Gauteng Faces Severe Strain in Cancer Care as Hospitals Struggle with Overcapacity

The report also identified significant human resource challenges, with outdated staffing models failing to meet the growing demands of Gauteng's population.

Gauteng, home to over 15 million residents, is grappling with a growing cancer care crisis as central hospitals operate far beyond their intended capacity, struggling to provide adequate healthcare services. These findings were revealed in a detailed report from the Health and Wellness Portfolio Committee, which conducted a comprehensive assessment of oncology services in the province.

The study, led by a multi-party team of lawmakers, included visits to several key healthcare facilities, such as Dr. George Mukhari Academic, Steve Biko Academic, Charlotte Maxeke Johannesburg Academic, and Nelson Mandela Children’s Hospital. The committee’s goal was to identify the major challenges in delivering cancer care and assess the operational efficiency of oncology services across Gauteng's public healthcare system.

Severe Overcapacity and Cross-Provincial Referrals

One of the most critical findings was that these central hospitals are overwhelmed, often receiving high volumes of cancer patients not only from Gauteng but also from neighbouring provinces like North West, Limpopo, and Mpumalanga. This overflow places additional pressure on already strained resources, as many of these facilities offer highly specialized oncology services that cannot be replicated at smaller, tertiary, or district hospitals.

Moreover, the influx of foreign nationals seeking cancer treatment further compounds the problem. The committee highlighted that Charlotte Maxeke Academic Hospital currently faces a debt of over R700 million, while Steve Biko Academic Hospital owes more than R400 million for the treatment of foreign nationals. This financial strain is crippling the system's ability to manage the increasing demand for healthcare services.

Staffing Shortages and Human Resource Challenges

The report also identified significant human resource challenges, with outdated staffing models failing to meet the growing demands of Gauteng's population. Oncologists, radiologists, and other specialized healthcare workers are in short supply, and the public sector struggles to retain talent due to the private sector's ability to offer more competitive salaries.

Additionally, the shortage of specialized nurses in operating theatres and intensive care units (ICUs) was flagged as a critical gap in the cancer care value chain. The committee urged the National Department of Health to expedite the approval and implementation of revised staffing plans proposed by hospitals to address these shortages.

“The staff-to-patient ratios are simply unsustainable, and healthcare professionals are under immense pressure. This has a direct impact on the quality and timeliness of cancer care,” the committee's report stated.

Infrastructure and Radiology Expansions

Historically, Gauteng had only two primary radiology centers for cancer treatment, but plans are in place to expand these services. Dr. George Mukhari Hospital is advancing the construction of a new oncology facility, which the committee believes will ease the burden on existing centers and improve cancer treatment capacity.

However, the committee stressed that expanding infrastructure alone is not enough. These facilities must be adequately staffed with specialized personnel to ensure they operate efficiently and provide timely care to patients. “We will closely monitor the progress of this project to ensure it meets deadlines and serves its intended purpose,” the committee stated.

Financial and Administrative Constraints

The committee acknowledged that budgetary limitations caused by national austerity measures have hampered the province’s ability to respond to healthcare challenges. Nonetheless, they emphasized that addressing the need for specialized personnel and improving oncology services should remain a top priority.

Advocate Ezra Letsoalo, Chairperson of the Health and Wellness Portfolio Committee, reiterated the importance of long-term planning: “We are committed to working with the Department of Health to enhance oncology services. Our goal is to ensure that all patients receive the high-quality care they deserve, despite the complexities involved in providing such specialized treatment.”

The Way Forward: NHI and Greater Cooperation

As the implementation of National Health Insurance (NHI) progresses, the committee expects that increased cooperation between different levels of the healthcare system will help alleviate some of the current challenges. Improvements in system coordination, clinical guidelines, and operational efficiencies are necessary to address the backlog in oncology services.

The committee concluded by affirming its dedication to supporting Gauteng’s healthcare system and ensuring that all residents, including those from outside the province and foreign nationals, receive the cancer care they need.

The next steps include monitoring the progress of infrastructure projects, pushing for the fast-tracking of human resource plans, and ensuring better financial management within the system.