Health Minister Dr Aaron Motsoaledi’s reluctance to place the Eastern Cape’s Department of Health (ECDoH) under administration is leaving thousands of patients under their care trapped in a cycle of pain and despair. Decades-long surgical backlogs are robbing them of their mobility, their dignity, and potentially, their lives. Each delay worsens the crisis, leaving more patients trapped in pain, waiting for relief that may never come.
At Frere Hospital a recent response to a parliamentary question revealed that as of November last year, 1,771 patients are waiting for hip or knee replacements. Yet, with the hospital only able to perform three to four surgeries per month, clearing the backlog would take over 44 years. For many of these patients, that wait is longer than the time they have left. The harsh reality is that some will not live long enough to reach the top of the list, forced to spend their remaining years in agony, abandoned by a system that no longer serves them.
Download: IQP 12 Question 247
At Livingstone Hospital, the situation is just as dire, with a backlog of 600 hip replacements and 500 knee replacements, the waiting lists for either procedure are more than a decade long.
Further delays will only deepen the crisis. The only viable solution is to place the department under administration immediately in terms of Section 100 of the Constitution. I have now written to the Minister of COGTA, Velenkosini Hlabisa, to request that he take this matter to the cabinet. I have sent the same plea to Dr Motsoaledi, to give him one last chance to show that he cares about the people of the Eastern Cape.
The ECDoH has proven, time and again, that it is incapable of managing its affairs. Poor leadership and reckless cost-cutting have crippled the healthcare system and crippled many thousands of patients who, in a better-managed department, would be walking today.
However, the impact extends beyond orthopaedic surgery—waiting lists in ophthalmology, ENT, and oncology continue to grow, with no meaningful intervention.
Three key failures have driven this crisis:
- Failure to pay suppliers of critical medical equipment and medicines, leaving hospitals without essential tools.
- Decaying infrastructure, with power failures and broken air-conditioning rendering operating theatres unsafe and unusable.
- Severe shortages of specialists, particularly anaesthesiologists, bringing surgeries to a standstill.
The Livingstone tertiary complex, which includes Dora Nginza and Port Elizabeth Provincial Hospital, currently has at least 11 anaesthesiologist vacancies, meaning that even when surgical facilities are available, they cannot be used.
The department’s so-called plan to decentralise surgeries to regional and district hospitals was supposed to have been implemented by the end of 2024. As expected, it remains nothing more than an empty promise. Even if it were executed, the severe shortage of specialists and anaesthetists would leave waiting lists virtually unchanged. There is no plan—only excuses.
Instead of prioritising healthcare at the coalface, the department has chosen to protect political patronage, refusing to make the difficult but necessary budgetary decisions that would allow for actual savings in non-core areas and a redirection of funds to essential services.
They have chosen to protect cadres over patients. They have chosen inaction over intervention. And in doing so, they have decided to let people suffer and possibly die rather than take responsibility.
The time for half-measures and empty reassurances is over. The Eastern Cape Department of Health must be placed under administration without further delay. Anything less is a potential death sentence for the thousands of people left stranded on waiting lists, hoping for relief that may never come.