Health’s ‘secret’ R9bn plan is about to start

Officials believe some hospitals will be downgraded

By NTANDO MAKHUBU

Health Reporter

THE Department of Health is under fire for going ahead with a R9billion plan that, it is believed, will leave the two million people in Mdantsane and other communities without hospitals with specialist services.

Mike Basopu, chairperson of the Health portfolio committee, and Democratic Nursing Association of South Africa (Denosa) shop steward Edward Maseti complained that they have not been consulted about the department’s plans to implement the major changes.

The department has so far kept details of its plan – scheduled to be in place by the end of May – a secret. However, sources at the East London Hospital Complex (ELHC) have told the Daily Dispatch that surgeons from Cecilia Makiwane Hospital in Mdantsane would be moving to Frere Hospital in April.

Basopu said: “We have seen evidence of the changes but whenever we confront the department, they deny them.”

His committee had been approached by doctors and other medical staff after they were informed that they would be relocated to other hospitals, in a move outlined in a May 2006 Service Transformation Plan.

The plan, authored by a team established by the Department of Health, outlines plans to reshape the health service delivery system, which include the downgrading of a quarter of the province’s 92 hospitals, and dismantling the province’s three hospital complexes.

This means that all specialist services would move to Frere Hospital, which would be upgraded, while CMH would become a district hospital.

Basopu’s committee is now demanding a report laying out exactly what is planned – and whether it fits in with national Health plans.

The changes come a mere six years after a process of rationalisation which saw hospitals across the province – including CMH and Frere – amalgamated into complexes at significant cost.

The cost of ELHC was estimated at R35million. Plush beachfront offices were established for managers, while CMH and Frere health-workers worked in deteriorating conditions.

Health Department spokesperson Sizwe Kupelo said the department would issue a statement later this week.

When the Dispatch first reported the plan, both Health Superintendent-General Lawrence Boya and MEC Nomsa Jajula denied the existence of any scheme to completely overhaul the public health system.

Denosa’s Maseti said: “Neither we nor our provincial leaders were consulted on this, yet nothing of this nature should be done without our input.”

Maseti said they were shocked to learn of the existence of a discussion document on the planned changes. “When we confronted them about our exclusion from its compilation, management agreed that it had been an oversight on their part.”

The National Education Health and Allied Workers’ Union (Nehawu) said they raised their concern about the planned changes time and again, but had been met with denial from the department every time.

But, said provincial secretary Cyril Langbooi, the plan was definitely in place and ongoing because Nehawu members were part of internal preparation workshops held by the Health department.

He mentioned two interlinked processes as part of the plan – the formation of two administrative Mega regions from which certain services would be accessible, and the transformation of services which included the downgrading of some hospitals and upgrading of others.

The Mega offices would be in East London and Port Elizabeth, and patients requiring financial, human resource, procurement and other administrative services would have to travel to these cities to access them.

Langbooi said: “We have tried numerous times to draw the department into discussing their plans, but they have denied them even in the face of glaring evidence.”

Basopu said the process had already started at Emadwaleni Hospital in the Transkei, where staff told the Health portfolio committee that it was being downgraded to a community health centre. After visiting the hospital and confronting the situation head-on, the committee asked the department about it. They were told that, as the hospital is in a radius of 200 kilometres of Zithulele Hospital in Mqanduli, it would be stripped of certain services which could be accessed in Zithulele.

“But unless one is travelling by helicopter, the distance between the hospitals is not 200km,” Basopu said, adding that the department had not taken into consideration the inaccessibility of Mqanduli to Emadwaleni communities.

“We requested a report unpacking the whole process, and we also want to know what the national position on the changes is,” he said.

The Dispatch is in possession of the original discussion document – drawn up in May last year by a team established by the department – which outlines plans to reshape the health services delivery system to provide accessible quality care health services.