Call for closure of Folateng private wards in public hospitals in southern Gauteng.

To the Editor: The facilities available in southern Gauteng for severely ill patients with diseases related to internal medicine are currently under severe pressure. Central and regional hospitals in this region have frequently had to close to admissions because their bed occupancies have exceeded 100%. This problem started in 2013 and has become progressively worse. The reasons for this crisis are not difficult to understand: (i) there is a very high burden of illness in the population served by these public hospitals, including communicable (HIV/AIDS, tuberculosis) and non-communicable (cardiac, pulmonary, metabolic, oncological) diseases; (ii) Gauteng is the most populous province of South Africa, with just over 12 million people; and (iii) despite this ever-increasing burden of illness, a decision was taken some years ago to close a number of public health facilities such as Hillbrow and Kempton Park hospitals. In addition, a significant number of public healthcare beds were privatised for use by patients with medical aids – Folateng private wards. It is no wonder that our existing public hospitals are overwhelmed. The Department of Medicine at Chris Hani Baragwanath Academic Hospital in Johannesburg has a bed capacity of 730, with bed occupancy of over 90%. We admit over 100 patients a day, and not infrequently have more patients than available beds. The result is that very sick people are kept waiting on chairs for long periods of time. The nurses, the doctors and the support services are frequently overstretched, resulting in suboptimal service delivery. This is a totally unacceptable situation that needs a strategic solution.