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