Why are the Western Cape Government's hospital upgrades still stalled?
It’s been more than 10 years since the decommissioning of the GF Jooste Hospital in Manenberg, and still, there is no alternative.
The Western Cape Government’s grand upgrade plans for its provincial hospital remain all but stalled.
In August 2024, the Western Cape Department of Health and Wellness (WCDHW) briefed the Standing Committee on Health and Wellness on its Annual Performance Plans (APP) for the 2024/25 financial year.
Led by MEC Mireille Wenger, the presentation provided a detailed overview of the strategic focus, operational plans, and budgetary considerations of the department.
In the presentation, the province informed the committee of a raft of new facilities, including three new mega projects – Klipfontein Regional Hospital, Belhar Regional Hospital, and Tygerberg Central Hospital.
When commissioned, Klipfontein Regional Hospital is envisioned to provide pressure relief to Mowbray Maternity Hospital, Mitchells Plain District Hospital, New Somerset Hospital, Groote Schuur Hospital, and Red Cross Children’s Hospital.
The plan started in 2011, with the initial intent to rebuild GF Jooste District Hospital; however, in 2015, the decision was made to build a larger regional hospital for the substructure, where Manenberg was selected as the preferred location. An estimated 3,500 to 4,000 people per day will use the hospital.
To allow the proposed hospital and the scale of the proposed development, properties need to be rezoned with Silverstream Secondary School, to be moved to the Manenberg School of Skills, currently under construction, and estimated to be completed in May 2026.
Sonderend Primary School is to be moved to Edendale School, estimated for November 2027. Demolition is required before construction to occur around January 2028.
Belhar Regional Hospital is envisioned to take pressure off Tygerberg, Khayelitsha, Eerste River, and Stellenbosch Hospitals.
The department decided to redevelop Tygerberg Hospital in 2009, and since 2018, the provincial Treasury has allocated earmarked funding for maintenance of the current hospital.
The maintenance programme primarily focuses on upgrading engineering services and bulk infrastructure to keep the current building functional until the new building is commissioned, and the old building is repurposed.
The hospital’s financial closure was slated for 2028, construction set for 2028-2032, and then commissioning from 2033 onwards.
Now, one year later since that briefing, the WCHD has shared an update on how plans are going, with minimal evidence of making any progress.
“The WCDHW continues to progress work on the Klipfontein Regional Hospital, Belhar Regional Hospital, and Tygerberg Central Hospital projects in line with required statutory processes, funding engagements, and interdepartmental dependencies,” they said.
“Design development and planning activities are advancing for Klipfontein and Belhar, with site and service requirements under consideration. The Tygerberg Central Hospital PPP (public-private partnership) is undergoing technical specification refinement, enablement works, and stakeholder coordination.”
Regarding the expected financial closure and demolition, they said: “The project programme is under review to ensure alignment with procurement, statutory, and funding processes. The WCDHW is working closely with stakeholders to sequence work appropriately, and enabling works are continuing.
“We will continue to keep the community and relevant stakeholders informed of progress and developments as the project advances.”
With the repeated budget cuts experienced across provincial and national departments, the province said that engagements to secure funding and ensure affordability within the broader provincial infrastructure programme remain ongoing, as they continuously review “capital build priorities to balance service delivery needs with available resources”.
As for the redeployment plan for the affected staff at the hospitals, WCDHW said that staffing considerations form part of the overall project planning process.
“Service continuity and staff redeployment will be addressed in line with confirmed project phases and timeframes.”
WCDHW added that it is working with the Western Cape Education Department and other stakeholders on dependencies relating to educational facilities and site readiness for the Klipfontein Regional Hospital.
“Social facilitation engagements have been undertaken, with further processes awaiting governance approval.”
“Community engagement is an integral part of the planning process. Initial engagements have taken place in certain project areas, and further opportunities for public input will be scheduled in accordance with governance and project requirements.
“Improving access to health care is not only about building new facilities, but also about strengthening the full continuum of health services. Alongside physical infrastructure projects, the WCDHW invests in initiatives that improve service reach and quality, such as expanded community-based health services, mobile and outreach programmes, digital health solutions, and targeted recruitment to address staffing pressures in high-demand areas,” they said.
“These interventions, combined with facility upgrades, are designed to ensure that communities have timely, appropriate, and equitable access to care.
“Our approach remains focused on delivering sustainable health services that meet the needs of both urban and rural populations.”
EFF Provincial Treasurer and Member of the WC Provincial Legislature, Aishah Cassiem, said that they remain alarmed that since GF Jooste Hospital’s decommissioning, no real alternative hospital is available to provide service to nearby communities.
“The initial date to complete the replacement hospital, Klipfontein Regional Hospital, was originally scheduled for 2029. However, as we have seen recently, the date has now been pushed beyond 2033.
“It is concerning that even the first phase of building this hospital has not started in full effect. It’s only now that we are told that they are busy with concept designs. It is concerning, and I doubt the hospital will start accepting patients at the proposed estimated date of 2033,” Cassiem said.
“We must expect further delays, which will have a huge negative impact on communities that need these services.
“The same can be said about the Belhar Regional Hospital, which they also plan to complete in the same year. It is also not acceptable that at those dates, these hospitals will only be able to accommodate around 200 and something beds.
“People cannot wait for so long only to later find out that these hospitals will still not have the capacity to deal with the pressure and influx,” she said.
“It is really worrying that people are waiting for so long, and those responsible seem not to be sure on the planning side of things. Those affected are once again people from poor, African and Coloured communities.”
theolin.tembo@inl.co.za