EXCLUSIVE ONLINE: Doctors’ first-hand account of the conditions at Standerton Hospital

The conditions at the Standerton Hospital from a patient’s point of view have been extensively covered to find out how the land lies, without input from doctors and health professionals.

READ SOME OF THE ARTICLES HERE:

1. Nurse at Standerton Hospital allegedly asleep while family has to struggle
2. Family scrutinize hospital over poor service rendered
3. Standerton Hospital in dire condition
4. Patients share their dissatisfaction after incidents at Standerton Hospital

The Standerton Advertiser published experiences of patients and family members in their 17 February, 10 March and 7 April editions.

The Department of Health only replied to the enquiries in one instance.

Doctors’ account of conditions at Standerton Hospital

Dr Nikola Batev, a surgeon, subsequently sent an e-mail, highlighting conditions at the institution.

He has been using services at the provincial hospital since 1991, acting as Principal Medical Officer, Chief Medical Officer and Medical Superintendent, or in today’s terminology, Medical Manager, up to 2004.

Dr Batev compared services from that time up to today, taking into account all the efforts from employees, and concluded that a deterioration of services and dilapidation of the facility itself were noticeable.

He referred to the South African Service Excellence Award for Medical Services Delivery that was awarded to the facility in 2002, boasting a well-trained and committed staff and management team.

According to him, the building today bears the grim reflection of economical degradation, collapse and decay countrywide, voicing his discomfort with the lack of ability and interest of the hospital management and staff in addressing and resolving some problems within their power.

He mentioned conditions in the two ill-equipped operating theatres comparing it to five well-equipped theatres 20 years ago.

The construction of the new hospital building is touched on where existing threatres were knocked down and some were converted into store rooms.

“Those two remaining theatre units are the heart of the hospital and main engine of the performance and treatment outcomes,” he said.

“All treatment values and consequences depend on the service quality in theatres”.

Dr Batev acknowledged the ongoing effort to fix some of the issues in the operating theatres.

A major water/rain leakage from the ceilings in the theatres was attended to although it took seven months to complete and both theatres were closed during that time.

The roof however, is still leaking.

The central air-conditioning system’s temperature varies daily from too hot to freezing.

According to him, both conditions can be a major health risk.

The autoclaves often do not work and theatres run out of sterile equipment such as linen and instruments.

Surgical instruments are well-outdated and orthopaedic supplies and accessories are non-existent with a lack of screws and plates, k-wires and Küntcher nails.

Drills are blunt and new ones have to be ordered.

He repeatedly requested more materials, screws, plates and drills and doctors sometimes run out of scrubbing material and have to buy their own for their patients.

The majority of orthopaedic trauma patients have to be transferred, which significantly reduces the income of the hospital and reduces the gaining of experience of young colleagues.

Theatre lights in theatre 2 were installed in 1974 and satellite light have not been working for 11 years and half of the bulbs of the main unit are blown and cannot be replaced due to some electrical faults, namely rotten cables in the ceiling.

According to him, these lights have been declared non-repairable by the electrician.

Theatre lights in theatre 1 were installed a few years ago and malfunction frequently due to the lack of maintenance or occasionally stolen UPSs in the ceiling.

Theatre tables were installed in 1974.

Table covers are worn, the unit is unstable, cushions are torn and the majority of accessories are either missing, thrown away or broken.

Showers in the doctors’ dressing room have not been operational for 15 years and are used presently as a storage area.

Even the toilet seat has been broken for few months now.

There is a lack of sterile linen and theatre uniforms and complaints have been raised recently about anaesthetic machines’ faults.

Dr Batev is of the opinion that the only reason why private practitioners use the hospital theatre is because Standerton does not have a private health institution.

Dr Eric Louw, a family health practitioner, was prepared to talk to the Standerton Advertiser, accentuating the difference between a surgeon and general health practitioner where the latter covers the health spectrum widely.

He said the anaesthetic machines are of a top quality and a new machine was bought.

Dr Louw was in agreement with Dr Batev about the regulation of the air-conditioning and mentioned a recent occurrence of blunt scissors.

He also agreed about the leaking ceiling, but had the proviso that you should decide by which standards the hospital is measured.

The gas used for the anaesthetic machines is similar to those used at the Mediclinic in Trichardt and soap for scrubbing purposes is always available.

He agreed with Dr Batev on linen presenting problems.

According to him, there were three theatres in the hospital all the years, two sterile ones and one septic, where septic cases such as abscess drainage were done.

Only the septic theatre was closed.

The new Berchtold theatre light has been completely repaired and the main light in theatre 2 is working with only the small additional light not working.

Dr Louw suggested that stakeholders, ranging from hospital management, political parties, community members and doctors engage in a meaningful discussion on how to solve the problems with the patient’s accessibility to health care first and foremost.

Former manager of nursing services’ views on effective management:

Ms Marie Coetzee, a former Manager of Nursing Services at the Standerton Hospital for about 10 years, agreed to share her views on effective management.

• Good management practices are expected to translate into improved service delivery, efficiency and effectiveness.
• Hospital management systems are built from many parts and must be coordinated to achieve functionality.
• Processes and procedures are very important in a hospital managerial system such as policy structure, decision points, resource allocation and accountability. Schedules for activities must be completed as auditing tools to implement corrective actions and create an upward spiral of continuous improvement.
• Management style is also of utmost importance because a manager must be able to share the vision and mission of the hospital through effective communication, involvement, participation, consultation and integrity.
• A manager should inspire and lead the junior staff by example which would lead to employee satisfaction and create a family-friendly workplace where the community and patients feel at home.
• Efficient management of hospitals requires responsible and effective use of funds, professional management and competent staff members.
• Decisions that foster the highest standards of patient care should be taken.
• Elements such as patients’ access to services, reliability and quality care must be considered as a high priority.