KZN Legislature Health oversight inspections reveal province is facing an EMS crisis

Issued by Dr Rishigen Viranna, MPL – DA KZN Spokesperson on Health
17 Oct 2019 in Press Statements

A looming Emergency Medical Services (EMS) crisis has been identified by the Democratic Alliance (DA) as the biggest issue facing the province following this week’s KwaZulu-Natal Legislature Health Institutions Functionality Monitoring Programme.

While the issues uncovered are primarily infrastructure and budget related they also include mismanagement of medical waste – with a toddler seen playing with a medical waste disposal bin at the Port Edward clinic – an asbestos roof at Gingindlovu clinic, a dirty pit toilet for members of the public at Makhowe Clinic in Big 5 and several instances where air-conditioning is not working, leading to cross infection.

While these are all serious problems, it is the EMS situation in our province that the DA regards as most alarming.

Almost everywhere we went, massive challenges were found in this area while the previously publicised ambulance roll-out was clearly just to replace existing ambulances rather than putting new ones on the road. Some of the challenges include;

  • In uMgungundlovu only 16 out of 24 ambulances are currently in working order to serve a population of 1.1million people
  • In Ilembe only eight out of a total of 28 ambulances are available to serve 700 000 people. This while there are also insufficient staff to manage all the vehicles
  • At Empangeni EMS officials reported a severe shortage of ambulances for the entire King Cetshwayo area with no proper bases for crews in areas including Nkandla, as well as a serious shortage of advanced life support paramedics
  • The Makhowe Clinic in the Big 5 Municipality also reported poor ambulance response times and related staff shortages and;
  • The Dundee EMS is in a disastrous state, with a severe shortage of vehicles as many are broken down

These shocking statistics come against a national norm requirement of one ambulance per 10 000 people. In light of the province’s shocking shortfall, the DA has proposed the following;

  • SCM processes to renew vehicles every two years due to massive mileage
  • The decentralisation of maintenance contracts to district offices to ensure that long repair waiting times are reduced
  • Additional effort towards recruitment and training of paramedics and staffing and;
  • A functional computer record system for calls which must be swiftly sent through to ambulances.

There can be little doubt that a major contributory factor towards many of the challenges encountered by the DA lies with the Department’s complete inability to manage its own expenditure. This was made crystal clear during this week’s Scopa hearing during which it was announced that the KZN DoH has incurred R4billion in irregular expenditure for 2018/19 – the second highest in the entire country.

This is money that could have been used to buy more ambulances, repair others and employ more emergency and other medical professional staff.  Staff shortages were witnessed at almost every facility while at the Turton Community Health Centre in Umzumbe Municipality, the DA found four doctors, despite the nine required. Despite having advertised for the posts twice, nobody appears to be applying.

Many of the staff that the DA spoke to are also working under extreme pressure under dreadful circumstances. Then there are the patients who must suffer further as a result of a health system which does not work.

The DA has already referred KZN’s EMS crisis to the South African Human Rights Commission (SAHRC) for investigation. We will now submit a supplementary letter with these shocking findings.

All life is precious and especially in an emergency, ambulances and response times are a matter of ‘life and death’. The DA will continue fighting for a professional, well-equipped and properly staffed Emergency Medical Services for all KZN residents.