Controversy over Jooste Hospital closure

Located in Manenberg, the hospital is planned to close on 31 March 2013, with the reconstruction expected to start a month later. The rebuilding process will take approximately three years to complete.

“It is envisaged that the new hospital will be fully constructed by December 2016, for commissioning in January or February 2017. Patients within the Klipfontein sub-district will access emergency services via a new temporary emergency unit within the Klipfontein area. For other services patients will have to go to Mitchell’s Plain District Hospital,” Western Cape Health MEC Theuns Botha said.

The hospital serves patients in Manenberg, Philippi, Heideveld, Gugulethu, Nyanga, parts of Crossroads, Mandalay and Mitchell’s Plain.

The Western Cape Health Department says that when the hospital closes patients currently seen at the hospital will be managed at the new Mitchell’s Plain District Hospital and Groote Schuur Hospital, which are both within 15km of the current GF Jooste Hospital site. It says no staff at Jooste will lose their jobs.

But SAMA has many concerns.

For example, it is worried the new Mitchell’s Plain Hospital would not be able to absorb the loss of beds following Jooste’s patients. Jooste sees about 85000 patients a year. It has 96 beds for medicine. The plan for Mitchell’s Plain is to have 60 medical beds, of which 45 will be taken by the move of a ward from Lentegeur Hospital. This leaves a net of 15 beds for the spillover from Jooste, or 81 fewer beds than there currently are.

In a written response to GroundUp, Botha said there will be no shortfall of beds and that Mitchell’s Plain Hospital would absorb the Jooste patients. A “new temporary emergency unit within the Klipfontein area” would absorb the remaining beds.

SAMA is also worried what will happen to Jooste’s CT scanner which currently does about 3,500 scans a year. In response Botha wrote that the “CT scanner will be relocated to Tygerberg Hospital. The current patient load will shift to Groote Schuur Hospital. “But the response does not explain where the capacity for doing CT scans on the Jooste patients relocated to Groote Schuur will come from.

Also, Jooste trains medical students, but no teaching or training is planned for the Mitchell’s Plain Hospital. In response, Botha wrote that “no undergraduate training will happen at the new [Mitchell’s Plain] hospital for the first two years. Students will be absorbed at other institutions.”

Patients with complications from infectious diseases like HIV are also referred to Jooste from other clinics because it has specialist care. SAMA is worried about what will happen to these specialist services. Botha responded that there will be an infectious diseases unit at the Mitchell’s Plain Hospital. He wrote, “it will be medical officer driven, supported by a specialist through outreach and support, meaning the specialist will come from another hospital, e.g. Groote Schuur.”

Dr Zameer Brey, the Provincial Chairman of SAMA, is also concerned that Botha did not consult properly before making the decision to close Jooste. He said MEC Botha had gone on record as saying he did not need to consult SAMA with major decisions taken in this province, and as long as there was a budget, he would proceed.

“It is unfortunate that the MEC believes Doctors are not important in the delivery of health-care. We think it is best that this is explained to the many thousands of patients in the community, who expect to be assisted by a doctor when they visit their local health facility. Consultation is an inclusive process fundamental to success in health-care delivery, not an optional extra that is used when convenient,” Brey said. “This approach conveys a rather distasteful heavy handed bureaucracy and a disregard for doctors, as part of a health care delivery system. Disappointingly the MEC has not responded to our request for a meeting. It is very clear that this is a matter that is much bigger than doctors. It involves all health-care workers at the facility and more importantly will affect the nearby population of more than a million people.”

In response, Botha said information sharing meetings were held with the facilities board and the staff. “The decision to rebuild GF Jooste Hospital is in the best interest of the people of the surrounding community. No formal or informal surveys were done. All staff will retain their positions.” Botha described the rebuilding of Jooste as “a good news story.”

The Treatment Action Campaign’s General Secretary, Vuyiseka Dubula, said they welcomed the plan to improve Jooste Hospital, but it had to be done in a manner that ensured people who need services, receive them while the new hospital is being rebuilt. “One of the key services is the Infectious Diseases unit. What will happen to people living with HIV who are taking their antiretroviral therapy at Jooste? Will Mitchell’s Plain cope with the numbers from Manenberg, Philippi, Heideveld, Gugulethu and Nyanga?” She asked.

Tambo Square resident Abegail Tontsi who gets her diabetes treatment from Jooste, said she didn’t even know that the hospital would be closed and rebuilt.

“Now we will have to use extra money to get to Mitchell’s Plain or these other hospitals. Jooste is just around the corner. But Jooste has been notorious for things like people dying when they go there for emergencies, so maybe an upgrade is needed,” she said.