Being a patient provides another perspective!

For most of February 2023 I was a patient in hospital requiring two laparotomies, a spell on a ventilator, two weeks in intensive care discharged home after just over three weeks. Somewhat chastened by the experience I am now 10kg lighter than when admitted and recuperating at home.

Certainly an experience of this nature brought me face to face with my own mortality but also emphasised the impact that sudden severe illness has on those close and dear to one. I am grateful that the pathology that required surgery was not malignancy and could be rectified by the surgical interventions. However, the experience brought home to me the crucial importance of competent health professionals and effective healthcare that is accessible when needed.

Since I am privileged to have medical insurance the majority of the not inconsiderable cost incurred was covered by that insurance. I was not required to decide whether I could afford the treatment or wait in a queue for my condition to be possibly prioritised over the needs of others. I am well aware that for a majority of citizens in this country this is not the case.

As a doctor I have spent a considerable part of my professional life working in hospitals and understand the dynamics that exist within these institutions but as a patient one gains another perspective. Whilst the doctor plays an important and indeed a vital role, as a patient the most immediate interface is with the nurse. Particularly in an intensive care unit where one is connected to multiple lines, tubes and catheters, your dependence on the nurse is absolute. When one’s mood becomes dark, the impact of a caring nurse is immense. This is when a simple word of encouragement or humour lifts one’s spirits and this from a nurse who works long hours day after day having left home early in the morning to come on duty and arrives home late to her own family after a long day. From the nurses, physiotherapists, dieticians and even phlebotomists (who woke me often in the early hours to draw blood) I was fortunate  to be cared for by health professionals who were true to their calling and a credit to their professions.

Now at home I have watched with both anger and sadness, images of public sector health workers on strike for higher pay that violate all that must form part of the caring ethos of a health professional. Images of chanting workers, categorised as providing an essential service and thus legally prevented for striking, preventing patients, health professionals who want to work and even emergency medical vehicles from entering health facilities have been shocking. A video of a young female doctor being dragged across a table and out of a consulting room by a group of men shouting abuse epitomises all that is wrong with the actions of these striking so-called health workers. The difference from what I experienced as a patient and what was reflected in theses images is stark and disturbing. I am sure that many health workers in the public sector would certainly distance themselves from the actions of these strikers and would if able have continued to provide care for their patients. However, the mob rule that has been witnessed in many cases prevented them from doing so.

Whilst I accept that health workers should be fairly remunerated and that the work that they do is stressful, in a country that has high levels of unemployment, it seems that those who are employed should value that fact and consider the millions in this country who are not. Unreasonable demands for salary increases in a fiscal environment where for various reasons the South African economy is under immense stress seem to demonstrate a disconnect from reality as do actions that lead to harm and even the death of patients in public sector health facilities. Of particular concern is the fact that the trade union responsible for what has happened at health facilities across the country, is a member of an umbrella labour organisation that forms part of the alliance supporting the ruling political party in South Africa.

As I mentioned my hospital admission was in a private sector hospital, which in the future it is envisaged would be incorporated into National Health Insurance and become part of the public sector with increased government regulation, control and unionisation of the health workers. Would the health professionals that I encountered during my admission make themselves guilty of the same behaviour that we have seen on our television screens? I find it difficult to believe. What has happened in the last week in the public sector must be a cautionary message to those so passionate to embark on a rapid path to implement National Health Insurance.

I sincerely hope that in addition to the implementation of the “no work no pay” rule for those in this unprotected strike, any health workers identified as guilty of actions that threatened the safety of patients and staff who wished to continue working will be summarily disciplined and dismissed. Such individuals in my view have absolutely no place in any health system. Decisively addressing this would be an important first step on the long road that lies ahead if South Africa is to implement a National Health Insurance system.

On a personal note I am privileged to have had access to a well managed health facility providing quality healthcare. I am grateful to have been treated by the health professionals that I encountered whilst in hospital. My thanks and gratitude to each and every one of them!