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Management: Paediatric hospitals
patient transport service, appropriately equipped and staffed to
stabilize and fetch children from the region and to integrate with
cross-border transfers.
Staffing and training
It is envisaged that most categories of paediatric and paediatric
sub-specialty medical personnel will be locally available to staff the
NMCH. Medical staff will be joint appointees at the University.
Specific categories of professional staff, including paediatric
surgical staff, will be recruited locally and abroad. The acquisition
of paediatric nursing staff remains the largest staffing challenge.
South Africa has, over the past decade, seen a deficit in available
nurses in all sectors and especially in the public sector, with losses
to first-world environments, an aging work force and movement
from the public to the private sector. The need to urgently attract
and above all train nurses for the NMCH has been recognized as
a priority and strategies are underway to address this. The
attraction to work in a modern, well-run institution, with
competitive earnings, is a strong drawcard.
A large group of paediatric clinicians have constituted the
Clinical Steering Committee and they have been consulted widely
at all stages of the project. This Committee is chaired by the
Academic Head of the Paediatric Department, Professor Peter
Cooper. This committee reports to the NMCH Task Team.
Reference
Ataguba et al., 2011. Socioeconomic-related health inequality in South Africa: evidence from
General Household Surveys. International Journal for Equity in Health 10:48.
Finances
The capital costs for the project will be raised by the Trust and are
projected to exceed R1 billion. (US$ 1 = R8).
Operating costs will derive from a variety of sources including
the National Department of Health (public patients), Health
Funders (private patients) and Government-to-Government
Funding (patients from neighbouring States). Modelling suggests
an 80:20 split of public to private patients. Admission to the
NMCH will be based entirely on medical need. No child will be
turned away because of an inability to pay.
Discussion
Effective comprehensive health care requires careful attention to all
levels of care. The most cost effective care is delivered at a primary
level and this includes preventive and promotive health. The South
African health services are currently revamping with attention
being given to all levels. The implimentation of a new National
Health Insurance aims to drastically reduce the inequities in health
and provide reasonable and affordable health care at all levels.
This includes appropriate tertiary levels of care as will be provided
by the Nelson Mandela Children’s Hospital. Children in the
developing world should also have access to the best! ❏
Keith Bolton is Associate Professor of Paediatrics at the University
of the Witwatersrand in Johannesburg. His major clinical and
research interests are in neonatology, clinical dysmorphology,
ethics and medical law. He serves as the Lead Clinician on the Task
Team of the proposed Nelson Mandela Children’s Hospital.
Acknowledgments
This article is based on a paper presented on 8th November, 2011
at the 37th World Hospital Congress in Dubai.
World Hospitals and Health Services Vol. 47 No. 4 23