‘I could die before surgery’: Cancer patient lost in Gauteng hospitals backlog

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.

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“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.

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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.”

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Other hospitals with long waiting lists

• Sebokeng Hospital – 2 870 patients;
• Helen Joseph Hospital – 2 623 patients;
• Mamelodi Hospital – 2 016 patients;
• Kalafong Hospital – 1 861 patients;
• Tembisa Hospital – 1 404 patients;
• Leratong Hospital – 762 patients; and
• Thelle Mogoerane Hospital – 502 patients.