Childrens hospital a mammoth boost not a white elephant

Author: Aaron Motsoaledi and Mandisa Maholwana

Source: Business Day

The R500m was an estimate based on the cost of running a 200-bed children’s hospital at full throttle.

We are shocked at the article about the Nelson Mandela Children’s Hospital (Mandela hospital faces funding crisis, September 11), which misrepresents a project that was dearly loved by Madiba.

There cannot be any debate about the need for this type of facility. The business case has been proven, international hospitals have partnered with us and the health ministry is on record emphasising how the hospital will augment healthcare as the second paediatric hospital in SA.

The hospital also has partnerships with the University of Witwatersrand (Wits) Medical School, the University of Pretoria Medical School and the Sefako Makgatho Health Sciences University.

Wits Medical School dean of health sciences Prof Martin Veller says the Gauteng universities look forward to using this facility to train paediatric and paediatric-associated specialists and subspecialists, and to do research in paediatric-related fields.

The claim that “there are fears among some doctors that [the hospital] will become a white elephant” is a concern. We have a vibrant platform of engagement with a committee of deans at the universities, as well as clinical advisory committees of academics and doctors from Chris Hani Baragwanath Hospital, Charlotte Maxeke Johannesburg Academic Hospital, Dr George Mukhari Academic Hospital, Steve Biko Academic Hospital, Helen Joseph Hospital and Rahima Moosa Mother and Child Hospital, who are all excited about this hospital.

The article also claims the Gauteng health department and Treasury have nothing to do with this hospital.

The health ministry is on record stating that the issue of funding was agreed with Mandela as far back as 2009; that the former president and the Nelson Mandela Children’s Hospital Trust would raise funds to put up infrastructure and equipment and have the trust maintain these.

The operating costs will be borne by the state, and the ministry stands by this.

In February 2017, the finance minister stated in his budget that “an additional R885m has been added to support the implementation of the universal test-and-treat policy for HIV, and R600m for the commissioning of the new Nelson Mandela Children’s Hospital”. This means the R600m is over the three-year, medium-term expenditure framework period. No state department or entity gets all the funding for the whole period at once, or in one financial year, so the hospital was given R150m for the 2017-18 financial year.

The figure of R500m has been punted as hospital’s running cost and used as proof that since the state gave only R150m, it will collapse. The R500m was an estimate made by experts based on the cost of running a 200-bed children’s hospital at full throttle.

The hospital is not yet running at that level.

The December 2016 launch of the hospital marked the successful completion of the infrastructure and the installation of equipment, which took place within two years, as planned — a project of this magnitude usually takes five years to complete.

Since then, there has been a thorough preparatory phase that has included the recruitment of executives, management and technical staff; the setting up of governance systems, policies and protocols; the establishment and contracting of service providers; the training of staff in running this type of hospital and its ultramodern equipment; and simulation exercises towards ensuring patient safety.

The finance minister committed the operating costs in the February 2017 budget speech and the new financial year to which the medium-term expenditure framework period refers, has only started on April 1. The first tranche of R150m was received only on May 1, and in June, the hospital accepted its first outpatients, as originally planned.

Since June, the hospital has seen almost 200 children with special problems. These are children who would otherwise have had to compete with adult patients for specialised tests such as MRI and CT scans because the volume and need for this type of care are huge in government hospitals as it is prohibitively expensive in private hospitals.

We wish to reiterate that the trust will support this project in terms of infrastructure and equipment maintenance, and the state will continue to provide support with regard to the operating costs.

• Motsoaledi is health minister and Maholwana CEO of the Nelson Mandela Children’s Hospital.