Ire over impact of possible clinic closures in Cape Town

THE Western Cape Department of Health’s plans to take over 10 City-run clinics, which may lead to closures, has been slammed as it will put pressure on the already strained system where patients are forced to sleep on the floor in some hospitals.

When MEC for Health Nomafrench Mbombo recently revealed that 10 clinics would be transferred to her department by June 30, she told MPLs that “we must dala what we must.”

The list of clinics include Dirkie Uys Clinic in Goodwood, Durbanville Clinic, Heideveld Clinic, Kasselsvlei Clinic in Bellville South, Nolungile Clinic in Khayelitsha, Nyanga Clinic, Parow Clinic, Ravensmead Clinic, Scottsdene Clinic in Kraaifontein and Fisantekraal facility in Durbanville.

“There are other smaller facilities run by the CoCT, some of which are in close proximity to Western Cape Government Health (WCGH) facilities. The CoCT and WCGH must still agree on this position. CoCT clinics are considered for closure when they are small and a nearby WCG health facility can provide the services currently being provided by the small clinic,” she said.

Speaking during a budget vote meeting before the standing committee, head of department, Dr Keith Cloete said the department’s policy was to have healthcare services under one management.

“Primary healthcare services in the metro should be under the provincial government’s authority. We have commenced processes with City counterparts and the (MEC) has met with the mayco member and we are looking at a phased process for consolidation of service,” he said.

According to its budget vote, the department has allocated R18 million for the 2020/23 financial year to the “provincialisation of the City of Cape’s primary health care services”. A further estimated R40m has been set aside for coming financial years.

The ANC’s health spokesperson Rachel Windvogel demanded answers as to what would happen to facilities once under the department’s control.

“The MEC is withholding critical information regarding clinics that may be closed down. The closure of clinics in Khayelitsha and Nyanga will only lead to further collapse of services in local health facilities and district hospitals. The closure of GF Jooste resulted in increased service pressure at Khayelitsha and Mitchells Plain District Hospitals. The planned closure of health facilities will worsen the impact. In addition to this, sick and frail patients will be forced to travel longer distances and forced to spend money to get basic health services.

“On top of the 63 health facilities that have closed in the province since 2014, additional facilities may be closed across the City before the end of June,” she said.

Mbombo said the department had over the past eight years closed down 63 health facilities that included clinics, satellite clinics, mobile services, intermediate care facilities, forensic pathology services and reproductive health centres.

“These facilities had provided temporary services, such as mobile clinics, which account for 21 of the closed facilities, and the CTICC Intermediate Care Facility, which closed once it was no longer needed for Covid-19 patients. Others, such as Robbie Nurock and Woodstock (Community Day Centre) CDCs amalgamated into District 6 CDC,” she said.

MPLs again questioned Mbombo and her team on whether there were plans to grant Khayelitsha Hospital R150m requested to help manage an increase in demand for services.

Last month, the hospital’s CEO David Binza said the 340-bed facility often exceeds its capacity by 130%.

Mbombo said she was aware that patients slept on the floor.

“They will be on the floor because we will never be able to accommodate not only the numbers but the disease profile there. No healthcare professional wants to take care of patients in the passage.

“There is nowhere else to go, unlike in schools when you bring (a) child for enrolment, they can say they are full and you must go elsewhere and when you are staying in a shack and want a house, you get (put on a list) and you have to wait, when you apply for a social grant, they’ll say wait. Unfortunately, with a hospital we cannot say we are full. It is beyond us, we don’t have money. We do understand, but we must dala (do) what we must to save lives even we don’t have money.

“And it is not just Khayelitsha, in Ceres they have to queue outside while waiting but it may be different situations,” she said.

Cloete said four facilities - Klipfontein which would replace the closed GF Jooste Hospital, Belhar regional hospital, Helderberg regional hospital and a replacement for Swartland hospital - were priority projects for the department.

During his budget speech this week Finance and Economic Development MEC David Maynier said R3.6 billion had been set aside to spend on health infrastructure, which includes a new facility to house the burnt Swartland Hospital.