Gustav Thiel

GROOTE SCHUUR Hospital's famed heart transplant unit could close down within months if government and private funding continue to dry up.

Its existence is endangered because the cardio-thoracic unit, of which it forms a part, is under the financial whip. The government is concentrating on primary health care, and discussions about wider funding have thus far proved fruitless.

Apart from heart transplants, the unit performs about 1 000 major operations a year. It is already drastically reduced from the glory days of 1967 when Dr Chris Barnard performed the world's first heart transplant. The tally since then is 418 transplants, mainly on South Africans and Namibians.

Groote Schuur's budget of R519-million in 1996/97 is down to R375-million for 1997/98. No figures are available for the cardio- thoracic unit because it does not have specific funding. But since 1995 the unit has lost nearly 50% of its staff because of budget cuts. The annual 50 transplants dropped for the first time last year to only 31.

Despite this, Groote Schuur is still providing internationally accepted standards of service and facilities, insists Dr Mike Worthington, a surgeon in the unit.

"We are able to do this mainly due to extraordinary commitment from our staff who work long hours often way beyond the call of duty," he says. "It would thus be unfair to say the situation at Groote Schuur is chaotic. We are, however, stretched to the limit and I cannot envisage maintaining the level of service for much longer."

Two years ago the unit's head, Dr Johan Brink, started consultations with Minister of Health Dr Nkosazana Zuma, with the aim of creating supra-regional facilities which would concentrate on the treatment of specific medical problems.

He proposed Groote Schuur become the national focal point for heart treatment, with patients referred from provincial hospitals in the rest of the country. According to Worthington, this is being done - but without the government's full support it cannot be properly realised.

He adds that private funding is also drying up, "because of a perception that the kind of tertiary health care we provide is less important than looking after primary health care".

A major fundraising drive in 1995 proved "fruitless", he says. Neither he nor Brink nor hospital representative Phillipa Johnson could supply figures of the hospital's private or government budget.

The chief financial director of the Western Cape Health and Social Services, Dr Gilbert Lourens, told the Mail & Guardian through a representative he would not respond to queries about Groote Schuur's budget.

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