The impact of crime on the health system

Debate Speech

Honorable Premier Madam Speaker Members of this house Guests in the gallery Members of the media

Good afternoon, Goeie middag, Molweni

Honorable members, I want to thank the Speaker for allowing the house to debate this very important issue of how crime impacts all of us. Every South African has either been victim of crime or have been affected by some crime.

Crime affects all societies. It occurs amongst the rich and the poor, in the suburbs as well as in the townships. Serious and violent crimes are reported in most newspapers almost on a daily basis. There is no single satisfactory answer as to the causes of crimes and its impact on the economy of this country.  

Honorable members, within the health system we feel the impact crime has on the available services.

The health system is already under pressure and overburdened, and is hard hit by the levels of crime we find in our communities

The national crime stats released in September, revealed that residents within the Western Cape are exposed to dangerously high levels of crime, specifically those crimes related to interpersonal violence.  

The health system is the recipient of all incidents of violent crimes, some relating to substance abuse.

The sharp increase in interpersonal violence cases negatively impacts on the services, because interpersonal violence is a major contributor to the pressures we experience especially within our Emergency Centres (ECs), which causes delays in the treatment of many elective procedures.

Patients requiring emergency treatment as a result of violent injury often take preference, as they often present to EC in a state of emergency as red patients.  

Honorable members, we also experience pressures on other service platforms such as our Emergency Medical Service (EMS), where life-threatening emergencies cause long waiting times for other patients.

Our EMS staff are also victims of many violent crimes, and are attacked and targeted by criminals in the execution of their duties.  These violent attacks correspond with the areas where there is a high crime rate and usually some gang-related activity. The Department views this as an extremely serious matter.

From January to May this year, 12 attacks on emergency medical workers had been reported, including robberies, physical and verbal attacks and the stoning of ambulances.

A number of measures have been implemented in response.

In the event an EMS vehicle or staff is attacked in a particular area, it will be declared a red zone - no EMS vehicle or staff will go into the area without a police escort, which results in delayed response times and delayed emergency medical care in the area.

Another service under pressure due to high levels of crime is our Forensic Pathology Services (FPS). Forensic investigations for murder cases result in a longer wait of routine cases due to a high number of compulsory autopsies.

The two FPS centres most affected are Salt River and Tygerberg. I often get frantic calls from families who want to lay their loved ones to rest but due the nature of autopsies to be conducted, we often find delays with the routine cases.

Our Primary Health Care facilities also experiences pressures such a long waiting times, and are negatively affected by crime. This impacts on service delivery at clinics, because gang-violence continuously flares up which result in the closure of facilities. Hanover Park and Hout Bay were some of the clinics which we have had to close due to violence. Unlawful protests also contributes to services being suspended. Just yesterday, two clinics in Vredenburg was temporarily closed due to protests, and another in Saldanha today with threats of burning down the facility.

Honorable members, in the case of our EC’s within crime ridden areas, we find that a large number of people present with interpersonal violence injuries relating to gun shot-, and stab wounds. Health absorbs all the ills that happens in society.

The violent crime stats reflected in the national statistics, are reflected within our health system. Just during the last few months, some of our facilities reported a steep upsurge in gunshot wounds and stabbings: 

The crime stats reflected 3698 attempted murder -, and over 62 000 assault cases across the province. We have seen these first hand at some of our facilities, especially those facilities linked to, and located close to the top 10 precincts for most reported crimes.

• Khayelitsha District Hospital – has an average of 180 – 230 gunshots and stab wounds per month
• Delft CHC – 181 gunshots and 1505 stab wounds
• Retreat Community Health Centre (CHC) – 174 gunshots and 686 stabbings
• Gugulethu CHC – 162 gunshots
• Victoria Hospital – 129 gunshot wounds and 259 stabbings
• Red Cross – 17 gunshot wounds and 8 stabbings
• Mitchells Plain Hospital – 110 gunshots and 398 stabbings
• Mitchells Plain CHC – 129 gunshots and 725 stabbings and assaults
• Hanover Park CHC - 15 gunshots, 1629 assaults including stabbings
• Kraaifontein CHC – 79 gunshots and 1000 stabs wounds  

Western Cape Government Health welcomes the additional policing resources recently launched in communities where violent crime is the highest. Communities, government and civil society further need to continue fostering a whole of society approach towards reduce the harms associated with social ills such as alcohol and drug abuse.

ENKOSI