Madiba’s Dream On Track

We are shocked and disheartened at the articles published on Monday 11 September 2017, about the Nelson Mandela Children’s Hospital. These articles deliberately misrepresent a project which was so dearly loved by Madiba and it well on track to deliver his dream for South African Children. 

Last week, National Department of Health (NDOH), Nelson Mandela Children’s Hospital (NMCH) and Nelson Mandela Children’s Hospital Trust (the Trust) responded comprehensively to queries from this journalist and we were under the impression that the facts about the hospital were fully understood.

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 Minister of Health is on record emphasising how NMCH will augment healthcare as the second paediatric hospital in South Africa.  

This hospital also has partnerships with academic institutions University of Witwatersrand Medical School, University of Pretoria Medical School and Sefako Makgatho Health Sciences University. And in response to yesterday’s reports, Prof Martin Veller, Dean of Health Sciences at the University of Witwatersrand Medical School said: “The Faculty of Health Sciences of Wits has always fully supported the development of NMCH. Such dedicated hospitals have dramatically improved the care of sick neonates and children who are amongst the most vulnerable in most societies. While the cost of such stand-alone hospitals is higher, the improved quality of care has justified this additional spend in many parts of the world. This is the reason that so many such hospitals exists in many countries. For example, Greater Ormond Street Hospital in London, The Hospital for Sick Children in Toronto, and the Royal Children’s Hospital in Melbourne.

“From an academic perspective, all Gauteng universities training in medicine look forward to using this facility to train paediatric and paediatric-associated specialists and sub-specialists, and to do research in paediatric-related fields. It must be noted that all such large projects take time to develop. For this reason, a slow start in getting NMCH clinical programme off the ground is not surprising.”

The claim that “there are fears amongst some doctors that [NMCH] will become a white elephant” are concerning. We have a vibrant platform of engagement with a committee of deans of 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 DOH and National Treasury have nothing to do with this hospital. The Minister of Health wants it on record that the issue of funding was agreed with Madiba as far back as 2009; that Madiba and the Trust would raise funds to put up infrastructure and equipment, and have the Trust maintain both infrastructure and equipment. But in order for the hospital to truly be a home for all children including the underprivileged, the operating costs would be borne by the State. The Minister stands by this commitment.

In February 2017, the Minister of Finance himself stated in his budget: “…An additional R885 million has been added to support the implementation of the universal test-and-treat policy for HIV, and R600 million for the commissioning of the new Nelson Mandela Children’s Hospital…”

This meant that the R600 million is over the three-year MTEF period. There is no government department or entity that gets all the funding for the whole MTEF period at once, or in one financial year, so NMCH was given R150 million for the 2017-18 financial year to make a start.

The figure of R500 million has been punted as the running cost of this hospital, and used as proof that since the state only gave R150 million, the hospital will collapse because the state is not interested in funding it. This figure was an estimate made by experts in the past 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 launch of NMCH on December 2nd, 2016, was to mark the successful completion of the infrastructure and the installation of equipment which took place within a period of two years as planned (a project of this magnitude usually takes five years to complete).

Since then, there has been a thorough preparatory phase which included recruitment of executives, management and technical staff; setting up of governance systems, policies and protocols; establishment and contracting of service providers; training of staff in running this type of hospital and its ultra-modern equipment and simulation exercises to ensure patient safety.

The Minister of Finance committed the operating costs in the February 2017 budget speech, and the new financial year to which the MTEF period refers only kicked in on the 1st of April 2017. The first tranche of R150m was received only on the 1st of May, and in June the hospital accepted its first outpatients as originally planned.

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

We all wish to reiterate that the Trust will support this project in terms of infrastructure and equipment maintenance, and the state will continue to support the operating costs of the hospital. This type of decision does not lie in the hands of a few faceless individuals, but in the hands of government and the Trust, as well as the international community as promised to Madiba, and South African society as a whole.