11 April 2021

KwaZulu-Natal Health MEC Ms Nomagugu Simelane has made an impassioned plea to the public to adhere to the Department's established patient referral system, saying this would help prevent unnecessary overcrowding of high-level and specialist hospitals due to the presence of patients with minor ailments.

Over the past year, the Department has recruited no fewer than 6 757 additional personnel, on a contractual basis, to bolster its capacity to fight the COVID -19 pandemic, as well as respond effectively to the province's pre-existing burden of disease.

The Department has also made massive investments in infrastructure development, which has included the upgrading of previously dilapidated and poorly-resourced health facilities through construction of COVID - 19 isolation facilities that can be easily converted into ICU and high care wards in future, as well as the procurement of health technology equipment.

All of this has, to a considerable extent, given healthcare facilities the ability to enhance service delivery by reducing patient waiting times, and improving overall client experience.

Furthermore, patients who may be aggrieved now have better recourse since the contact details of hospital Public Relations Officers, clinic operational managers, hospital CEOs, and district managers have been made visible at strategic facility areas, and on publicly available on the Department's official website and on its social media platforms - as per the directive from MEC Simelane.

The Department also has a help desk that is accessible through its official Facebook page (KwaZulu-Natal Department of Health) inbox.

Speaking during the official renaming and opening of the Mfundo Arnold Lushaba Community Health Centre (former Turton CHC) at Umzumbe on Friday, MEC Simelane said: "It is important, wherever we go, that we talk about how our referral system works, so that our communities understand and adhere to it. For an example, if I wake up today suffering from a bout of flu, is there really a need for me to go GJ Crookes, or come to a Community Health Centre when I have a Primary Health Care clinic closer to me?

"When we have minor ailments, but leave our clinics and come to health facilities at a higher level care, we are taking up space for people who have serious conditions, or who may be seriously or critically injured and require emergency care."

The South African public healthcare system is structured as follows:

1. Primary Health Care Clinics: A Primary Health Care Clinic offers services such as immunisation, family planning, anti-natal care, and treatment of common ailments, treatment and management of Tuberculosis, HIV/AIDS counselling, among other services. If the clinic cannot assist, they will refer the patient to a Community Health Centre.

2. Community Health Care Centres: A Community Health Care Centre, which is also known as a "mini hospital", is the second step in the provision of health care, but can also be used for first-contact care. It offers similar services to a Primary Health Care Clinic, but with the addition of a 24-hour maternity service, emergency care, casualty, and a short stay-ward. The Community Health Care Centre will refer a patient to a District Hospital when necessary.

3. District Hospitals: These hospitals normally receive patients who have been referred by Primary Health Clinics or CHC, and provide generalist support such as diagnostic, treatment, care, counselling and rehabilitation services. Clinical services offered at a District Hospital include Surgery, Obstetrics & Gynaecology, Out-Patients Department, Medicine, Peadiatrics, Mental Health, Geriatrics, Casualty and Clinical Forensic Medical Services, among others. Patients at district hospitals will be delivered by doctors and primary health care nurses. If the District Hospital cannot help a patient, then they will refer them to the local Regional Hospital for treatment.

4. Regional Hospitals: This is the second level of health care. These hospitals will normally receive referrals from district hospitals, and provide specialist support. If the Regional Hospital cannot help; they will refer to the Provincial Tertiary Hospital.

5. Provincial Tertiary Hospitals: These hospitals provide sub-specialist support to a number of regional hospitals and are at the third level of health care. They are staffed by specialists and generalists and offer services such as neurosurgery, neurology, Plastic & reconstructive surgery, Cardiology, Urology, Paediatric surgery, maxillio-facial surgery, Psychiatry, Occupational health and Orthopaedics amongst other services. If a Provincial Tertiary Hospital is unable to help a patient, they will refer them to a National Central Hospital.

6. Central Hospitals: Central hospitals are at the fourth and highest level of health care. They consist of very highly specialised referral units, which together provide an environment for multi-speciality clinical services, innovation and research. Patients are referred to these hospitals by Provincial Tertiary Hospitals.

MEC Simelane added: “When we design these referral patterns, our intention is not to make our people suffer. Yes, once you arrive at a hospital, you may not be turned away... but it's important that we make the public understand these things, so that they seek help at the appropriate level, according to their ailments.

"That will ensure that our facilities do not get known for being overcrowded when they need not be."

The nearly 7000 staff members who have recently been recruited at clinics, Community Health Centres, and hospitals have been deployed in various categories, as follows:

• Staff nurses: 3 844
• Nursing Assistants: 1 238
• Admin Clerks: 611
• General Orderlies: 923
• Data Capturers: 30
• Physiotherapists: 21
• Radiographers: 26
• Psychologists: 4
• Audiologists: 26
• Optometrists: 4

From these numbers, 1030 enrolled nurses have been promoted to professional nurses.

The Department will continue to seek out ways to improve the quality of healthcare provision in the province, said the MEC.