The flailing Eastern Cape Department of Health will “repurpose” 19 small hospitals – those with fewer than 50 beds – in efforts to save money, a decision welcomed by healthcare organisations.
Health MEC Ntandokazi Capa announced the decision in her maiden budget and policy speech in the Eastern Cape legislature last week, reports News24.
The province has 92 hospitals and the decision is expected to affect small facilities with fewer than 50 beds, and which do not meet the criteria required to be classified as hospitals.
“The economic climate demands that government reviews the way we conduct our business,” Capa said.
The department’s “management of public hospitals in South Africa” policy, which came into effect in 2012, stated that the department should ensure promulgation of applicable legislation to improve the functionality of hospitals.
This includes that district hospitals be classified as small district hospitals when they have no less than 50 beds and no more than 150 beds; as medium-sized district hospitals when they have more than 150 beds and no more than 300 beds; and as large district hospitals when they have no less than 300 beds and no more than 600 beds.
“In the Eastern Cape, we inherited what was called provincially-aided hospitals which were run by NGOs but subsidised by the Department of Health,” she said.
“Nineteen of these have fewer than 50 beds …. So we will objectively consult all relevant stakeholders, especially communities, to … repurpose these, while ensuring communities receive good quality healthcare.”
Capa’s spokesperson, Mkhululi Ndamase, said extensive consultations would be held before the implementation of the plan.
The list of hospitals would be made public thereafter “so that there won’t be any misunderstandings or misinformation that might agitate communities”.
He said the principle of repurposing was premised on delivering the appropriate services, driven by the need and burden of disease.
“For example, there is an increase in admissions among the young population with substance-induced psychosis, prompting the need to establish or expand the mental health services, while there has been a reduction in TB patients.”
The Rural Health Advocacy Project, a division of Wits Health Consortium, said the repurposing of small hospitals was vital.
“The province has to consider the functionality of its hospital fleet,” it said, while the
Democratic Nursing Organisation of South Africa (Denosa) also supported the decision but stressed that consultation was critical.
“We are not yet clear on which hospitals will be repurposed and what their geographical location is but, in principle, we are in support.
“We know some of these hospitals are on private property, making it difficult to maintain or refurbish them, and some are TB hospitals no longer serving the purpose, as most TB patients are no longer hospitalised.
"However, in all this we demand effective and efficient service delivery through an organogram that is based on the needs on the ground.”
Two years ago, in her 2022 budget speech, former provincial Health MEC Nomakhosazana Meth had had said “low levels of hospital admissions for TB, coupled with a lack of district hospital and psychiatric facilities, have prompted the decision to close and repurpose” some TB and smaller hospitals.
See more from MedicalBrief archives:
Eastern Cape TB hospital closed but repurpose plans stall
Hospital staff who refused to be reallocated get R67m for doing nothing
DA: Orsmond TB Hospital in Uitenhage in danger of collapse