to provide radiation and oncology services to cancer patients 'unlawful and unconstitutional.' The court also ordered the Gauteng Health Department to take 'all steps necessary' to provide radiation oncology services to patients on the backlog list for treatment at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital. Appeal After the judgment, the department filed an application for leave to appeal the decision. Gauteng Health Department spokesperson Motalatale Modiba said they filed a notice of application for leave to appeal on 2 April 2025. 'The decision confirms that there are substantial legal grounds warranting further judicial consideration on several critical aspects of the case. ALSO READ: Court orders Gauteng Health to clear radiation oncology backlog at public hospitals 'The Department will now proceed with the appeal process to ensure that the issues raised in the judgment are comprehensively assessed and clarified,' Modiba said. Cancer Alliance The Cancer Alliance, represented by advocacy group Section 27, filed an application in the High Court in Johannesburg against the Gauteng health department for allegedly failing to spend R784 million allocated by the Gauteng Treasury in 2023. The radiation and other surgical backlogs showed that about 3 000 cancer patients were awaiting cancer treatment, some for more than three years. Judgement In the judgment, Acting Judge Stephen van Nieuwenhuizen noted that the constitutional rights of patients on the radiation oncology backlog list had been 'trampled upon' by the Gauteng Health Department. Nieuwenhuizen said this was because the ring-fenced funds specifically intended for patients and made available in April 2023 were lost due to the department's failure to outsource the radiation oncology service and spend such funds urgently before the annual obligation to return funds to Treasury came up. ALSO READ: Gauteng cancer patients battle illness and broken system amid R784m funding dispute
