The death of Hillbrow Hospital is bad news for patients from the city centre, writes Angella Johnson
A senior doctor at Johannesburg’s Hillbrow Hospital warns that people will die from lack of immediate medical care when it closes at the end of the year. But Gauteng health officials are adamant there will be no reprieve for the 102-year-old hospital.
“It’s a done deal. The decision has been taken, announced and cannot be changed,” declared Dr Norman Kernes, director of hospitals for the central Witwatersrand. “It will become a primary-care centre.”
Despite the finality of these words, Dr Harry Berzen, head of orthopaedic surgery at Hillbrow, said doctors are lobbying behind the scenes in a final desperate attempt to show that lives will be at risk if this famed teaching hospital is lost.
In a letter to the Department of Health he said: “Neither the Helen Joseph nor the Johannesburg Hospital will cope with the serious injuries we at present treat at Hillbrow. On a daily basis we get cases from the Johannesburg Hospital, which tends to close some time each afternoon.
“We are taking cases from Germiston and Boksburg/Benoni Hospital where surgeons believe that they work too hard and therefore are on strike and do not want to treat cases over the weekends.
“I predict that all the outreach projects you envisage will come to nothing and … the public will not get the service they are entitled to.”
From January to May this year, Hillbrow treated 11 582 surgical patients. There were 1 450 emergency cases a month.
Professor John Milne, academic head of the department of medicine at the Johannesburg Hospital, said he was “very concerned” about the decision. He argued that resources at his hospital are already stretched and the hospital will not be able to pick up the shortfall.
Staff at Hillbrow Hospital were told in June that it would close on December 31 this year, but knew for two years before that it was on the cards.
The Gauteng Health Department says the decision has been based on good fiscal policy. “We are a middle-income country with severe budgetary restraints and a national commitment to upgrade clinical and primary health care,” explained Dr Kernes.
He added that although Hillbrow was the best site for a teaching hospital, it would cost too much money to modernise after being neglected over the years. “Most hospitals worldwide reach the end of their lives after about 80 years unless significant money is spent on them, which we cannot afford to do.”
Surveys have shown that most of Hillbrow’s patients come from the greater Johannesburg area and beyond. The plan now is to build up regional hospitals in Gauteng service people in their districts.
But critics claim this is a false economy when the city is trying to rebuild its central business district (CBD). According to a former professor at Hillbrow – who does not want to be named – “the government does not realise that it has underfunded Johannesburg, which has more people than is realised. Because urbanisation is taking place at a rapid rate we need a tertiary hospital to cover the CBD.”
This view is shared by Robert Mhlongo, who has had extensive reconstruction surgery and skin grafts at Hillbrow to restore his left knee and calf, after he had been hit by a taxi in the centre of town.
“I think I would either have died or lost my leg if I had to be taken to Johannesburg Hospital, with no guarantee that they would treat me immediately.”
Hillbrow staff are heartbroken. Even though they have been offered alternative postings, many say they are chosing to leave the country rather than go to other hospitals which, they claim, are not properly resourced. In the orthopaedic unit three top specialists left in June – two for Scotland and one into private practice.
“I’m not appealing as a head of this department but as a citizen. This is a travesty, an injustice,” Berzen said.”Our doors are never closed and if this hospital closes then people will have nowhere to go.”
If current pleas fail, he hopes at least to save the trauma unit by moving it to Edenvale Hospital. Another concern is that Hillbrow has the only radiography therapy unit in the province, which will be transferred to Johannesburg Hospital.
“That is going to cost about R16-million and it has not even started yet. What will happen in the interim once this is gone?” asked Berzen. “I’ll tell you: many will not survive, or will have to be treated in expensive private clinics.”
Kernes, who trained at Hillbrow, said that while he was emotionally ambivalent about the closure, on an analytical level it was the right way to go to provide adequate health care for as many people as possible.