Presentation to Health Committee D Kahn Department of Surgery

Presentation to Health Committee Impact of CSP Implementation of CSP Health budget Transformation

Comprehensive Service Plan Excellent plan Primary Health Care approach Appropriate care at the appropriate level Improve level 1 services

Comprehensive Service Plan Excellent plan Primary Health Care approach Appropriate care at the appropriate level Improve level 1 services ………BUT…….

Comprehensive Service Plan Major concerns about the impact on the Level 2 and Level 3 (Tertiary) services

GENERAL SURGERY TERTIARY SERVICES HPB P BORNMAN J KRIGE J SHAW 15 BEDS (+4) THEATRE COLO-RECTAL P GOLDBERG D STUPART 15 BEDS (+4) THEATRE ENDOCRINE/ ONCOLOGY E PANIERI 15 BEDS (+4) THEATRE VASCULAR N NAIDOO 15 BEDS (+4) THEATRE TRANSPLANT D KAHN E MULLER 7 BEDS THEATRE ICU L MICHELL TRAUMA A NICOL P NAVSARIA (S EDU) 45 BEDS THEATRE

GROOTE SCHUUR HOSPITAL GENERAL SURGERY TERTIARY SERVICES GF JOOSTE J VENTER D ALLARD FCS M LUKASIEWICZ FCS REGISTRARS MEDICAL OFFICERS SOMERSET (N CLOETE FCS) H BOUGARD FCS REGISTRARS MEDICAL OFFICERS VICTORIA I LORIMER FCS S LONGHURST REGISTRARS MEDICAL OFFICERS

GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

GENERAL SURGERY TERTIARY SERVICES HPB P BORNMAN J KRIGE J SHAW 15 BEDS (+4) THEATRE COLO-RECTAL P GOLDBERG D STUPART 15 BEDS (+4) THEATRE ENDOCRINE/ ONCOLOGY E PANIERI 15 BEDS (+4) THEATRE VASCULAR N NAIDOO 15 BEDS (+4) THEATRE TRANSPLANT D KAHN E MULLER 7 BEDS THEATRE ICU L MICHELL TRAUMA A NICOL P NAVSARIA (S EDU) 45 BEDS THEATRE LEVEL 2 SERVICE SURGEON REGISTRARS / MO BEDS? THEATRE?

THEATRE TIME No of Theatre Lists / week PASTCURRENT HPB52 VASCULAR62 COLORECTAL72 ONCOLOGY52 NEUROSURGERY ORTHOPAEDICS4617 UROLOGY94.5 ENT157 CARDIAC145

GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

Comprehensive Service Plan Current surgical services are working well CSP will impact on: –Service delivery –Teaching medical students –Training of registrars

Implementation of CSP Level 2 service in GSH Level 2 surgeon No additional theatre time/beds

Implementation of CSP Rationale : 40 – 50% of the service is Level 2 (Study by Dr Belinda Jacobs)

Implementation of CSP ? Should we appoint a Senior Specialist (Level 2) to do 5% of the work

Health Service Budget driven Needs driven Quotas

Transformation Fully support transformation Cannot agree with the policy of demographic targets which affects Indians

Thank you