1. Presentation to Health Committee D Kahn Department of Surgery

2. Presentation to Health Committee Impact of CSP Implementation of CSP Health budget Transformation

3. Comprehensive Service Plan Excellent plan Primary Health Care approach Appropriate care at the appropriate level Improve level 1 services

4. Comprehensive Service Plan Excellent plan Primary Health Care approach Appropriate care at the appropriate level Improve level 1 services ………BUT…….

5. Comprehensive Service Plan Major concerns about the impact on the Level 2 and Level 3 (Tertiary) services

6. GENERAL SURGERY TERTIARY SERVICES HPB P BORNMAN J KRIGE J SHAW 15 BEDS (+4) THEATRE COLO-RECTAL P GOLDBERG D STUPART 15 BEDS (+4) THEATRE ENDOCRINE/ ONCOLOGY E PANIERI 15 BEDS (+4) THEATRE VASCULAR N NAIDOO 15 BEDS (+4) THEATRE TRANSPLANT D KAHN E MULLER 7 BEDS THEATRE ICU L MICHELL TRAUMA A NICOL P NAVSARIA (S EDU) 45 BEDS THEATRE

7. GROOTE SCHUUR HOSPITAL GENERAL SURGERY TERTIARY SERVICES GF JOOSTE J VENTER D ALLARD FCS M LUKASIEWICZ FCS REGISTRARS MEDICAL OFFICERS SOMERSET (N CLOETE FCS) H BOUGARD FCS REGISTRARS MEDICAL OFFICERS VICTORIA I LORIMER FCS S LONGHURST REGISTRARS MEDICAL OFFICERS

8. GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

9. GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

10. GENERAL SURGERY TERTIARY SERVICES HPB P BORNMAN J KRIGE J SHAW 15 BEDS (+4) THEATRE COLO-RECTAL P GOLDBERG D STUPART 15 BEDS (+4) THEATRE ENDOCRINE/ ONCOLOGY E PANIERI 15 BEDS (+4) THEATRE VASCULAR N NAIDOO 15 BEDS (+4) THEATRE TRANSPLANT D KAHN E MULLER 7 BEDS THEATRE ICU L MICHELL TRAUMA A NICOL P NAVSARIA (S EDU) 45 BEDS THEATRE LEVEL 2 SERVICE SURGEON REGISTRARS / MO BEDS? THEATRE?

11. THEATRE TIME No of Theatre Lists / week PASTCURRENT HPB52 VASCULAR62 COLORECTAL72 ONCOLOGY52 NEUROSURGERY5.52.5 ORTHOPAEDICS4617 UROLOGY94.5 ENT157 CARDIAC145

13. GROOTE SCHUUR HOSPITAL PATIENT REFERRAL CONSULTANT INTERACTION REGISTRAR ROTATION ACADEMIC MEETINGS MORBIDITY AND MORTALITY MEETINGS SOMERSET GF JOOSTEVICTORIA

14. Comprehensive Service Plan Current surgical services are working well CSP will impact on: –Service delivery –Teaching medical students –Training of registrars

15. Implementation of CSP Level 2 service in GSH Level 2 surgeon No additional theatre time/beds

16. Implementation of CSP Rationale : 40 – 50% of the service is Level 2 (Study by Dr Belinda Jacobs)

19. Implementation of CSP ? Should we appoint a Senior Specialist (Level 2) to do 5% of the work

20. Health Service Budget driven Needs driven Quotas

21. Transformation Fully support transformation Cannot agree with the policy of demographic targets which affects Indians

22. Thank you