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During the last 24 hours discussion and meetings have taken place to address the question of emergency medical care in the central areas of Johannesburg.

The conversion of Hillbrow Hospital into a community health centre is a really major change in service provision and the Gauteng Health Department certainly expected there would be some rough patches along the road.

However, the impact on Johannesburg has been larger than was expected.

We have taken stock of the situation and made the adjustments we believe are necessary to restore a balance between the demand for emergency care and our capacity to meet this demand.

Despite the fact that Hillbrow Community Health Centre will have a 24-hour casualty section, fully staffed and equipped to deal with a wide range of emergencies, many residents have already ceased using Hillbrow. Largely as a result of this, Johannesburg has experienced a rise in trauma cases (in the range of about 30%). On weekends, when trauma cases reach a peak, the hospital has struggled to cope.

As a result of discussions, the following steps are being taken:

A shuttle service will operate to transfer patients from Johannesburg to Hillbrow in instances where the injury or illness is not so severe as to require hospital care. The Hillbrow casualty is well-equipped and staffed. It could cope with hundreds of patients daily - but presently is seeing just 30 or 40 a day. Only the most serious injuries and illnesses, those referred to as "Priority One" cases, will normally be seen at Johannesburg Hospital.

Potential obstacles to the use of Hillbrow have been identified and addressed. For instance, signs have been erected to counteract the impact of new security measures which could reinforce the perception that Hillbrow has "closed". Possible miscommunications by personnel, including security workers and emergency services, have been checked. Pamphlets giving a run-down on the new health centre's services continue to be distributed in surrounding areas.

Johannesburg Hospital today received additional equipment for its casualty department from Hillbrow Hospital. The equipment ranges from basic items, like trolleys, to sophisticated instruments used in resuscitation. This will enable the hospital to cope far more effectively, particularly during peak periods.

Staff will also be seconded temporarily to Johannesburg Hospital from Hillbrow. They include porters and clerks, whose availability during peak night shifts will free nursing staff to do more appropriate work. Some staff nurses will also be seconded to Johannesburg. Every effort is being made to see that staff are in place by the Christmas long weekend.

I spent several hours last night at Johannesburg and Hillbrow Hospitals to get a first-hand sense of the problems. And I feel confident that these new arrangements are appropriate and that they will ensure satisfactory access to emergency care for the people of Johannesburg during the festive season and beyond.

Dr Eric Buch Acting Superintendent-General

Inquiries to Jo-Anne Collinge Tel 082 574 5510
Issued by: Gauteng Provincial Government
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