Why state medical facilities may be bad for your health
MOST South African state clinics and hospitals flunked their compliance exams and fail to meet even the most basic healthcare standards.
Some facilities were keeping expired medication on their shelves — putting patients’ health at risk — and some stored medicine alongside food in fridges.
In other cases, blood was being drawn into expired test tubes, which could alter test results. Hygiene and infection control standards were being ignored; in one case patients drew water by hand from a bucket and shared it from one cup.
These are among the most damning findings in a report by healthcare compliance watchdog the Office of Health Standards Compliance.
Between 2012 and March 2016 the OHSC conducted 1 887 inspections at 1 500 healthcare facilities across South Africa, and the findings were released two weeks ago.
Just under 40% of the country’s 3 816 health facilities were inspected.
Only 39 of the 1 887 inspections yielded scores above 80%, the minimum for “excellent” compliance. This translates to just 2% of the country’s healthcare facilities. The Eastern Cape, Limpopo, Mpumalanga and Northern Cape had not a single “excellent” facility.
At the bottom of the scale, the study found that 660 inspections (34.9%) returned results of 39% or lower — with facilities being graded “F” and labelled “critically noncompliant”.
The Department of Health acknowledged that the findings showed the state sector had “a lot of work to do to get all our facilities to meet the standards that have been set”.
OHSC board chairman Professor Lizo Mazwai said the findings were based on broad categories, including the state of the facilities’ infrastructure, governance and management of the facilities, supplies of medicine and equipment, general hygiene and patient satisfaction.
The Treatment Action Campaign and public-interest law centre Section27 say the findings accurately reflect what they have seen. “This new report confirms a lot of things we have been picking up on the ground. It’s pretty compelling evidence there is widespread dysfunction in our health system,” said TAC head of policy Marcus Low.
Section27 attorney Sasha Stevenson said the findings confirmed “that many health facilities fail to comply with quality standards, leaving patients without the access to healthcare services that are their right”.
Mazwai referred to the Holy Cross Hospital in the Eastern Cape, which was red-flagged by the OHSC. After intervention by the health department following civil society pressure, a subsequent inspection found vastly improved conditions. He said this success could be replicated — with dedicated leadership.
OHSC CEO Bafana Msibi said the problems were widespread and affected all types of healthcare facilities, from clinics to academic hospitals.
He said Limpopo was a particular worry. In the 219 inspections in the province, 143 facilities scored an “F”, 51 an “E”, 14 a “D”, 10 a “C” and one scored a “B”. Not a single inspection returned a score above 80%.
“The bulk [of facilities] in Limpopo were graded E and F, a really worrying trend.”
Msibi said there were a number of facilities, including those in deep rural areas, that excelled — proving that the standards could be met.
“It’s not all bad. There are weaknesses, but it’s easy to fix those weaknesses because, really, our standards are basic.”
Health department spokesman Joe Maila said the findings would be thoroughly assessed and used to improve national healthcare.
It’s pretty compelling evidence there is widespread dysfunction in health system