Health

1. There are various factors that were considered in the planning and forecasting of hospital beds which are described in the Healthcare 2030:  Acute hospital bed plan which still remains the guideline for our hospital planning going forward.  The provincial acute hospital bed plan is a projection of hospital beds required over the next two decades based on the principles and strategic direction of Healthcare 2030. Forecasting hospital bed needs requires taking into account a range of factors, including amongst others, burden of disease and the heath needs of the population, local specifics of the geographic area, broader organisational arrangements of the health service, global and local utilisation trends, advances in technology, changes in the national and provincial policy context, affordability and the availability of  skilled human resources. This planning exercise has therefore coupled hard systems modelling with judgement based on the experience within the province, lessons learnt from previous planning exercises and feasibility. The policy directives that guided the metro hospital planning included easy and equitable access to district hospitals as first line hospital care ;  district and regional hospitals should provide a comprehensive package of care ; functional arrangements will be created to coordinate regional hospitals and district health services ; large district hospitals will render a varying degree of specialist services ; regional hospitals are referral hospitals to be located on major transport routes and the central hospitals will also provide general specialist services to the population in their immediate vicinity.

In order to differentiate between degrees of deprivation an equity measure was developed based on household income bands published in census 2011. The measure is applied at ward level and persons likely to use public health services are referred to as dependent persons.   The equity measure ensures that poor settlements will receive proportionately more resources to address their relatively higher burden of disease. The admissions per 1000 population and the ALOS for district and regional hospitals are differentiated according to household income to favour the poorest households.

2. As stated above, Healthcare 2030: Acute hospital bed plan considered various factors in deciding the way forward in determining the number of district beds and regional hospital beds. This bedplan has been approved by Cabinet and forms the basis of future roll out of Hospitals. We are constantly reviewing the service pressures and refining the health platform response. This is also part of the service re-design process that is unfolding in the department. The recognition of Helderberg Regional Hospital, Klipfontein Regional Hospital and TBH regional hospitals are proposed mega projects in the coming years speaks to the growing health burden and need for more specialist services in these drainage areas.

3. The budget allocation in terms of operational cost will first and foremost depend on the size of the hospital and then on the package of care, level of services and the appropriate staffing and support services required.