Presentation to Health Committee
D Kahn
Department of Surgery
Presentation to Health Committee
• Impact of CSP
• Implementation of CSP
• Health budget
• Transformation
Comprehensive Service Plan
• Excellent plan
• Primary Health Care approach
• Appropriate care at the appropriate level
• Improve level 1 services
Comprehensive Service Plan
• Excellent plan
• Primary Health Care approach
• Appropriate care at the appropriate level
• Improve level 1 services
• ………BUT…….
Comprehensive Service Plan
• Major concerns about the impact on the Level 2 and Level 3 (Tertiary) services
GENERAL SURGERY TERTIARY SERVICES
HPB
P BORNMANJ KRIGEJ SHAW
15 BEDS (+4)THEATRE
COLO-RECTAL
P GOLDBERGD STUPART
15 BEDS (+4)THEATRE
ENDOCRINE/ONCOLOGY
E PANIERI
15 BEDS (+4)THEATRE
VASCULAR
N NAIDOO
15 BEDS (+4)THEATRE
TRANSPLANT
D KAHNE MULLER
7 BEDSTHEATRE
ICU
L MICHELL
TRAUMA
A NICOLP NAVSARIA(S EDU)
45 BEDSTHEATRE
GROOTE SCHUUR HOSPITAL
GENERAL SURGERY TERTIARY SERVICES
GF JOOSTE
J VENTERD ALLARD FCS
M LUKASIEWICZ FCS
REGISTRARSMEDICAL OFFICERS
SOMERSET
(N CLOETE FCS)H BOUGARD FCS
REGISTRARSMEDICAL OFFICERS
VICTORIA
I LORIMER FCSS LONGHURST
REGISTRARSMEDICAL OFFICERS
GROOTE SCHUUR HOSPITAL
PATIENT REFERRAL CONSULTANT INTERACTION
REGISTRAR ROTATIONACADEMIC MEETINGS
MORBIDITY AND MORTALITY MEETINGS
SOMERSETGF JOOSTE VICTORIA
GROOTE SCHUUR HOSPITAL
PATIENT REFERRAL CONSULTANT INTERACTION
REGISTRAR ROTATIONACADEMIC MEETINGS
MORBIDITY AND MORTALITY MEETINGS
SOMERSETGF JOOSTE VICTORIA
GENERAL SURGERY TERTIARY SERVICES
HPB
P BORNMANJ KRIGEJ SHAW
15 BEDS (+4)THEATRE
COLO-RECTAL
P GOLDBERGD STUPART
15 BEDS (+4)THEATRE
ENDOCRINE/ONCOLOGY
E PANIERI
15 BEDS (+4)THEATRE
VASCULAR
N NAIDOO
15 BEDS (+4)THEATRE
TRANSPLANT
D KAHNE MULLER
7 BEDSTHEATRE
ICU
L MICHELL
TRAUMA
A NICOLP NAVSARIA(S EDU)
45 BEDSTHEATRE
LEVEL 2 SERVICE
SURGEONREGISTRARS / MOBEDS?THEATRE?
THEATRE TIME
No of Theatre Lists / week
PAST CURRENT
HPB 5 2
VASCULAR 6 2
COLORECTAL 7 2
ONCOLOGY 5 2
NEUROSURGERY 5.5 2.5
ORTHOPAEDICS 46 17
UROLOGY 9 4.5
ENT 15 7
CARDIAC 14 5
GROOTE SCHUUR HOSPITAL
PATIENT REFERRAL CONSULTANT INTERACTION
REGISTRAR ROTATIONACADEMIC MEETINGS
MORBIDITY AND MORTALITY MEETINGS
SOMERSETGF JOOSTE VICTORIA
Comprehensive Service Plan
• Current surgical services are working well
• CSP will impact on:– Service delivery– Teaching medical students– Training of registrars
Implementation of CSP
• Level 2 service in GSH
• Level 2 surgeon
• No additional theatre time/beds
Implementation of CSP
• Rationale : 40 – 50% of the service is Level 2
• (Study by Dr Belinda Jacobs)
Implementation of CSP
• ? Should we appoint a Senior Specialist (Level 2) to do 5% of the work
Health Service
• Budget driven
• Needs driven
• Quotas
Transformation
• Fully support transformation
• Cannot agree with the policy of demographic targets which affects Indians
Thank you
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