Address by Minister Botha on the Reconstruction of GF Jooste Hospital

It is noted that the range of organisations that are signatories to the memorandum handed over on Monday appreciate the excellent work done by the staff at GF Jooste Hospital, and that the signatories support the construction of a new purpose-built hospital in the Klipfontein sub-district.

The GF Jooste Hospital will be rebuilt on its present site between 2013 and 2016. The hospital services currently provided to the Klipfontein community are fragmented. In fact, the current GF Jooste Hospital provides no maternity, gynaecological or pediatric services. Once complete, the new hospital will provide a full range of hospital services and support to the primary health care platform within the Klipfontein sub-district. While the hospital will have significant specialist presence and CT scan capabilities, patients requiring higher level specialist and sub-specialist care will be referred to Groote Schuur Hospital and Red Cross War Memorial Children's Hospital, in accordance with the referral policy of the department.

The new Mitchell's Plain Hospital is nearing its final stages of completion, and services at this hospital will be commissioned by June 2013. During the construction period of the new GF Jooste Hospital, staff and services will be largely relocated to the new Mitchell's Plain Hospital and Groote Schuur Hospital. Prior to the closure of GF Jooste Hospital, the department will make provision for the health needs of the surrounding communities, and continue to provide access to emergency services for the full duration of the construction period. It is important to acknowledge that if the GF Jooste Hospital were not closed during the construction period there would be significant disruption of services, as has occurred elsewhere. In addition, the cost of construction would escalate significantly.

There will be structured communication between the department and the affected communities, via the legislated structures - the District Health Council and the facility boards of the two hospitals. This will include the use of the print and electronic media, surveys and broader community meetings. Organized labour and individual staff members are being engaged in a structured fashion. This engagement commenced three months ago and is ongoing.

Specific concerns raised:

1. Down-grading of services:
   There will be no down-grading of services. The services that will be rendered at both Mitchell's Plain Hospital and the future GF Jooste Hospital includes district hospital services and generalist specialist care, appropriate for the burden of disease in the respective drainage areas.
2. Transport:
   Patients will continue to access emergency care within the Klipfontein sub-district at an Emergency Centre at the Heideveld Community Health Centre (CHC), with 30 overnight beds. If patients are to be admitted to another hospital, they will be transported by Emergency Medical Services (EMS) to the appropriate hospital for further care.
3. Human resources:
   Staff at GF Jooste Hospital will all retain their jobs. The majority of the staff will work at Mitchell's Plain Hospital for the duration of the construction of the new GF Jooste Hospital. They will return to work at GF Jooste Hospital upon completion of the hospital. All staff will work in posts equivalent to their current posts. During this month all staff members will receive individual written communication about their specific conditions of employment for the duration of the construction of the new hospital.
4. Interim plans to absorb the GF Jooste Hospital workload:
   Detailed plans are being finalised to ensure that patient care is not compromised during the period of the construction of the new hospital. These plans include specific details for each general specialty. Mitchell's Plain Hospital will render general specialist services (including CT scan services), in addition to the Family Medicine service delivery model. The eight high-care beds will relocate to Groote Schuur Hospital.
5. Stand-alone Emergency Unit:
   The Emergency Centre at Heideveld CHC will function with Emergency Medicine Specialist presence, and a 30 overnight bed ward facility. Any patient that requires additional care will be transported by EMS to either Mitchell's Plain Hospital or Groote Schuur Hospital.
6. Additional workload on CHCs:
   It is envisaged that the potential increase in workload at the surrounding CHCs will be adequately managed during the hospital construction period.
7. Closure of eight high-care beds:
   The eight high-care beds will relocate to Groote Schuur Hospital.
8. Infectious diseases:
   There will be appropriate infectious diseases care provided at the CHCs in the Klipfontein sub-district, as a well a rapid assessment unit at the Mitchell's Plain Hospital.
9. Student teaching platform:
   The department has undertaken to jointly plan with the University of Cape Town (UCT) to ensure that the current student activities at GF Jooste Hospital are successfully placed elsewhere on the service delivery platform for the duration of the construction of the new hospital.
10. Linking the opening of Mitchell's Plain Hospital with closure of GF Jooste Hospital:
    There will be no reduction of hospital services. There will in fact be additional paediatric and maternal and neonatal care provided in Mitchell's Plain Hospital.
11. Consultation:
    The department will prioritise the construction of the new GF Jooste Hospital on the basis of need. The plan to address access to hospital services is being developed in consultation with clinicians across the service delivery platform.
    The department will engage with all the relevant stakeholders in the coming weeks to address all their concerns in a systematic fashion. The process is complex, and it does require that all stakeholders work in synergy to ensure a desirable outcome for the patients of the Klipfontein sub-district.
    It must be noted that cabinet needs to give final endorsement to this project in the next month.

In closing:
Earlier this year we officially opened the Khayelitsha Hospital for the people of Khayelitsha. At present we are constructing the Mitchell's Plain Hospital for the people of Mitchell's Plain. Now we bring you the new GF Jooste Hospital for the people of Klipfontein.