Indemnity outfit boosts State surgical rescues

Johannesburg – A local insurer of healthcare professionals, EthiQal, has donated R240 000 to Operation Healing Hands, OHH, a non-profit-organisation set up to relieve the overwhelming burden of surgery in the public sector. The organisation selects disadvantaged, clinically-eligible patients for life-saving and life-enhancing surgery.

EthiQal, the medico-legal division of Constantia Insurance, chose to back the selfless, service and caring ethic of Mandela Month this July by boosting the eponymous efforts of OHH. OHH has helped over 280 underprivileged patients with various disfiguring and disabling conditions since it was formed by private sector specialist surgeons three years ago.

Volker von Widdern, CEO of Constantia Insurance, says, “The OHH project is a fantastic example of goodwill that is evident in almost all South Africans and aligns strongly with our belief that new approaches can make substantial differences to the challenges we have. EthiQal’s business purpose is to add value and improve our environment. We seek to do this throughout the year and for policy holders on a continuous basis, not only when we may need to defend a doctor or pay a claim.”

EthiQal was approached by Dr Helené Basson, the founder of OHH and also an EthiQal policy holder. The cash injection will enable a network of private sector surgeons, supported by private hospitals and other suppliers of healthcare services, to provide transformative care to public sector patients without the means or time to afford it. Often a single surgical operation can make a life-altering difference to these patients who may otherwise wait several years on a State elective surgery list.

The OHH surgeries are highly specialised and diverse and include mainly general orthopaedics, arthroplasty (replacement surgery), general surgery, head and neck surgery and ENT surgery.

Helping patients and doctors

Launched in November 2016 in response to debilitating healthcare sector medico-legal claims threatening the very existence of higher-risk specialities, EthiQal last year garnered top honours at the annual award ceremony of the Risk Management Institute of South Africa for its far-reaching interventions. These include reducing premiums, enhancing professional indemnity cover, and sponsoring risk mitigation initiatives like multi-stakeholder conventions to discuss solutions and outline a joint path forward to stabilise the practice environment for healthcare professionals.

The resulting recommendations include legal amendments, better health outcomes data collection, increased mortality and morbidity meetings, risk-reducing practice guidelines, patient support and best mediation practice.  Whereas legal reform is a prolonged process, some of the specialist-driven risk mitigation tools supported by Constantia are already bearing fruit.

The electronic platform of SafeSurgery for capturing patient safety data has been advanced significantly and Surgicom, another doctor organisation, has produced a series of patient educational leaflets and conducted research into where things go wrong in surgery, together with recommendations on how to avoid difficulties. The medico-legal bill (settled and audit- pending), in the public healthcare sector currently stands at R98 billion, the national health department Director General, Precious Matsotso, confirmed recently.

Operation Healing Hands was launched on Mandela Day in 2016, built on the values lived and displayed by Nelson Mandela, who would have turned 101 years old on July 18th this year. Mandela Day was designated as a global call to action with people and organisations donating 67 minutes to commemorate the 67 years Madiba fought for social justice. During the month of July 2019, 30 surgeries were conducted in Gauteng.

OHH was founded by Dr Helené Basson, a Pretoria orthopaedic surgeon at the Life Eugene Marais Hospital. Seeing public sector patients in dire need of surgery waiting for interminable periods or with virtually no hope of help and realising this was a national crisis, she gathered together a willing group of surgeon friends to set up the rescue NPC.

An idea of the surgery crisis can be gauged by the following statistics, provided by OHH spokesperson, Ané du Preez; at Steve Biko Hospital in Pretoria, 680 surgeries have either been cancelled or postponed due to a lack of facilities and a shortage of ICU beds between 2017 and 2018. Over the same period, Steve Biko Hospital saw more than 800 patients waiting for hip or knee replacements. In 2015 the waiting list for life-changing surgeries at Baragwanath Hospital in Johannesburg was so long patients had to wait 7 years to be helped. In 2016 the number of patients waiting for surgery at the Charlotte Maxeke Academic Hospital in Johannesburg was 2,400.  2018, at least 1‚400 patients awaited surgery at the Helen Joseph Hospital, west of Johannesburg. Most needed at this hospital in the same year, were eye surgeries for about 600 patients, followed by orthopaedic surgeries for at least 500 patients.

Less than 16% of the South Africans are able to afford private medical aid while more and more medical aid schemes are excluding procedures like spinal surgery and arthroplasty, because of the high costs involved. Not only are OHH patients able to return to work and contribute to the economy again, but the demand on South African state hospitals is alleviated through the work done by OHH in the private sector, creating compound benefits.

By backing these selfless surgeons, Constantia Insurance is improving access to more equitable quality healthcare, a key driver of the impending National Health Insurance. EthiQal estimates that nearly half of South African neurosurgeons and obstetricians and gynaecologists in private practice have taken their professional indemnity cover which has materially contributed to the sustainability of their practices

Patient selection criteria

According to Du Preez, surgery resources are allocated based on clinical evidence and financial need, with strict ethical oversight. Highly qualified surgeons and anaesthetists give time and care on a voluntary basis, while private hospitals and pharmaceutical companies provide the facilities and medicines for free or almost-free. This includes pre and post-operative consultations, (the latter for three months, including rehabilitation and prosthetics). OHH raises funds to supplement any shortfalls, thus creating a sustainable financial model. Du Preez says the EthiQal donation will primarily go towards patient consumables.

One of the higher-profile beneficiaries of OHH this year was Sipho Hleza, 29, one of the founding members and Assistant Musical Director of the Ndlovu Youth Choir, who achieved almost overnight international fame this year after performing on America’s Got Talent. Sipho, raised in poverty by his late grandmother, underwent a failed operation to correct a lazy eye 14 years ago. ’I was just too scared to go back again a second time’ said Sipho in his interview. Luckily all went well the second time round and Sipho ‘eagle-eye’ Hleza can look his competitors straight in the eye this time around.

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