The Auditor General’s office has revealed, in its latest report, that the country’s biggest referral hospital, Parirenyatwa Group of Hospitals, cancelled 1 688 surgical operations in one year, owing to a lack of medical equipment.
In the report on state enterprises and parastatals, which was presented to Finance minister, Mthuli Ncube, on 30 April 2021 and subsequently tabled in parliament on 14 June 2021, Auditor-General Mildred Chiri said this may compromise health service delivery.
She also found that during the year under review (2018) the hospital did not have adequate monitors in anaesthetic rooms and recovery areas, with only eight out of 18 stations in use. Said Chiri:
Due to financial constraints to re-tool the theatres over the years, most of the equipment broke down and the hospital was unable to provide adequate theatre coverage hence cancellations of theatre cases.
However, during the third quarter of the year, procurement of spare parts which was used to repair the equipment was done which reduced the number of theatre cancellations.
The year 2018 witnessed two industrial actions by medical personnel in February and December 2018 which contributed to theatre cancellations.
Furthermore, the availability of Anesthetists was also a challenge and this resulted in theatre cancellations.
The other reasons for theatre cancellations were: overbooking of elective cases by surgeons, shortage of material resources, poor preparation of patients, shortage of ICU beds, shortage of equipment such as multi-parameter monitors.
Chiri also found out that the hospital was operating with inadequate key equipment and resources during the year under review. She said:
The Hospital did not have adequate monitors in anaesthetic rooms and recovery areas and only eight out of eighteen stations were in use.
In addition, the Intensive Care Unit and Higher Dependence Unit (HDU) did not have adequate beds to accommodate patients.
The hospital’s management, in response to the audit findings, said the cancellation of surgical operations had also been influenced by job action by the health sector as well as poor preparation of patients and shortage of intensive care unit (ICU) beds, among other challenges.
They also said they had not been able to acquire more equipment and service existing machines because of foreign currency shortages. Their response read:
Critical equipment such as monitors and anaesthetic machines were inadequate due to a shortage of foreign currency.
Orders for replacement and/or procurement of new equipment was hampered by a lack of foreign currency.
The minimum allocation of ICU and HDU beds should have been 10% of the hospital capacity which translates to 120 beds.
This was far-fetched as the hospital itself was not designed to comply with that provision.
Furthermore, assuming space would be provided, that space would not have been utilised because of the shortage of specialist nurses who are even not adequate to cover the ICU and HDU beds that are available at the moment.
The Auditor-General said management should engage the key stakeholders and formulate plans to resolve all the issues noted in relation to limited capacity and shortage of drugs and equipment without any further delay.