Strengthening Academic Medicine and the Future of Academic Health Complexes

We, the Deans of the Faculty of Health Sciences of the University of Cape Town and the Faculty of Medicine and Health Sciences of the University of Stellenbosch, are committed to building an accessible, responsive, accountable, efficient and effective health system in our country, through the implementation of the National Health Plan that meets the pressing health needs of our people.

We acknowledge the current challenges facing Academic Medicine and the future of Academic Health Complexes. The National Health Act of 2003 prescribes that Academic Health Complexes (AHC) may be established by the National Minister of Health, in consultation with the National Minister of Higher Education and Training. The academic health complexes 'may consist of one or more health establishments at all levels of the national health system, including peripheral facilities, and one or more educational institutions working together to educate and train health care personnel and to conduct research in health services'.

The lack of a comprehensive and integrated national framework to guide the relationships and responsibilities between the National Departments of Health, Higher Education and Training, and Science and Technology, and the provincial departments of health and the universities has created major challenges for all parties concerned. The lack of an integrated funding framework for health professional education and training, together with increasing budgetary pressures on provincial Health Departments, have contributed significantly to an imbalance between the resource utilisation for health services on the one hand, and the education and training and research on the other. Specific areas of concern relate to conditional grants that currently fund components of AHC's, and problems experienced with accountability, efficiency and effectiveness in measuring performance of their components.

We urge the National Minister of Health to initiate a policy development process that involves all stakeholders and that will result in the publication of the Regulations governing Academic Health Complexes as provided for in the National Health Act of 2003, Chapter 7, section 51(a) and (b). We advocate that policy proposals on the governance, organisation and management, and financing of academic Central Hospitals to be resolved via this policy development process.

To this effect, we will continue to engage in robust discussion with national health stakeholders as part of the Minister of Health's Standing Advisory Committee on the Planning and Financing of health professional development, and Academic Health Complexes. The Committee has established task groups to develop policy proposals on the financing of AHC including the financing of health professional development and Central Hospitals.

Further, we call upon the National Ministers of Health and Higher Education and Training to establish a funding framework for AHC - including Central Hospitals - that provides and protects the flow of funds from the Departments of Health, Higher Education and Training and Science and Technology to deliver on our joint mandate of providing good quality health services, health professional training and development, and research. Ring-fenced funds to Academic Health Complexes will ensure the delivery of appropriate levels of health care; establish teaching and training posts needed to educate the country's health professionals; and develop and maintain the capital infrastructure required to meet the service, education and training, and research needs of our country.

Professor Sue Kidson	Professor Jimmy Volmink
Interim Dean	Dean
Faculty of Health Sciences	Faculty of Medicine and Health Sciences
University of Cape Town	University of Stellenbosch