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
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.