Debate on Western Cape health infrastructure

Speaker

At present the Western Cape Government is managing R8 billion worth of capital projects and upgrades - the most that this Province has been working on at any given time in our history. But what does this mean when we talk of creating wellness and to people who depend on the state for health services? It means that we aim to establish a health facility within easy travelling distance for every citizen, whether it be close to a train station or a taxi rank. In line with this aim, the ongoing maintenance of infrastructure remains a priority.

Health infrastructure management directly supports the strategic goal by providing infrastructure that is centrally located to ensure accessible health care. It is designed to ensure the efficient and effective utilisation of both human and material resources and to function in an environmental friendly manner. These facilities are constructed for ease of maintenance to promote long-term sustainability.

The revitalization of Valkenberg Hospital is now a priority project for this Department on the grounds of the need to provide a facility capable of providing a forensic psychiatric assessment service to the Department of Justice. For some years now normal judicial processes have been seriously delayed because the current Valkenberg Hospital does not have the capacity to assess awaiting trial persons who have committed crimes as serious as murder. The R978 million rebuilding project is the largest capital project undertaken by this government. Construction will begin in January 2013 and will increase the bed capacity from 340 to 432 beds. Final construction is aimed to be complete by 2016.

In terms of infrastructure delivery a number of small projects were executed under Programme 7: Healthcare Support Services which made an important difference to the primary health care platform. The best example of this is the upgrade of the newly purchased building in Oudtshoorn which was transformed into a clinic. At a cost of R3.75 million I regard this project as one of the best value for money investments I have opened in the past year.

The most noteworthy community day centres and clinics that were upgraded were Grassy Park, TC Newman and Melkhoutfontein.

One of the major highlights this year has been the completion and commissioning of Khayelitsha Hospital. The hospital provides world-class modern infrastructure and will render a district hospital service which has been described as the best on this continent.

The construction of Mitchells Plain Hospital is in progress and is scheduled for completion by December 2012.

Other district hospitals to be completed were Vredenburg phase 2 A and Riversdale phase 3 upgrading. In terms of provincial and central hospitals, the completion of Paarl Hospital and the PET scan at Tygerberg Hospital stood out. The Western Cape Department of Health put R14.75 million on the table for this tomography centre, which positions the Western Cape again as a trendsetter - the first centre of this kind at a public health facility.

The excellent relationship with the Red Cross Memorial Hospital Trust continued and saw the completion of ward C2. In June I will open Ward B2.

The strengthening of our emergency medical services in rural areas continued with the completion of the Lamberts Bay and Vredendal ambulance stations and the emergency centre at Ceres Hospital.

The tender for the phase 2B construction at Vredenburg Hospital (33 months) was awarded in January 2012.

In addition we are looking into a district hospital for Du Noon, and regional hospitals for the Helderberg Basin and for Mossel Bay. Another key project that is in the planning stage is the building of a new replacement hospital on the site of the current GF Jooste Hospital.

A project manager was appointed for the public private partnership (PPP) for the new Tygerberg Hospital.

In the hospital services sub-programme the following upgrades were done:

• Paarl Hospital Phase 2.
• Paarl Sonstraal Hospital - UV lights.
• Somerset Hospital - a lift upgrade.
• Stikland Hospital - a ward upgrade.
• Harry Comay Hospital - Phase 1 upgrade.

Other projects in planning are the redevelopment of the Brooklyn Chest TB Hospital in Rugby, a new Emergency Centre at Karl Bremer Hospital, ambulance stations at Knysna and Piketberg, and forensic pathology laboratories for Beaufort West and Riversdale.

Healthy Design
I am proud that our new hospitals - both the Khayelitsha Hospital and the Mitchell's Plain Hospital - and all current and future health facilities - are built in line with the latest international design trends for health facilities, featuring environment-friendly and power saving devices.

The design approach enhances the healing process. The goal is to create both a welcoming and functional facility that creates a 'healing environment which aims to minimize stress in a clinical environment.

These new facilities feature environment-friendly design, of which probably the first decision is the orientation of the building, meaning that buildings are properly orientated to prevent negative impacts on the energy performance of the building over its entire life cycle.

The following are the key design principles:

• Natural light - the design of windows and openings to be thought through in terms of views, privacy and light.
• Creating choice - people feel stressed if they have no choice. Patients often wait for long periods of time in a clinic. The aim is to create a clinic where people have a variety of spaces to wait, a variety of seats to choose from and a choice of sitting inside or outside.
• Visual Interest - using a varied palette of colours and materials so that not all spaces look the same. This also makes it easier to orientate oneself in the building.
• Access to nature - carefully designed landscaping to create beautiful green spaces around and within the building. Nature is soothing and one of the best ways of reducing stress.
• Noise control - noise is a major cause of stress. Acoustic control in the form of acoustic ceilings are used to ensure spaces remain as quiet as possible and that privacy is maintained in consulting rooms so that patient's consultations are not overheard.
• Circulation routes - to provide the shortest circulation routes for both patients and staff.

In line with this, a pilot study was undertaken at Groote Schuur Hospital by Schneider International to monitor electricity usage. A tender process will now be undertaken to obtain Green Efficiency interventions. This will include the administrative process to register for carbon credit trading. The department will also undertake research during this financial year to determine the options available to invest in Green Efficiency, as well as investing in Green Energy supply.

Natural Light
All health facilities are now built capitalizing on natural light. Hospitals and clinics now feature courtyards that allow natural light and air into all the rooms reducing the need for artificial light.

Then there is the aspect of sun shading. The use of sun shading devices and recessed windows for optimal shading and weather protection for patients and staff, and the planting of trees around the whole building for shading. Trees are planted in certain areas to provide the building with shade during summer and sun during winter. These keep the building cool or warm to reduce the load on the mechanical air conditioning system. There is less heat build-up around buildings since it is landscaped, rather than paved.

Insulation also contributes to a healthy and healing environment. Well-insulated roofs reduce heat in the building and thus reduce load on mechanical air-conditioning system. In the electrical installation compact and tubular fluorescent lamps are used in combination with occupancy sensors to switch off lights in empty rooms.

The design uses as much natural ventilation as possible, while air conditioning systems with chilled water provides higher efficiencies than other systems, and reduces the use of electricity.

Locally produced materials are used, generating employment and growth opportunities in the surrounding communities.

The use of low formaldehyde content in the joinery and non-toxic paints further reduce toxic fumes on the interior of the building and reduces ourcarbon footprint. Sustainable timber is used for seats, pergolas and staircases. Some of the bricks used are made from recycled materials. In the plumbing aerators are used on taps to reduce water flow and solar geysers for natural heating. The strategic objective of creating wellness can be seen in the landscaping. Indigenous vegetation does take longer to root, but once established, requires less water.

Finding Additional Resources for Infrastructure Maintenance
For the Western Cape to stay on par and set the trend in this country and this continent, we need to invest in our infrastructure, our facilities and our equipment. There is no way that the state's purse can have the capacity to invest in state-of-the-art technologies. The state's purse provides for the bare necessities.

So in the Western Cape, in order for this province to grow our economy and create job opportunities, we had to find a way to invest in our health infrastructure without delving into the provincial health budget.

To this end we established the Western Cape Health Foundation - an independent foundation that will form strategic partnerships with the corporate sector. This means that through the private sector, the Department of Health will be able to undertake projects with provincial government and in the process strengthen their own brand, and our health facilities will benefit.

In Closing
Now, through Health Care 2020, the department will be shifting its focus to the patient experience. I am confident that the construction and upgrade of health care facilities in the Western Cape will positively impact on our patients' healthcare experience and increase wellness for all residents of the Western Cape.