Counting the cost as patients return
● Private health-care groups Netcare and Mediclinic have seen an increase in patients returning to their facilities, a good sign after the businesses were hammered by the cost of preparing for Covid-19.
Jacques du Plessis, managing director of Netcare’s hospital division, said the preparations set the group back about R1bn — which has allowed it so far to treat 10,632 patients since the virus reached SA.
But for the business’s revenue that relies on 27% of its patients to be admitted for elective or planned medical procedures, the number of those coming in its doors — even if they needed treatment — has plummeted.
“The public are scared, even though it’s safer to go to hospital than your local supermarket,” Du Plessis said.
Stefan Smuts, chief clinical officer of Mediclinic Southern Africa, said planned medical surgery or treatments are — depending on the hospital and area — about 60% of its business. This figure has dropped dramatically during lockdown.
“Mediclinic has seen a huge reduction in patients,” he said. He declined to disclose how many Covid-19 patients the group’s hospitals have treated.
Both groups continued to offer elective surgery during lockdown, but those who did receive treatment were evaluated according to medical necessity.
Hip replacements that could possibly be postponed were, said Du Plessis, while other operations, such as those required for cancer treatment, were prioritised.
Mediclinic used the same process, said Smuts. “It is a balancing act,” he said, adding that elective surgery requiring intensivecare unit facilities is, if it is medically possible, delayed when there is a surge in Covid19 patients.
A spate of Covid-19 infections at some Netcare hospitals prompted their closure. In May, health authorities temporarily closed Netcare’s St Augustine’s Hospital after 119 people tested positive for Covid-19 and 15 died, while Kingsway Hospital was also temporarily closed for new admissions.
Despite the large reduction in patients, both groups had to plough money into ensuring their hospitals were safe.
Du Plessis said Netcare spent a lot on the increased requirement for more regular cleaning, as well as the increase in the cost of disposal of medical waste.
Included in the bill was the purchase of 45 robots that use ultraviolet light to sterilise surfaces. Each came with a R2m price tag.
Du Plessis said that along with the increased requirements in personal protective equipment, the procurement process not only saw a 30%-50% increase in the price of masks but also a decrease in quality.
This meant that masks that did not meet the N95 requirements, the quality specification required for masks in the medical field, had to be destroyed.
“Unfortunately, manufacturers have been unscrupulous,” he said — they had taken advantage of the limited stock available in SA, which relies on international imports for these products.
Smuts said Mediclinic benefited immensely from its international procurement department that services its clinics in Switzerland and the Middle East, but it too found masks of inferior quality being delivered. These were sent back for a full refund.
Both groups said staff costs consumed the largest chunk of their budgets.
“The cost of health-care workers had a significant impact on our budget,” said Smuts, with, for example, staff on leave while in self-isolation needing to be replaced. “Filling the gap added costs,” he said.
An estimated 2,000 of Netcare’s 18,000 health-care workers that were either at high risk of infection or infected with the virus required quarantine facilities, which were provided by the business, said Du Plessis.
But, he added, the highest cost was that “we’ve lost 13 nurses and seven doctors to the virus”.