#HASA2019: Collaboration - the art of possible

“Minor miracles in equitable, quality healthcare provision can happen when unlikely partners join forces,” said Dr Sue Tager, WDGMC CEO at the Hospital Association of South Africa, (Hasa) conference in Cape Town.

The facility was born out of concern about the future of sub-specialist training and how hi-tech equipment could be funded in the public sector. In addition, there were no funded posts for sub-specialist training and it was difficult to retain consultants in academia.

The desire was to create a new, more affordable model for healthcare and increase access to highly specialised healthcare, Tager said.

The WDGMC story

Looking for a more affordable type of healthcare delivery model, Wits University had tried and failed to set up private training sites at various hospitals. In the late 1990s, and supplemented by a generous donation from the Sir Donald Gordon Foundation, Wits bought the dilapidated Kenridge Hospital. But it soon became apparent that “universities cannot and should not, run hospitals", Tager said.

Enter Mediclinic. The private hospital group bought a 49% share WDGMC, bringing in much needed cash and expertise.

“They were a knight in shining armour, saving us from bankruptcy. They wanted to help us build academia and ensure the next generation of locally-produced doctors whom we can retain,” Tager said.

The turnaround involved bringing in part-time clinicians eager to return to academia and focused on a higher common purpose, training doctors from 2007 onward.

WDGMC functions as a private hospital, defining itself as business with a social purpose. Mediclinic is only paid a management fee, and all profits are reinvested into the hospital for refurbishment or supporting clinician/academics.

The 220-bed private academic hospital runs on 20% of donor funding and 80% of its own profits. Bed occupancy had gone from 23% in 2002 to 85,3% this year. Training has gone from 20 super specialists to 80 currently, with more than 1,000 doctors rotating through the facility.

She said it was a great sadness that there have not been any funded public sector sub-specialist posts in the 17 years since the centre was established.

“It’s a marriage of two very different worlds and environments, but today we’re flourishing. It seems to me that this training model is scale-able and I’d love to see it replicated all over the country,” Tager said.

Groundbreaking medicine

The hospital has also established itself as a leader in liver transplant. The unit has gone from 13% of paediatric liver patients coming from the public sector in 2013 to 59% referred from state hospitals today. It has also pioneered a number of procedures, including a liver transplant from an HIV-positive mother to her HIV-negative child.