Gemeenskapsgesondheid : 'n nuwe naam en 'n nuwe benadering

Abstract

When the Medical Faculty was established in 1941, provision was made for a part-time Head of the Department of Public Health . In the early sixties, Professor Albert Strating took over and became the first full-time professor in Public Health in South Africa. He changed the name to the Department of Preventive and Promotive Medicine and introduced a whole new approach to the subject, as well as starting post-graduate training. In keeping with modern trends, the name has now again been changed, this time to Community Health. Medicine of the 20th Century has been continually changing from an early General Practitioner Era through the Specialist Era and the Scientific Era to the present-day Community Era. In addition, the picture of infectious diseases has changed radically in recent times, and the question is discussed whether the training of medical students is keeping pace with changing medical needs. Training must be influenced by possible or idealized developments in connection with community health services. The present system, whereby every province individually establishes its own facilities and enacts own controlling legislation for secondary health services while the Department of Health and Welfare provides the primary and most of the tertiary services, carries with it many disadvantages and requires change. It is proposed that provincial health services as such should disappear but that the country should be divided into a large number of service regions, without taking provincial boundaries into account. The director of every region should control the hospital or hospitals, health services and clinics in his region and should carry out the functions of city medical officer of health, with delegated powers within a broad policy laid down by a central authority. Lastly, the Department's research policy is discussed. Under- and postgraduate students should be stimulated to become research orientated. The work load of the teaching staff and lack of funds are mentioned. The question is asked whether the country can continue to allow the ANNUAL budget of the Medical Research Council to be on a par with what is spent EVERY DAY of the year on alcohol and cigarettes.