Plan to centralise teaching hospitals
The health department’s plan to run all South Africa’s academic hospitals is the only way to give patients the treatment they deserve, says Minister Aaron Motsoaledi.
Experts in the health sector hope the centralisation plan will particularly help patients in provinces like North West, Mpumalanga and Limpopo, who are allegedly often turned away from Gauteng hospitals.
Currently, South Africa’s 10 academic hospitals are run by the relevant provincial health departments.
These are Groote Schuur and Tygerberg hospitals in the Western Cape, Steve Biko, George Mukhari, Charlotte Maxeke and Chris Hani Baragwanath hospitals in Gauteng, King Edward VIII Hospital and Inkosi Albert Luthuli Central Hospital in KwaZulu-Natal, Universitas Hospital in the Free State and Nelson Mandela Academic Hospital in the Eastern Cape.
At its Mangaung conference last month, the ANC decided these hospitals should in future be run by the national government.
It will take some time before the policy is finalised, Motsoaledi said.
The plan was greeted with unhappiness by the DA-led Western Cape provincial government but Motsoaledi is not fazed.
“It is not a matter of what provincial governments want but a matter of what is best for South Africans,” he said.
“Patients are the ones who suffer because of serious abnormalities happening in these hospitals.
“Training of medical specialists has also taken a knock because the provincial government uses the money budgeted for skills development on other things.”
Professor Malegapuru Makgoba, vice-chancellor of the University of KwaZulu-Natal who – together with other university principals – proposed the idea to Motsoaledi in 2010, welcomed the plan.
He said: “I don’t understand what the fuss is about, because everywhere in the world academic hospitals are the competency of the national government.”
“Even the universities which are attached to the academic hospitals are accountable to the minister of higher education and not provinces.”
“So then why should academic hospitals be a provincial competency?” Makgoba asked.
Currently, academic hospitals get their operational budget from provincial governments, which also decide how much money will be spent on training specialists and how many doctors should be hired.
For a specialist to be trained at these hospitals, the provincial department needs to create a position for a registrar.
Registrars are qualified medical doctors who intend to specialise in a certain field of medicine.
Motsoaledi said this process caused “a nightmare for medical professionals and managers of academic hospitals”.
“Academic hospitals would request the provincial department to create a position but it would never be filled because there was no money to pay a registrar. Yet Treasury had made available a grant for education and training,” Motsoaledi explained.
Professor Khaya Mfenyana, chairperson of the committee of medical school deans and head of the faculty of health sciences at Walter Sisulu University in Eastern Cape, echoed his sentiments.
Mfenyana said: “The problem with the grants for education and training was they never reached where they were supposed to go.
“The Treasurer would allocate grants but the provincial departments would use them for something else and training of specialists would suffer,” he said.
Dr Poppy Ramathuba, the chairperson of the public sector doctors’ division at the South African Medical Association, welcomed the centralisation plan.
She said: “Many medical doctors want to specialise but, because the provincial governments are not creating positions for registrars, it is impossible.”
She also expressed concerns which she said would be addressed by the plan.
“Patients living in the North West, Limpopo and Mpumalanga have suffered because Gauteng refuses to treat their patients, claiming these provinces owe them (money).”
Motsoaledi admitted he had received complaints about this, and said it was largely why his department had decided to intervene.
He said: “This shouldn’t have happened because central hospitals are national assets.
“All people referred to public hospitals should have access to them, irrespective of who owes whom.”