- Elective surgeries – non-emergency procedures scheduled in advance – in South Africa have been suspended at various points throughout the pandemic.
- This has been done to increase the capacity of hospitals and clinics to deal with Covid-19 patients during a surge of infection.
- Temporary suspensions have hit the revenue of private healthcare firms, while allowing medical insurers to grow their reserves.
- But a backlog is building and those needing non-critical surgery will likely have to wait a while longer once the third wave subsides.
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South Africa’s private healthcare companies have suspended non-emergency and non-urgent surgeries at various points throughout the pandemic to free up resources for the fight against Covid-19. This has hurt hospitals’ revenue and led to a backlog of elective surgeries.
The Covid-19 pandemic has had a devastating impact on the economy, with private healthcare suffering a dual-blow due to admissions soaring as infections surge and receding to well-below pre-pandemic levels outside of waves.
Mediclinic, which operates more than 50 private hospitals and clinics in South Africa, recorded a 15.3% decrease in revenue per paid patient day (PPD) in 2020. Occupancy rates, although longer in terms of time spent in facilities, almost halved and revenue dropped by almost 10%.
“Mediclinic can confirm that the most significant impact on revenue during the 2020/21 financial year was during April 2020 with the strict lockdown measures and suspension of non-urgent elective surgical procedures,” Dr Gerrit de Villiers, Mediclinic’s Chief Clinical Officer in South Africa, told Business Insider South Africa.
When South Africa first entered hard lockdown at the end of March 2020, hospitals and clinics swiftly suspended elective surgeries. This was done to reserve all critical resources – beds and healthcare workers – for treating the influx of Covid-19 patients.
South Africa’s largest private healthcare provider, Netcare, gradually resumed elective surgeries in May before fully reopening in August.
“Should there be a capacity constraint in a specific hospital at a certain time, this is also taken into consideration in determining which surgeries should be given priority,” Managing Director of Netcare’s hospital division, Jacques Du Plessis, said at the time.
Further constraints come towards the end of the year when South Africa officially entered a much fiercer second wave of Covid-19. Private hospitals reinstituted the suspension of pre-arranged surgeries but, this time, focused on specific regions which were experiencing a surge in cases.
The targeting of surgical suspensions was further refined when South Africa entered the third wave of Covid-19 infections in June.
“The decision to cancel elective surgery is not based on the risk of infection, as all protocols are in place to ensure our patients’ safety, but rather to increase potential capacity for Covid-related admissions,” said De Villiers.
“Although all elective procedures at Mediclinic facilities were terminated during the initial lockdown... that has been revised to cancel or postpone elective surgery only where hospitals are experiencing specific resource constraints. Where there is capacity at associated day clinics, elective surgeries may continue. This is evaluated on a hospital basis and reviewed regularly.”
And although medical aid schemes have benefited from these suspensions – increasing their reserves by 35% to nearly R93 billion due to postponed elective procedures – private healthcare providers have lost money and are expecting to deal with a massive backlog once the third wave passes.
“We are anticipating that hospital admissions related to elective procedures will pick up again once the third wave starts to abate, however there is likely to be a significant backlog that could result in potentially lengthy waiting lists for elective procedures,” Dr Jacques Snyman, advisor to the Health Squared Medical Scheme, told Business Insider SA.