Gauteng Finance MEC Jacob Mamabolo announced on Thursday that the provincial treasury had allocated R784-million to the Gauteng Department of Health to address the backlog in surgical and radiation oncology services.

Delivering his budget speech in the Gauteng legislature in Johannesburg, Mamabolo explained that the backlogs were caused by shortages in both personnel and equipment, and the knock-on effect of the pandemic that stretched the capacity of the provincial health system. 

“In efforts to clear the backlog, Gauteng provincial treasury and Gauteng Department of Health have worked with civil society organisations, SECTION27 and Cancer Alliance, in an approach which involves the procurement of the necessary machinery and equipment needed for radiation therapy to assist the patients on the waiting list, particularly given that the nature of the disease requires urgency,” he said. 

“This collaborative approach with civil society in addressing the crisis is expected to address the waiting lists, and I anticipate this time next year we will be outlining the resolution to this challenge,” he added. 

‘An immediate humanitarian crisis’

Salomé Meyer, project manager of the Cancer Alliance’s Access to Medicine campaign, says the decision by the Gauteng treasury is extremely helpful.

“It’s dealing with an immediate humanitarian crisis… we’ve been working tirelessly for two-and-a-half years to get the Gauteng Health Department to understand that this is a humanitarian crisis,” she said.

Read more in Daily Maverick: “Dear MEC Nomathemba Mokgethi, you must address Gauteng’s cancer treatment crisis” 

The backlogs reportedly developed as a result of bad management in terms of equipment and staffing. 

At Charlotte Maxeke Johannesburg Academic Hospital, there is a desperate need for new equipment.

“They do not have enough Linac machines (linear accelerator) to treat patients, and this has been highlighted for many years,” said Meyer. The facility also has equipment that has become obsolete over the years and was never replaced.

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“This hasn’t been done for many years, to the extent that we’ve got a waiting list of more than 3,000 patients,” she said.

The waiting list grows daily as new patients are added to the list.

“If you don’t have machines, and you have a staff shortage, you can’t do anything, you can’t treat your patients,” she explained. 

Read more in Daily Maverick: “Stark realities face cancer patients at Charlotte Maxeke Hospital despite glimmer of hope reopening brings” 

The Cancer Alliance will now work with the provincial treasury to implement the project.

“We will have to monitor it very closely to make sure that we achieve the objectives of this project, and to ensure that we don’t run into similar problems at a later stage,” said Meyer.

Meyer hopes this project will lead to longer-term strategies to address the crisis.

“The other advantage is that this is setting a precedent to engage with other provinces that are having similar problems with regard to oncology services, that are just not getting the required attention.”

It’s predicted that there will be 160,000 cancer cases a year in South Africa by 2030.

Read more in Daily Maverick: “The cost and burden of cancer: Report gives a wake-up call to avert healthcare crisis”

A welcome ‘band-aid’ 

Khanyisa Mapipa, an attorney at SECTION27, welcomed the financial allocation and explained that this had not been an adversarial process, but rather one aimed at finding a solution to a problem that had existed for some time. 

In November 2021, SECTION27, along with the Treatment Action Campaign and the Cancer Alliance, brought specific problems relating to radiation oncology at Charlotte Maxeke Hospital to the attention of the Gauteng Department of Health. 

In March 2022, the health department established a cancer crisis task team to advise the head of the department on the treatment of cancer patients in the province; oversee concerns related to the Occupation Specific Dispensation of radiation oncology personnel, and advise on the procurement processes for cancer-related equipment. 

The task team considered various solutions, including further triage, rental of radiation machines, the appointment of additional personnel, operating the functional machines over time, and outsourcing radiation oncology services. However, each of those solutions had its own difficulties.

“We ended up agreeing that the proposed solution of outsourcing these services is probably the most feasible one, would be the most immediate, and could be a temporary solution while they get their affairs in order as the Department of Health and procure the equipment that they require, build the bunkers for that equipment, and sort out their personnel issues,” she said.

Mapipa noted that this was a temporary fix, but nevertheless a welcome one: 

“This is temporary… it is almost like a band-aid, but it’s a very good band-aid because services aren’t halted as they previously have been while we get the system ready.” DM/MC