Health and Wellness
With regard to forensic pathology services in the province:
- (a) What is the total number of forensic pathologists currently employed in the province, (b) what is the current caseload per forensic pathologist, expressed as an average ratio of cases per practitioner, and (c) what are the prescribed standards and norms for workload allocation for forensic pathologists in provincial forensic services;
- (a) what is the current backlog of forensic pathology cases, including the exact number of cases in waiting;
- what is the average workload and caseload per forensic pathologist during periods of peak or seasonal high mortality in the province;
- what measures are being implemented to address staffing shortages and to reduce the backlog in forensic pathology services, particularly during periods of increased mortality demand?
Please note that pathologists are highly specialised healthcare professionals. Registrars and medical officers support pathology services by performing a range of functions appropriate to their scope of practice, helping to distribute workload across the service. The caseload ratios below exclude the contribution of registrars and medical officers and therefore do not reflect the actual caseload managed by pathology teams. As a result, the ratios should be interpreted as the caseload per pathologist only and not as a measure of the total clinical capacity available within the service.
(1)(a) As of June 2026, there are 20 forensic pathologists employed in the province.
(1)(b) When expressed as cases per full-time equivalent (FTE), this equates to approximately 657 cases per FTE per annum.
(1)(c) The National Association of Medical Examiners norm, which is used as a benchmark, is 250 cases per pathologist.
(2) There is currently no backlog of cases pending autopsy examination. As at 24:00 on 31 May 2026, there were 111 cases pending examination. These cases form part of the normal operational workflow and do not constitute a backlog.
(3) During periods of peak or seasonal high mortality, pathologists are generally allocated three cases per day. This allocation is, however, influenced by other service requirements, including court attendance, clinical governance duties, teaching, and academic commitments.
It should be noted that each post-mortem examination requires more than the autopsy itself. The process may include consideration of death scene information, toxicology, histology, and radiology. Once those results are available, they must be assessed, interpreted, and integrated with the post-mortem findings before a cause of death can be formulated and a report issued.
This places significant pressure on clinicians, particularly at high-volume facilities. At the busiest facility, pathologists deal with an average of approximately 926 cases per FTE.
(4) The Western Cape is incrementally increasing the number of forensic pathologist posts, as funding allows. As it takes approximately five years for a forensic pathologist to qualify, forensic pathology remains an extremely scarce skill, with limited training posts available nationally and suitable candidates not always available.
The service is also affected by international recruitment, with South African forensic pathologists being actively recruited by international healthcare providers.
In addition to staffing measures, the Western Cape is exploring the use of technology to support forensic pathology services. One proposed modality is post-mortem computed tomography, which may assist in managing service pressures and supporting the work of forensic pathologists.
