Professional Documents
Culture Documents
- Public Health Care Nurses - General polyclinic services for - Comprehensive ambulatory and - Basic polyclinic
children and adults and people outreach care equipment
- Midwives with mental illness or chronic
diseases - Mainly Level 1 care for people in - Drugs as listed in the
- Medical Officers (full-time and one part of a Health District EDL (Essential Drug
part-time) - Ante-natal and maternity List) for primary care
services - Normally 95% of patients can be
- Some Senior Medical Officers treated and sent home, with 5% - Basic equipment for
- Casualty services and initial or less being referred to a resuscitation and
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- Some other health care treatment of common hospital intravenous therapy
professionals emergencies
As for Community Health Centre As for Community Health Centre - Comprehensive ambulatory care As for Community Health
PLUS: PLUS: Centre PLUS:
- General practitioner care of in-
- More medical officers, with one - General wards for admissions patients - Basic equipment for
available on call at night wards and operating
- Operating theatre services - Receives referrals from, supports theatres
- More other health care and refers back to Community
professionals - Diagnostic, radiological and Health Centres - Drugs in the EDL for
laboratory services primary care
- More senior nursing and - Mainly Level 1 care for people of
administrative staff - Some specialist out-patients one Health District and adjacent
services areas
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- Some visits by specialists
- Oral health services - 90% of those requiring admission
should be fully and appropriately
treated there, with 10% or less
referred to a Regional Hospital.
LEVEL II: REGIONAL HOSPITALS
As for District Hospital PLUS:
As for District Hospital PLUS: - Comprehensive hospital care As for District Hospital
- Specialists in the more common PLUS:
disciplines including: - Specialised services - 24 hour specialist cover on call in
many disciplines - Wide range of
Medicine, Surgery, Paediatrics, - A wide range of more complex diagnostic and
Obstetrics and Gynaecology, diagnostic and therapeutic - Receives referrals form, supports therapeutic
Anaesthesiology, Mental Health, services BUT with far fewer, if and refers back to several District equipment, including
Orthopaedic Trauma, any, ambulatory polyclinic Hospitals radiological services,
Otorhinolaryngology services provided - district level imaging and usually a
services to be available in the - Mainly Level II care for people CAT scanner
- Dentists and other oral health area from one or more Health Regions
professionals of a Province - Drugs as specified in
EDL for Regional
- All of the other health care Hospitals
professions
HUMAN RESOURCES SERVICES LEVEL OF CARE EQUIPMENT AND
DRUGS
LEVEL III: CENTRAL HOSPITAL
As for Regional Hospital PLUS: - Common speciality and - Highly specialised care As for Regional Hospital
subspeciality services PLUS:
- A range of teams led by - Mainly Level III care for people
specialists in the more common - Some highly specialised from several or all Provinces - A range of highly
specialities and subspecialities services (often these will be specialised
different in different Central - Receives referrals from, supports equipment (often
- Some staff in highly specialised Hospitals) and refers back to Regional different in different
units Hospitals all over South Africa hospitals)
- NO POLYCLINIC OR GENERAL and elsewhere in Southern Africa
CASUALTY SERVICES - Drug in EDL for
Central Hospitals
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SPECIALISED HOSPITALS
Specialised Hospitals are those that treat only patients with particular conditions. They may be a Specialised District Hospital like many of the TB hospitals, or a
Specialised Regional Hospital like a Spinal Injury Hospital.
ACADEMIC/SATELLITE HOSPITALS/DEPARTMENTS/FACILITIES
Any type of hospital may be an academic or satellite hospital if a significant amount of teaching, training and research takes place there AND there is a formal
agreement between the relevant employing Health Authority and a tertiary educational institution, as well as recognition as such by the Medical and Dental
Professions Board. Such an agreement will normally involve the joint appointment of some staff, the provision of additional space for teaching, provision for more
investigations than would otherwise be done, and higher levels of staffing than would be needed to provide only services.
However, continuing medical education, internship training, in-service training and research will also take place in many facilities that are not labelled to be
“academic/satellite”.
_______________________________
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GOVERNMENT NOTICE
DEPARTMENT OF HEALTH
The Minister of Health intends, in terms of section 35 read together with section 90 of National Health
Act, 2003, (Act No. 61 of 2003), after consultation with the National Health Council, to make the
regulations in the Schedule.
Interested persons are invited to submit any substantiated comments or representations on the
proposed regulations to the Director-General: Health, Private Bag X828, Pretoria, 0001, within a
period of two months from the date of publication of this notice.
SCHEDULE
Definitions
1. In these regulations any word or expression to which a meaning has been assigned in the
National Health Act, 2003, shall have such meaning and unless the context otherwise
indicates:-
“post levels and salary scales” mean post levels and salary scales as determined from time to time
by the Minister for Public Service and Administration in terms of the Public Service Act, 1994
(Proclamation No. 103 of 1994) as amended.
District hospitals
3. (1) District hospitals are categorised into small, medium and large district hospitals with the
following number of beds:
(a) small district hospitals with no less than 50 beds and no more than 150 beds;
(b) medium size district hospitals with more than 150 beds and no more than 300 beds;
and
(c) large district hospitals with no less than 300 beds and no more than 600 beds.
(2) A district hospital must –
(a) serve a defined population within a health district and support primary health care;
(b) provide a district hospital package of care on a 24 hour basis;
(c) have general practitioners and clinical nurse practitioners providing health services;
(d) provide services that include in-patient and ambulatory health services as well as
emergency health services.
(3) A district hospital receives outreach and support from general specialists based at regional
hospitals.
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(4) A district hospital may only provide the following specialist services –
(a) Paediatric health services;
(b) obstetrics and gynaecology;
(c) internal medicine; and
(d) general surgery.
Regional hospitals
Tertiary hospitals
5. A tertiary hospital –
(a) provides specialist level services provided by regional hospitals;
(b) provides subspecialities of specialities referred to in paragraph (a);
(c) provides intensive care services under the supervision of a specialist intensivist; and
(d) receives referrals from regional hospitals not limited to provincial boundaries; and
(e) has between 400 and 800 beds.
Central hospitals
Specialised hospitals
7. A specialised hospital –
(a) provides specialised health services like psychiatric services, tuberculosis services,
treatment of infectious diseases and rehabilitation services; and
(b) has a maximum of 600 beds.
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List of public hospitals
10. (1) Public hospitals must be managed in accordance with national policy as determined from
time to time by the Minister in terms of sections 3(1)(c) and 23 (1) of the National Health Act,
2003.
(2) The policy referred to in subregulation (1) shall include:
(a) management structures, post levels and salary scales;
(b) delegation of functions;
(c) list of health establishments; and
(d) hospital boards.
11. The Minister shall publish in the Gazette the policy referred to in regulation 10.
Transitional measures
12. Public hospitals that exist at the time of commencement of these regulations and that require
time to effect changes to their structures, number of beds, services or any other matter in
order to comply with these regulations shall effect such changes within a period, after the
commencement of these regulations, as requested by the relevant Member of the Executive
Council and approved by the Minister.
DR A MOTSOALEDI, MP
MINISTER OF HEALTH
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ANNEXURE
CENTRAL HOSPITALS
Gauteng Province
Limpopo Province
Mpumalanga Province