Public/private Parktown hospital a model of equity/access
Hospital Association of South Africa – Wednesday, 28 August 2019
Minor miracles in equitable, quality healthcare provision can happen when unlikely partners join forces, Dr Sue Tager, CEO of the Wits University/Donald Gordan Medical Centre in Parktown, Johannesburg told the Hospital Association of South Africa, (HASA), conference yesterday (Tuesday, 27 August).
Speaking on “Collaboration in Healthcare; the art of the possible,” she told an admiring audience that the 220-bed private academic hospital, established in 2002, had gone from training 20 super-specialists to 80 currently, with over a thousand doctors having rotated through it.
Originally the dilapidated Kenridge Hospital, the Centre was purchased in the late 1990’s by Wits University, supplemented by a generous donation from the Sir Donald Gordan Foundation. It was born out of concern for the future of sub-specialist training and the lack of high-tech equipment in the public healthcare sector. Doctors in the public sector were forming limited private practices, leaving trainees unsupervised, while a more affordable type of healthcare delivery model was urgently needed. Dr Tager said Wits university had tried and failed to set up private training sites at various hospitals – and it soon became apparent at her institution that “universities cannot and should not, run hospitals’.
With the facility ageing along with its doctors, Mediclinic bought into it as a 49% shareholder, bringing in much needed cash and expertise; “a knight in shining armour, saving us from bankruptcy,” she quipped.
The turnaround included bringing in part-time clinicians eager to return to academia and focused on a higher common purpose, training doctors from 2007 onward. “They wanted to help us build academia and ensure the next generation of locally-produced doctors whom we can retain,” Dr Tager said.
The hospital went from being 30% full on weekdays, dropping to 15% full over weekends to constant, almost-full patient occupancy and today sees its self as business with a social purpose, even though Mediclinic is paid only a management fee, with all profits going back into refurbishing the hospital or supporting clinician/academics. She said it was a great sadness that 17 years since the Centre was established, there were still no funded public sector sub-specialist posts.
Outlining subsequent successes, Dr Tager said their liver transplant unit had gone from 13% of paediatric liver patients coming from the public sector in 2013 to 59% referred from State hospitals today. The only other liver transplant unit in the country (Groote Schuur Hospital), was doing less than five transplants a year. The hospital was running on 20% of donor funding and 80% of its own profits. Bed occupancy had gone from 23% in 2002 to 85,3% this year.
“It’s a marriage of two very different worlds and environments, but today we’re flourishing. It seems to me that this training model is scale-able and I’d love to see it replicated all over the country,” she said.