Doctors lose the bed battle

Devastated doctors have lost the battle to prevent the closure of 60 beds at Groote Schuur hospital, with medical superintendents ordered to start the process from Monday.

Provincial health department spokesperson Faiza Steyn said 15 beds had already been closed at Tygerberg hospital and a further 15 closures will follow.

The Groote Schuur order comes after a week during which not a single bed was open in the entire hospital and doctors were warned to cut back on admission of patients for elective procedures.

Groote Schuur was unable to ease the even worse load of Manenberg's GF Jooste hospital, where patients were "lying around for long periods" waiting for beds to open.

The bed closure order came in a memorandum on Thursday from Groote Schuur's chief operational officer, Dr Saadiq Kariem.

"The closure of the beds must begin on Monday, September 17," says the memorandum.

Doctors, unions and civil society groups have been fighting the bed closures for months and the news has left staff disappointed and angry.

Although it appears they have lost, there have been suggestions that individuals should continue to resist the process until they are certain services will be replaced by something of an equal standard.

"We cannot justify closing a single bed or clinic.

"People are crying out so desperately for health care. This is totally unjustifiable," said Dr Lydia Cairncross, spokesperson for the Health Coalition Against Budget Cuts.

Professor Del Kahn, head of surgery at Groote Schuur, said the news was unacceptable, coming at a time when the hospital was experiencing such a critical shortage of beds.

"It just doesn't make sense. It's insensitive at a time when patients are suffering," he said, adding that last week they had been asked to "be careful about elective admissions and even emergency cases experienced delays".

In his memorandum, Kariem acknowledges the objections of the doctors to the bed closures which he says have been "recorded on numerous occasions in our Combined Clinical Centre meetings with heads of department".

He adds that he understands the process "will be difficult", but makes it clear "we have to proceed with immediate implementation" and appeals for the support of the medical heads.

Kariem reports that the formal approval for the closure of the 60 beds came on Thursday from Health MEC Pierre Uys and the acting head of the provincial health department, Dr Beth Engelbrecht.

Provincial health head Dr Craig Househam, who has been vilified for putting the budget before the care of patients, is on holiday in the US.

According to Kariem's memorandum, the following beds will be closed: 27 private beds; 10 adolescent orthopaedic beds; 7 adolescent endocrine beds; 2 adolescent dermatology beds; and 4 adolescent radio oncology beds.

The details add up to only 50 beds, but Steyn said that the outstanding 10 beds were paediatric beds which would be moved to Red Cross Children's Hospital.

Kariem says in the memorandum that the closures will result in financial savings that will help address over-expenditure for the hospital this financial year.

He suggests that as patients are discharged from these beds, no new patients be admitted and the bed subsequently closed.

A disappointed Cairncross said the sudden implementation of the controversial cuts was a "callous disregard for the lives of the patients entrusted to our care and to the care of the administrators of the health system".

Kahn said the news of bed closures had crushed spirits at the hospital at a time when staff were feeling more upbeat that their objections were going to be considered.

"It's very disappointing," he said.

• This article was originally published on page 1 of The Cape Argus on September 14, 2007