Medicine, Bureaucracy, Press Freedom*

The latest fun development in the South African Health Care Sector (source):

Yesterday, the HoDs at the Port Elizabeth Hospital Complex called a press conference. They declared that it was not possible for them to work in their understaffed, under-equipped states. I can vouch for this. Too few RNs, too few security guards and not nearly enough basic clinical equipment. Or enough beds for that matter.

They declared that only the emergency departments would be working full-time, and clinic-time would be restricted. I suppose at least they are not denying emergency care. But is it really ethical to restrict clinic care, when that includes ensuring that chronic diseases are adequately managed (or detected, for that matter), so that they don’t become life-threatening?

The problem is that when you work for the government, you’re not supposed to talk to the press without going through the PR-office. Which is not something I agree with in the least, but with so many thousands of employees for a single department I suppose it prevents a barrage of different comments going out from every Dick-Tom-and-Harry with an opinion.

However, in student government I’ve learned how bureaucracy and red tape tends to get in the way of progress. So often I have requested meetings and lodged complaints, only for nothing to come from it. If the “appropriate” channels have not delivered results; and the wellness of your patients as well as the integrity of your profession are in danger, what do you do?

And is it really fair for your employer to expect you to shut up; to expect you to take the blame when your patients and their families complain to you about the state of the sector?

There is another side to the story though.

The Department of Health is in the red. And you can’t simply say it is not adequately managed, because without an adequate allocated budget even the most experienced administrative staff cannot run a successful department.

So who’s in the wrong? I don’t know. Everyone I suppose, but some more than others.

I just hate how people get so involved with the politics of a situation that they forget to handle it appropriately.  I dread the thought of working in a place where bureaucracy rules. I dread having my voice taken from me. I dread the thought that medicine cannot treat every ill of my country.

*EDIT: I’m linking this up to Pour Your Heart Out with Things I Can’t Say.

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