Patients paramount

MEMBERS of South Africa’s health care profession – although deeply saddened by Esidimeni – were not universally surprised that it happened.

Our nurses, doctors and allied medical professionals are often witnesses in the course of their work to examples of insufficient capacity, poor management, unilateral implementation of dire cost-saving measures and deep power imbalances. This is as true in the public as it is in the private sector.

The most obvious Esidimeni lesson for South Africa’s healthcare practitioners is this: patient well-being is our responsibility, and our responsibility to patient well-being must be paramount.

Here’s another lesson from Esidimeni: the powerful and senior people from whom instructions come are almost always absent when it’s time to account for the consequences of those instructions. We saw time and time again at the Esidimeni hearings that practitioners faced Justice Dikgang Moseneke alone.

Perhaps, in time, some person or some entity will be held to account for the Esidimeni tragedy. However, this much is clear: in this particular case there was insufficient regulatory oversight to prevent what happened there.

We are now in an age of healthcare in South Africa when medical professionals must – through the societies that represent them, and individually – voice their concerns when patient care is compromised.

Not only this, they need to put pressure on managers and authorities when they see that decisions or instructions compromise patient care.

Such decisions could be a unilateral decision to cut costs as was the case of Esidimeni. But they could also be budget cuts for upskilling and recruitment; dwindling investment for equipment and infrastructure; excessive and exhausting workloads; or drug shortages.

While there is still much that’s good in South Africa’s healthcare sector, there are areas where healthcare is inefficient, ineffective and potentially dangerous.

Skilled, qualified and practising members of the healthcare profession must fight to make sure that whatever steps are taken in the sector are not unethical, unsafe or unfair.

We must, especially, guard jealously that these steps in no way put patients in harm’s way. Failing to do so makes another Esidimeni inevitable.