IT IS hard not to see the proposal for national government to take over control of Tygerberg and Groote Schuur hospitals in the Western Cape as a political move.
Health Minister Aaron Motsoaledi’s proposal to place South Africa’s top 10 academic hospitals under the control of his department will undermine the mandate of provincial health departments.
Although the proposals were mooted some time ago, the move gained new impetus with the support of delegates at the African National Congress’s national conference in Mangaung last month.
If it is implemented, the Western Cape government would lose control of Groote Schuur Hospital and Tygerberg Hospital.
The reason given by Dr Motsoaledi for taking control is that there are concerns that some provincial treasuries are diverting funds away from training doctors.
As part of a process of overhauling the health system in preparation for the introduction of national health insurance, a new system has been gazetted placing all state hospitals into one of five categories, including a new category of central hospitals. These 10 hospitals are considered to have strategic importance because they are South Africa’s top teaching hospitals.
While the proposal is being sold as essential to the process of upgrading state facilities in preparation for national health insurance, the question must be asked why government intervention is necessary in hospitals that deliver on their constitutional mandate.
This policy of centralisation is in direct contrast to the pragmatic approach taken by Dr Motsoaledi in the appointment of new CEOs in all state hospitals last year. Under a new policy that standardised the necessary qualifications for hospital managers, the Department of Health advertised 92 posts for new hospital CEOs.
Western Cape hospitals were, however, exempted from the process after an audit of staff revealed that all CEOs met or exceeded this basic level of qualification.
There is no question that the national government should intervene when provincial departments fail to deliver, as we have seen in the case of education in the Eastern Cape and Limpopo, but provinces that deliver on their constitutional mandate should be allowed to get on with the job.
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