Speech by Gauteng Premier Mbhazima Shilowa at the opening
of the Pretoria Academic Hospital

2 March 2007

The opening of the new Pretoria Academic Hospital is yet another testimony to our commitment to continuously improve health infrastructure for the benefit of all South Africans. We commend the national and provincial departments of Health, the City of Tshwane and the University of Pretoria for working tirelessly to make this flagship project a reality.

From its early beginning as a hospital reserved only for a single race group (die volk) to a general hospital catering for all categories of patients to a tertiary referral hospital providing highly specialised care, this hospital has evolved into a national asset that we can all be proud of.

For those who have been involved in the planning and construction of this hospital, it probably feels like the end of a long marathon. For the staff, the medical practitioners, the nursing personnel and the academics from the University of Pretoria, it is a dawn of a new era - to be able to work in a new facility equipped with the latest medical technology.

For the people of Tshwane and for the patients, who come from Mpumalanga, Limpopo and some from the North West, this is a fulfilment of a promise of a better life and a better health care system for all.

The returns on the R1.2 billion - invested in the construction of this hospital (R700 million) and the purchase of latest technology equipment (R500 million) - will be seen for many years to come in the number of people whose lives will be saved and the number of medical personnel who will receive training here.

This is a showpiece of our hospital revitalisation programme and our commitment to improving the quality of health services in our province.

During the opening of the Gauteng legislature we said the following:

"Imagine the following scenario: All patients with chronic diseases are in possession of a smart card containing all their medical history. When Mr Dlamini collapses at home and is rushed to hospital, the doctor simply swipes his card to immediately know what illnesses he was treated for previously and the prescribed medication. The doctor is in turn able to speedily diagnose what may have caused Mr Dlamini's collapse.

After recovery, when Dlamini returns to the hospital, administration clerks do not have to go through a long process of opening a new file for him. They too simply swipe his card to know that he has come to pick up his monthly supply of medicine. The dispensary is immediately alerted of Dlamini's presence and pharmacists begin packing his medical supplies before he arrives at their window. When he gets to the window, he simply collects his medical supplies and goes home.

Improbable? No! If Gauteng is indeed a smart province it will be so!"

As you have seen during the presentation, the hospital has no less than 22 well-equipped theatres including specialised theatres for cardiothoracic surgery, neurosurgery, reconstructive surgery and gynaecology. This hospital is also pioneering the introduction of digital radiology. In simple terms it means that we have done away with x-ray plates and that the scanned images are now available on computer screens to assist the clinicians with the diagnostic process. Yet another step by the province to use the new technology to improve service delivery.

Since 1994, we have focussed on improving access to health care for all the people in our province. With primary health care as a central pillar of our new health care system we have been building and upgrading clinics and hospitals around the province.

However as we were improving the health infrastructure we realised that, in most cases, this did not translate into improved service delivery.

Therefore a more comprehensive programme, called the revitalisation programme was developed to address the many factors affecting the delivery of quality health care. Over and above infrastructural improvement, we said health equipment must be of good quality and always available. There should be improvement in human resources and the management of the Hospital. The programme also addresses the issues of quality information management as critical in improving efficiency.

In Gauteng, the Pretoria Academic Hospital is the first facility on the revitalisation programme to be completed. Chris Hani Baragwanath and Mamelodi hospitals are two other facilities on this programme and they are still under construction.

After we have done all the work, a sceptic might still ask the question: "so what has changed?" It will not be sufficient to point to the brick and mortar structure and the cold platinum, iron and steel equipment as evidence of what has changed. To answer the question sufficiently we will have to look at the experience that our patients have at our hospitals. We will have to look at the attitude of our personnel towards patients and visitors to find answers to this question.

If patients still wait in long queues to see a doctor, if they continue to feel that they are not receiving proper and adequate care and if they continue to die in stretchers waiting to be attended to, a sceptic will be led to conclude that our efforts are like pouring old wine in new bottles.

As we build this province into a globally competitive city region, we are required to re-examine the manner in which we deliver services, including health care. Once we come to a point where waiting are no longer in existence, when patients feel that they are treated with dignity and respect, when adverse events from our hospitals are no longer a common feature in newspapers, when surgical backlogs no longer exist we will say we have achieved a service revolution in our health care system. For staff and managers working in this hospital, this is a start of that revolution. Our aim is total quality improvement.

For our partners at the University of Pretoria and other medical schools this will requires a re-look at the kind of training provided to our nurses, our medical and related personnel. Gauteng's two medical schools the University of Pretoria and Wits produce a third of medical doctors trained in this country. Notwithstanding this we are still experiencing a shortage of doctors at a time when our health system is under pressure because of HIV and AIDS, TB, and disease of lifestyle. To achieve the target - set in the national Human Resources Strategy for Health - of doubling the number doctors produced by our medical schools by 2014 will required a fundament change in mindset.

It seems to me that medical schools have to pay close attention to the attrition rate among medical students of African descent. While the schools are now enrolling more of these students, the number of those who eventually graduate is still small. The number of African and female who take up post-graduate studies is even smaller.

According the Human Science Research Council, the number of African students enrolled in all eight of medical schools throughout the country, has improved from 32.8 in 1999 to 41% in 2003. The number of graduates is lagging behind with a marginal increase from 29% in 1999 to 32.6% in 2003.

This centre of excellence we have been able to establish here, gives me confidence that we will be to find solutions to these challenges and in time we will be able to answer our critics when they are ask: "So what has changed? Is this not old wine in a new bottle?"

As we take steps to preserve this hospital as a truly tertiary institution, it will be essential to avoid making it an ivory tower, inaccessible and unresponsive to the health needs of the people.

Research activities undertaken here should not merely be for academic purposes but must seek to respond to every day health challenges faced by the overwhelming majority of the people of our province, our country and our continent. Conditions such as malaria, HIV and AIDS, waterborne diseases, conditions related to poverty and deprivation and, to an increasing degree, lifestyle oriented diseases, place a heavy burden on the health of our people and require your attention.

There is an urgent need to address factors that give rise to ill-health, to teach our people to manage their lifestyle better rather than waiting for them to develop hypertension and complications of heart disease before we intervene with sophisticated and expensive treatments.

Therefore an institution of the calibre and reputation of Pretoria Academic Hospital can assist greatly promoting healthy lifestyles, stress management and regular exercise. This is the only insurance that the hospital can take to protect itself against an avalanche of patients seeking treatment for complications brought about by avoidable factors obesity, alcohol and drug abuse as well as other unsafe health practices. The carnage on our roads, homes and in society also places a pressure on facilities such as this one with more people admitted for lengthy periods because of road accidents, domestic violence and crime. Our doctors and nurses must therefore join hands in with civil society in a national effort to the scourge of trauma that afflicts our people.

I want to pay tribute to everybody who has made a contribution towards the establishment of this facility. The current administration and the current health sciences faculty at the University Pretoria have run the final mile but their efforts have been preceded by generations of dedicated medical personnel who played a pioneering role in caring for and looking after the health status of our people.

My sincere thanks go to the former MEC for Health Dr Gwen Ramokgopa who championed the revitalisation of this hospital for years. Mr Brian Hlongwa, I also thank you for successfully finishing this project. I also want to express my appreciation to the Hospital Board under the able leadership of Mr Sandy Lebese, for their contribution to retain vital links between the hospital, the professionals and the communities they serve.

It is now my pleasure and privilege to declare the Pretoria Academic Hospital officially opened.

Thank you.