A New Health Sciences University incorporating Medunsa

Transcription

Report of the Joint Technical Team on the Establishment of
a New Health and Allied Sciences University incorporating
the Medunsa campus
31 February 2014
Table of Contents
List of Appendices
iii
List of Tables and Figures
iv
Acronyms and Abbreviations
v
Foreword
vii
Executive Summary
viii
Introduction
1
1. Background
7
2. The South African health care context
11
3. Health care and health science education and training internationally
15
4. Health and allied science programmes at South African universities
24
5. Health and allied science programmes at the University of Limpopo
26
6. Proposed programmes and academic model for the new university
30
7. Infrastructure, space and clinical training
41
8. Cost implications
63
9. Guidelines for incorporating the Medunsa campus into the new university 67
10. Conclusion and recommendations
72
References
80
Appendices
83
ii
List of Appendices
Appendix A: Terms of Reference
Appendix B: Members of the Joint Technical Team
Appendix C: Site plan of the Medunsa campus
Appendix D: Detailed site plan of the academic core buildings on the Medunsa
campus
Appendix E: Detailed site plan of the veterinary production unit on the Medunsa
campus
Appendix F: Location of South Africa's nine medical schools
Appendix G: Proposed extent of clinical training platforms
Appendix H: Proposed clinical training platform: location of regional and district
hospitals
Appendix I: Example of a rural and community based clinical training model:
Ukwanda
Appendix J: Proposed clinical training platform: phased growth
Appendix K: Proposed clinical training platform: options for infrastructure
Appendix L: Potential veterinary clinical training platform
Appendix M: Development Implementation Plan
Appendix N: Projected development costs, 2014-2019
Appendix O: Estimates of Rand values of standard cost units (SCUs) for universities
Appendix P: Proposed new administration building
Appendix Q: Proposed new student building
Appendix R: Proposed new science and technology building
Appendix S: Proposed veterinary science teaching building
Appendix T: Proposed new clinical staff office building
Appendix U: Proposed new residence for 588 students
Appendix V: Proposed new CTP residence for 3 students
Appendix W: Proposed new CTP residence for 60 students
Appendix X: Proposed Programme Qualification Mix
Appendix Y: Consolidated summary of issues arising from public consultations
Appendix Z: Draft Protocol for Engagement
Appendix AA: Terms of Reference: Joint Specialised Teams
iii
List of Tables and Figures
Table 1: Medicine Programmes
Table 2: Nursing Programmes
Table 3: Pharmacy Programmes
Table 4: Physiotherapy Programmes
Table 5: Speech, Hearing and Sight Programmes
Table 6: Dietetics and Nutrition Programmes
Table 7: Occupational Therapy Programmes
Table 8: Public Health Programmes
Table 9: Oral Health Programmes
Table 10: Science Programmes
Table 11: Medical Technology Programmes
Table 13: Proposed Academic Organisational Structure
Table 12: Veterinary Science Programmes
Table 14: Current capacity of Medunsa campus student residences
Table 15: Utilisation of key undergraduate Science laboratories
Table 16: Utilisation of undergraduate Medical Science laboratories
Table 17: Planned building alterations, extensions and constructions by space-use
category
Table 18: Projected space shortfalls and surpluses in 2024
Table 19: Proposed clinical training platform
Table 20: Projected costs of new buildings and other construction, 2014-2019
Table 21: Projected costs of new off-campus housing for clinical training purposes,
2014-2019
Table 22: Projected costs of extensions, alterations and renewals, 2014-2019
Table 23: Phases of incorporation
Figure 1: Current (2011) space shortfalls and surpluses
Figure 2: Potential office space modifications
Figure 3: Model of classroom occupancy
Figure 4: Space shortfalls and surpluses 2019
Figure 5: Space shortfalls and surpluses after development (2019)
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Acronyms and Abbreviations
AHPCSA
ASM
Bio-MEMS
BSc
CESM
CHE
CPD
CTP
DAFF
DHET
DoE
DoH
ENT
FHS
FTE
HEQC
HEQSF
HIV/AIDS
HPCSA
HRHS
ICT
JST
JTT
MBChB
MeCRU
Medunsa
MLW
NHI
NHLS
NMMU
NWU
PHC
PPP
PQM
PSSA
QS
SADC
SADTC
SAMA
SANC
SAPC
SASOP
SAVC
SCU
SLP
THES
Allied Health Professions Council of South Africa
Assignable Square Metres
Biomedical Micro electro mechanical Systems
Bachelor of Science
Classification of Educational Subject Matter
Council on Higher Education
Continuing Professional Development
Clinical Training Platform
Department of Agriculture, Forestry and Fisheries
Department of Higher Education and Training
Department of Education
Department of Health
Ear, Nose and Throat
Faculty of Health Sciences, University of Limpopo
Full-Time Equivalent
Higher Education Quality Committee
Higher Education Qualifications Sub-Framework
Human Immunodeficiency Virus/Acquired Immunodeficiency
Syndrome
Health Professions Council of South Africa
Human Resources for the Health Sector
Information Communication and Technology
Joint Specialised Team
Joint Technical Team
Bachelor of Medicine and Bachelor of Surgery
Medunsa Clinical Research Unit
The Medunsa campus of the University of Limpopo, formerly the site
of the Medical University of Southern Africa (1976-2004)
Mid-Level Worker
National Health Insurance
National Health Laboratory Service
Nelson Mandela Metropolitan University
North West University
Primary Health Care
Public-Private Partnership
Programme Qualification Mix
Pharmaceutical Society of South Africa
Quacquarelli Symonds
Southern African Development Community
South African Dental Technicians Council
South African Medical Association
South African Nursing Council
South African Pharmacy Council
South African Society of Psychiatrists
South African Veterinary Council
Standard Cost Unit
Speech and Language Pathology
Times Higher Education Supplement
v
Turfloop
TUT
UCT
UJ
UKZN
UL
UMST
UN
UNESCO
UNIN
Unisa
UP
UNIVEN
UWC
VUT
Wits
WSU
The Turfloop campus of the University of Limpopo, formerly the site
of the University of the North (1959-2004)
Tshwane University of Technology
University of Cape Town
University of Johannesburg
University of KwaZulu-Natal
University of Limpopo
University of Medical Sciences and Technology, Sudan
United Nations
United Nations Educational, Scientific and Cultural Organization
University of the North
University of South Africa
University of Pretoria
University of Venda
University of the Western Cape
Vaal University of Technology
University of the Witwatersrand
Walter Sisulu University
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Foreword
South Africa needs to produce increasing numbers of suitable high quality health
professionals in order to meet the country's pressing health care needs; and a
dedicated higher education institution able to offer a wide and varied set of health
professional programmes will be well-placed to help achieve this objective.
Accordingly, in the light of further investigation and advice, the Departments of
Higher Education and Training and of Health jointly decided to establish a new
comprehensive health and allied sciences university on the site of the Medunsa
campus of the University of Limpopo and to incorporate that campus into the new
university. The establishment of this new university will, moreover, be only a part of
a wider process already underway, namely the construction, improvement and
refurbishment of health and higher education facilities across the country.
This report was prepared by the high-level Joint Technical Team appointed by the
Minister of Higher Education and Training to advise him and the Minister of Health
on the processes needed for establishing the new university and incorporating the
Medunsa campus into it. The Joint Technical Team consulted with a wide range of
external and internal stakeholders, at the same time conducting site visits and research
and feasibility studies. It also took careful account of various national health and
higher education priorities, including the Human Resources for the Health Sector
strategy, the imminent introduction of National Health Insurance, and the need to
expand access and improve quality in higher education.
The report proposes, inter alia, a distinctive academic model and Programme
Qualification Mix for the new university, situates these in terms of the local, national
and international health care and training contexts, examines what infrastructure,
facilities, space and clinical training platforms are likely to be required, together with
the projected costs thereof, and suggests various transitional arrangements to facilitate
the incorporation of the Medunsa campus of the University of Limpopo into the new
university.
These proposals and accompanying recommendations are not cast in stone. On the
contrary, many if not all of the suggestions made here need further discussion (and,
thereafter, operationalisation) by all relevant stakeholders, particularly the provincial
Departments of Health, the various statutory bodies regulating the health profession,
role players in the higher education sector, the private sector and, not least, the
Council of the University of Limpopo and the Interim Council of the new health and
allied sciences university.
This report thus constitutes a broad framework aimed at advising and guiding the
Ministers, the relevant government Departments and staff at both the national and the
provincial levels, and the management and staff of the new institution, who are tasked
with establishing the new health and allied sciences university and incorporating the
Medunsa campus into it.
Dr BE Nzimande
Minister of Higher Education and Training
Date:
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Executive Summary
Background
This report was prepared by the Joint Technical Team (JTT) appointed by the
Minister of Higher Education and Training to advise him and the Minister of Health
on the establishment of a new comprehensive health and allied sciences university
incorporating the Medunsa campus of the University of Limpopo.
The Terms of Reference of the Joint Technical Team, as specified by the Minister, are
given in full detail at the end of this document (see Appendix A). In summary form,
the Joint Technical Team was asked to advise the Minister on, inter alia, all legal,
governance, management, academic and financial requirements and processes for
establishing a new stand-alone autonomous health sciences university and
incorporating the Medunsa campus of the University of Limpopo into this new
university.
In carrying out its mandate, the JTT adopted a multi-pronged strategy, including:
meeting with external and internal stakeholders and other interested parties; inviting
and receiving comments and proposals; considering existing health and higher
education legislation and policies; reviewing the literature on the state of health
professional education and training, and the kinds and range of health and allied
science programmes and training platforms available, both locally and internationally;
conducting research into a range of possible academic models and programmes;
assessing the feasibility of various views of the new comprehensive health and allied
sciences university in relation to the Medunsa campus' current infrastructure, facilities,
enrolments and programmes; and considering appropriate transitional governance
arrangements for the incorporation of that campus into the new institution.
The report is divided into nine sections. The first section provides brief background
information. The second section examines the South African health care context, and
the third section investigates health professional education and training around the
world. The fourth and fifth sections list the health and allied science programmes
currently offered at South African universities, in general, and at the Turfloop and
Medunsa campuses of the University of Limpopo, in particular. The sixth section
proposes an academic model and an associated range of programmes for the new
health and allied sciences university. The seventh section details what the new
university will require in terms of infrastructure, facilities, space and clinical training
platform in order to be academically and financially viable. The eighth section
outlines the projected costs, and the ninth section provides guidelines and identifies
transitional arrangements for the incorporation of the Medunsa campus into the new
health and allied sciences university. The final section concludes the report and lists
the recommendations of the Joint Technical Team.
The South African health care context
It is of crucial importance, for both health and broader socio-economic reasons, that
South Africa begins to train more and better health professionals in innovative ways
such as to embed them in, and render them more responsive to, the health needs of the
country and the communities they are to serve.
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In South Africa today, mortality rates amongst mothers, infants and children under
five are increasing, along with infectious diseases, with interpersonal violence, road
traffic injuries and unhealthy lifestyles further impairing the wellbeing of the
population. At the same time, there is a general shortage and insufficient production
of almost all kinds of health professionals, including doctors, specialist nurses,
clinical and public health specialists, community health workers and mid-level
workers; and the quality of clinical training infrastructure and supervision needs to be
improved. New graduates are not being sufficiently absorbed into the public sector,
where vacancies are high even though growth in the number of clinical posts has been
largely stagnant; and poor, remote and rural communities are under-provided for in
terms of the number and distribution of health professionals.
Most of these health issues facing South Africa are not exceptional in a global context.
In much of the world, health professional education and training takes place either in
medical schools attached to traditional universities (as in South Africa) or in standalone health sciences universities; but in both cases, the models of health science
education and training currently in place are often outdated and ineffective.
In response to these challenges, government has adopted a strategy premised on a reengineered district-, ward- and school-level team-delivered primary health care
system which prioritises maternal, child and women’s health and HIV/AIDS; and this
in turn depends on the development of education and training platforms to produce
sufficient numbers of appropriately trained health professionals who can prevent
disease and promote health.
It follows, too, that apart from training as many new health professionals as is
academically possible and economically feasible, the new comprehensive health and
allied sciences university must help improve the competencies of all health
professionals by offering both formative and Continuing Professional Development
programmes which emphasise, among other things, teamwork, community- and
patient-centeredness, service learning, interdisciplinarity, and the use of evidence and
research.
The new university must therefore align itself with national priorities, including the
pending implementation of National Health Insurance, by improving the availability
of health care and health care training for the country's underserved communities in
particular; and be comprehensive in terms of offering a full range of qualifications
and programmes, both undergraduate and postgraduate, both technical, professional
and academic, and both core and health-related.
Health care and health science education and training internationally
A review of health science programmes offered elsewhere in the world, and
particularly at publicly-funded comprehensive stand-alone health sciences universities
similar in nature to what is intended in South Africa, revealed that among the most
common programmes on offer are medicine, dentistry, pharmacy and nursing, as well
as public health, while among the least common are homeopathy and chiropractic.
There are also trends towards establishing tertiary institutions with a combined focus
on engineering, technology and medicine, and towards offering transdisciplinary
programmes such as biomedical technology, bioengineering and medical informatics.
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Health and allied science programmes at South African universities
South Africa's health science faculties are on a par with stand-alone health sciences
universities around the world in terms of the range of programmes on offer. All public
universities and a few private higher education institutions in South Africa offer for
the most part the same or similar programmes as in other countries, most commonly
nursing, pharmacy, dentistry, dietetics, medicine, physiotherapy, occupational therapy,
radiography, biomedical technology, public health and environmental health. Also
like other countries, there is a relative paucity of programmes in allied health
professions such as chiropractic and homeopathy. Only the University of Pretoria
currently offers a full range of veterinary science programmes, but a few other
institutions also offer diplomas or degrees in veterinary technology and animal health.
Health and allied science programmes at the University of Limpopo
For its part, the University of Limpopo offers health and allied sciences at both of its
campuses, Turfloop and Medunsa, although for the most part the two sets of campusspecific programmes are completely separate, taught by separate staff with separate
resources and examinations. The Medunsa campus is by far the larger of the two in
terms of both the number of health science programmes available and the number of
health science students enrolled.
According to available information on the Programme Qualification Mix, the
Medunsa campus offers programmes in medicine, dentistry, nursing, pharmacy,
occupational therapy, physiotherapy, radiography, dietetics, speech and language
pathology, audiology, public health and environmental health. The Turfloop campus
offers programmes in nursing, pharmacy, public health, optometry and health
promotion, of which only the last two are not also offered on the Medunsa campus.
Proposed programmes and academic model for the new university
In terms of health and allied science programmes offered at South African universities
in general, the Medunsa campus' range of programmes is one of the most extensive in
the country; it is also one of only eight universities offering the MBChB. For the most
part, too, the Medunsa campus offers very similar kinds of programmes to what is
available at stand-alone health sciences universities internationally.
However, the Medunsa campus does not offer any programmes of the sort which are
increasingly prominent internationally, such as biomedical technology,
bioengineering or medical informatics. The Medunsa campus also does not offer
programmes in optometry, health promotion, social work, prosthetics, laboratory or
clinical medical technology, paramedical and emergency medical services, or many
allied health professional programmes; and since 1999 it has not offered programmes
in veterinary science.
Despite the fact that all current (and many envisaged) programmes offered by the
Medunsa campus are also offered by other nearby universities (with implications for
the availability of staff and of clinical training platforms), the absolute and relative
shortages of almost all categories of health professionals in South Africa make it
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essential that the new university, apart from being intended to be comprehensive in its
scope, also offer these programmes, and more.
In other words, the Programme Qualification Mix of the new university should ideally
include: (1) all programmes currently offered on the Medunsa campus (medicine,
dentistry, nursing, pharmacy, occupational therapy, physiotherapy, radiography,
dietetics, speech and language pathology, audiology, psychology, public health,
environmental health and basic sciences); (2) programmes in biomedical technology,
biomedical engineering, clinical technology, medical informatics, veterinary science,
emergency medical services, optometry, sport science, prosthetics and orthotics,
rehabilitation, health promotion and gerontology as well as (at an introductory level)
Traditional, Complementary and Alternative Medicine; and (3) health-related
programmes in health information technology, military health science, aviation
medicine, forensic health science, health science education, medical law, medical
social work and health management (including health administration, finance, human
resources and research).
Nevertheless, the feasibility of thus increasing and extending the Programme
Qualification Mix of the new university must be carefully considered, particularly the
capacity of the Medunsa campus' currently available infrastructure, facilities, space
and clinical training platform to deliver these programmes and accommodate the
increased student enrolments they will entail.
Infrastructure, space and clinical training
The feasibility study commissioned by the JTT showed that although the academic
buildings on the Medunsa campus are mostly well-built and in a fair condition, a
number of infrastructural aspects are likely to require large-scale funding, including
the refurbishment of existing and the building of new student residences and other
buildings, and improved electricity, water and sewerage reticulation, among other
things.
The feasibility study also found that the total existing assignable space within
buildings (including circulation, mechanical, custodial and/or structural space) on the
Medunsa campus exceeds the space generated in accordance with DHET space norms
by a substantial margin, particularly with respect to office space, classroom space and,
to a lesser extent, general-use space, laboratory space and health care space, but that
there is under-provision with regard to study space. The excesses are due for the most
part to the accommodation of staff in joint appointment posts in university space,
unnecessarily large office sizes, the fact that few classrooms are centrally allocated,
and the fact that a significant amount of spaces in university buildings serve hospital
functions.
Notwithstanding this problem of excess space (or, in the case of study space, a
shortfall) – which can in part be addressed by modifying, reassigning and/or better
utilising spaces – the projected increases in student enrolments (a headcount of 7 000
students by 2019 and 10 000 by 2024) will require the construction of a number of
new buildings, extensions to existing buildings, and provision of other facilities, not
least in order to accommodate the planned expansion or addition of programmes in
areas such as basic sciences, medical technology, information technology and
veterinary science.
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The required new buildings and facilities include: a new purpose-built administration
building; a new student building; a new science and technology building; a new
veterinary science teaching building; a new office block for clinical staff; two large
250- to 300-seater teaching venues; an expanded library building; and additional
recreational facilities. Of perhaps greatest importance is the construction of a new
Level 3 Academic Hospital, for which a feasibility study is currently in progress.
It is calculated that, once all these building alterations, extensions, constructions and
other space-use revisions have been completed, and also taking into account both the
proposed expansion in programmes and enrolments and the reorganisation of and
additions to assignable space, by 2019 generated space at the new health and allied
sciences university will exceed existing or actual space in respect of study space and
general-use space, there will be sufficient classroom space, health care facilities space
and laboratory space, and a healthy excess of actual office space. Projected continued
increases in student enrolments up to 2024, however, will require further provision of
classroom, laboratory and study space and additional student housing in the proposed
form of two large laboratory-dominated academic buildings with considerable areas
set aside for study, four new residences and new indoor sports facilities.
Most health science programmes (including veterinary sciences) require
undergraduate students to spend time engaged in supervised clinical practice.
Furthermore, given that (i) the expansion of programmes and increased enrolments on
the Medunsa campus in the context of its incorporation into the new health and allied
sciences university will require an expansion of places and facilities for clinical
training, (ii) accommodation and/or transport arrangements for students and
supervisory staff (especially at or near Level 1 and Level 2 hospitals where clinical
experience is essential) will be needed to realise the new institution's intended
community and service orientation, and (iii) other nearby universities also have
clinical training needs and footprints which must be considered, the new university's
clinical training platform ought to extend north and west of the Medunsa campus, and
hence to the Bojanala District of North West Province and Regions 1 and 2 of the
Tshwane metropolitan area in Gauteng Province (see Appendix G), and it ought to
have preferential access to hospitals, community health centres and clinics in these
areas for clinical training purposes.
This clinical training platform will need to be phased in over time. The Job
Shimankana Tabane Hospital can act initially as a sub-campus providing
accommodation to students (a role later to be taken over by the new Soshanguve
hospital); it can also act as a base for academic staff providing supervision to students
sent to the surrounding hospitals, which in turn will need to accommodate students on
after-hours duties.
The successful establishment and functioning of the new university's clinical training
platform will depend on an effective partnership, a shared vision and a coordinated
strategy between the national and provincial Departments of Health, the Department
of Higher Education and Training and the universities within the area.
Clinical training with regard to veterinary programmes is usually addressed in a
veterinary academic hospital. However, the costs of establishing and maintaining such
a facility on the Medunsa campus would be high (although having the existing
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production unit facilities refurbished would permit certain programmes to commence
and also accommodate an animal house for research and training purposes), and it
would also tend to compete with the University of Pretoria's nearby veterinary
hospital at Onderstepoort, which currently generates sufficient student caseloads of
companion animals (such as dogs, cats and small exotic animals) but must transport
students to production animals (farm and game animals). Establishing a satellite
veterinary hospital at a distance from the new university would be equally if not more
costly (given additional logistical and student accommodation costs), and high costs
are also associated with mobile clinics, which could conceivably operate from the
Medunsa campus.
It follows that the most cost-effective alternative to establishing a veterinary academic
hospital on the Medunsa campus would be to partner with selected and approved
veterinary practices (both urban and rural, with both companion and production
animals, and with at least one specialising in game animals) where students could be
taught and supervised by seconded or visiting academic staff and/or specifically
trained practitioners.
Nevertheless, further discussions are needed among all role-players in the veterinary
field, including the Department of Agriculture, Forestry and Fisheries, the South
African Veterinary Council, and institutions already offering veterinary qualifications
such as NWU, TUT, UP and Unisa, as to the feasibility and costs of establishing and
operating a veterinary faculty either at the new university or elsewhere in the country,
including research into supply and demand, programmes, graduate placement, post
provisioning and clinical training possibilities with regard to all categories of
veterinary professionals.
Cost implications
The total cost of all new buildings and extensions, alterations and renewals of existing
buildings for the first five-year phase, 2014-2019, is estimated at approximately R939
million. This can be broken down as follows:
•
•
•
New buildings and other construction: approximately R725 million.
New off-campus housing for clinical training purposes: approximately R33
million.
Extensions, alterations and renewals to existing buildings: approximately
R181 million.
A new 590-bed student residence will constitute almost half of all newly constructed
on-campus assignable space, but the single most expensive new building will be the
science and technology building, at almost a quarter of a billion Rand. Housing for
students and supervisors on clinical practice will need to be provided primarily at the
Job Shimankana Tabane Hospital, and to a lesser extent at surrounding community
health centres. In terms of extensions, alterations and renewals to existing buildings,
the most costly single development will be the alterations and renewals to the Clinical
Pathology building, followed by the vertical extension of the Library.
Additional costs are likely to be incurred in the process of ensuring that existing
buildings and facilities continue to be maintained and/or are repaired or refurbished to
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meet the new university's needs. This will be particularly necessary with regard to the
existing student residences and current electricity, water and sewerage reticulation.
All in all, the new health and allied sciences university is likely to require a minimum
initial capital injection of some R1 billion. While university funding will be provided
thereafter on an annual basis, it will be essential for the new university to generate a
significant amount of third stream funding, in order to move as quickly as possible
towards financial self-sufficiency.
Guidelines for incorporation
All policies, procedures and structures on which the new university is to be based,
including its culture and ethos, should be pertinent and uniquely relevant to it as a
new institution, reflecting its nature as an autonomous health and allied sciences
university offering a comprehensive range of programmes.
Two main phases in the incorporation process can be distinguished: an interim phase
(from January/February 2014 to July/August 2014) and a final phase (from
July/August 2014 to January/February 2015). The interim phase will begin with the
formal establishment of the new university and the appointment of an Interim Council,
followed by the appointment of interim management and preparatory work to
facilitate the incorporation of the Medunsa campus. The final phase will involve the
formal incorporation of the Medunsa campus into the new university, consequent
upon which the Interim Council will dissolve and the Council of the new university
will take office with full powers and responsibilities.
As stipulated in the Higher Education Act (Act No. 101 of 1997) and the Standard
Institutional Statute (Government Gazette No. 23065, 27 March 2002), the Interim
Council will be appointed by the Minister, and will then itself appoint an interim
management to run the new institution's day-to-day activities. Its primary
responsibilities will be to constitute the various governance structures as contemplated
by the Standard Institutional Statute; and to take forward and where possible conclude
preparatory investigations being undertaken by Joint Specialised Teams (representing
both the Medunsa and the Turfloop campuses of the University of Limpopo) to
facilitate the separation and incorporation process, including conducting audits of all
academic programmes, human resources, space, finances, student support, ICT and
library structures, services and systems, and developing an overall incorporation plan.
In keeping with the requirements of the Standard Institutional Statute (Government
Gazette No. 23065, 27 March 2002), the Medunsa campus of the University of
Limpopo will continue to offer all existing programmes under their existing rules until
such time as the campus has been incorporated into the new health and allied sciences
university and the Council of that university decides to amend or restructure these
programmes or rules. The same applies to existing training platforms currently
utilised by Medunsa campus students (such as the Dr George Mukhari Hospital and
others), which will continue to function and be available to current students until such
time as new arrangements are made by the new health and allied sciences university.
On the date of the incorporation of the Medunsa campus into the new university, all
rights and obligations of the University of Limpopo for the Medunsa campus will
devolve upon the new university. This means that on the date of incorporation all UL
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Medunsa campus staff are assured of employment as per their existing contracts and
will retain their existing conditions of service and benefits, including their salaries.
Once the Interim Council has completed its work, the new university Council will
take office, appoint senior management and proceed to govern the new health and
allied sciences university with full powers and responsibilities.
Throughout both phases of the incorporation process, the role of the Department of
Higher Education and Training will lie in the provision of financial and technical
support and guidance, and in monitoring the process at an institutional level.
The period during which the Medunsa campus is being separated, de-linked and
unbundled from the University of Limpopo and being joined, linked and incorporated
into the new health and allied sciences university, leading up to the date of
incorporation, will be governed by a Protocol for Engagement between, on the one
hand, the Council of the University of Limpopo, and on the other hand, the Interim
Council of the new health and allied sciences university.
Recommendations
Recommendation 1:
The new health and allied sciences university incorporating the Medunsa campus
should continue to offer, and where possible expand, extend and diversify,
programmes in
medicine, dentistry, nursing, pharmacy, occupational therapy, physiotherapy,
radiography, dietetics, speech and language pathology, audiology, psychology,
public health, environmental health and basic sciences,
giving particular consideration to the specific qualifications and programmes (both
current and proposed) listed in Section 6 of this report.
Recommendation 2:
The new university should also consider offering programmes in
biomedical technology, biomedical engineering, clinical technology, medical
informatics, veterinary science, emergency medical services, optometry, sport
science, prosthetics and orthotics, rehabilitation, health promotion and gerontology
(as well as at least an introductory module in Traditional, Complementary and
Alternative Medicine),
Recommendation 3:
In addition to the core health and allied science programmes listed above, the new
university should consider offering programmes in
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health information technology, military health science, aviation medicine, forensic
health science, health science education, medical law, medical social work and
health management (including health administration, finance, human resources and
research),
Recommendation 4:
In the medium to long term, the new university should, where resources allow and
demand exists, give consideration to developing and offering additional allied health
science programmes, including homeopathy, naturopathy, chiropractic, osteopathy,
somatology, acupuncture, Chinese medicine, herbal medicine and various other
traditional, complementary and alternative medicines.
Recommendation 5:
The Interim Council and interim management of the new health and allied sciences
university should, with the assistance of relevant academic staff and on the basis of
clear and agreed upon criteria, investigate various possible academic administrative
and organisational structures for the new university, including the most optimal
manner of housing both new and existing academic programmes and the most
effective form and organisation of Schools and/or Faculties.
Recommendation 6:
Wherever feasible, the new health and allied sciences university should seek to:
•
•
•
develop all programmes from the undergraduate level right through to
postgraduate and postdoctoral levels;
supplement all programmes with a range of Higher Certificates and Advanced
Certificates in corresponding fields and specialisations; and
complement all programmes with a range of Continuing Professional
Development programmes and short courses.
Recommendation 7:
Further investigations and discussions among all role-players in the veterinary field
need to take place as to the feasibility and costs of establishing and operating a
veterinary faculty at the new university, including research into (a) exactly which
categories of veterinary professionals are in short supply, and to what extent, (b)
whether and where new graduates in these fields can be placed, absorbed or better
distributed, (c) how and by which programmes and host institutions the demand for
veterinary training might be best addressed, and (d) in which part or parts of the
country such programmes, and indeed an entire new veterinary faculty, along with the
associated clinical training requirements, would be best located.
xvi
Recommendation 8:
If, after further investigation, the establishment of a veterinary faculty at the new
university should be considered feasible, veterinary science programmes should be
introduced gradually – with an initial focus on undergraduate programmes
(particularly the Diploma in Animal Health, the Certificate in Animal Welfare, the
Bachelor of Animal Health, the Bachelor of Veterinary Nursing and the Bachelor of
Veterinary Science) as well as the Postgraduate Diploma in Veterinary Health – and
close cooperation between UP's Onderstepoort veterinary faculty and the new
veterinary faculty will be essential in order to promote complementarities and avoid
unnecessary competition.
Recommendation 9:
Repairs to and/or renewal of existing infrastructure on the Medunsa campus will be
required in relation to:
•
•
•
•
•
•
•
•
•
the veterinary production unit complex (should a veterinary faculty be
established or, if not, to accommodate a comprehensive animal house);
electricity transformers;
the main water supply pressure reducing valve;
water ring mains;
air-conditioning plants;
lift controls;
a cut-off drain below the upper dam;
campus roads; and
the sewerage system.
Recommendation 10:
The following new buildings will be required:
•
•
•
•
•
•
an administration building;
a student building;
a science and technology building;
a veterinary science teaching building;
an office block for clinical staff; and
a 590-bed student residence.
In addition, the Library building should be expanded vertically by one level.
Recommendation 11:
Assignable space on the Medunsa campus must be (re)organised and utilised in such a
way as to be both consistent with DHET norms and fit for purpose, and all classrooms
containing more than 30 seats should be centrally allocated.
xvii
Recommendation 12:
Planning already in progress under the auspices of the University of Limpopo with
regard to two new on-campus residences (one in the form of a Public-Private
Partnership) needs to be prioritised and taken further, with the ultimate aim of housing
at least 80% of students on-campus.
Recommendation 13:
All infrastructural and clinical training matters (particularly those pertaining to the
construction of the new academic hospital, the new Polokwane academic health
complex, the new Soshanguve hospital, the refurbished Dr George Mukhari Hospital
and the proposed office block for clinical staff) must be finalised as soon as possible
in joint discussions between the new university, the national Department of Health,
where relevant the provincial Departments of Health and, where necessary, regional
public higher education institutions.
Recommendation 14:
All feasibility studies related to the new university (including those pertaining to the
new academic hospital, the new Polokwane academic health complex, the new
Soshanguve hospital and the refurbished Dr George Mukhari Hospital, as well as the
feasibility study for the new university which was initiated by the JTT and informs
parts of this report) should be synchronised, aligned and completed in time (c. July
2014) to be available to be considered simultaneously by Treasury.
Recommendation 15:
The new university's clinical training platform should consist mainly of the hospitals
and community health centres of the Bojanala District of North West Province and
Regions 1 and 2 of the Tshwane metropolitan area in Gauteng Province, where
appropriate accommodation should be built for students.
Recommendation 16:
A substantial proportion of students' time, especially clinical training time, ought to
be spent in facilities other than the planned new Level 3 Academic Hospital or its
equivalents, and at least 10% of students' time should be spent in rural facilities.
Recommendation 17:
Careful consideration should be given to ensuring that an equitable distribution of
practical training and experiential opportunities is afforded to all health professional
students, whether those enrolled or to be enrolled at the new university or at the
various existing medical schools and health faculties in close proximity to it. In this
regard, an overall Human Resources strategy which takes into account the varying
staffing, student and training needs of all the nearby higher educational and health
facilities may need to be formulated.
xviii
Recommendation 18:
All existing claims upon or rights to the land occupied by the Medunsa campus and
ultimately by the new university must wherever possible be investigated and resolved
by the Interim Council of the new university.
Recommendation 19:
Research and research productivity at the new health and allied sciences university
should be improved by:
•
•
•
•
•
•
•
•
•
establishing research programmes in key areas of national need such as
clinical research and the development of datasets and prevalence studies of
infectious and non-communicable diseases, violence and injury, and maternal
and child mortality;
initiating new niche research programmes in areas such as rural-oriented
primary health care, indigenous medicines, spinal research and food security;
seeking funding and scholarships from national and international donors and
the pharmaceutical industry more broadly for programmes intended to develop
new high quality academic clinical researchers;
exploiting research opportunities arising out of work-integrated and service
learning clinical training practices;
fostering inter-departmental research collaboration;
building mid-level staff research capacity, including but not only at the
existing Clinical Research Unit (MeCRU);
building research leadership capacity;
attracting research funding and support from external bodies, such as that
pledged by the Medical Research Council and others, and generating
additional third stream income through research; and
generally promoting a culture of critical inquiry, hiring additional high quality
research staff, attracting additional postdoctoral students, increasing the
number of research publications and establishing research partnerships with
other institutions.
Recommendation 20:
The new university will require strong leadership, not only at the executive and
administrative levels but also at the Faculty and academic levels, supported by equally
strong leadership at the levels of district hospitals and provincial departments of
health. In keeping with both international trends and the national health policy
emphasis on improving leadership skills so as to improve health system performance,
leadership capacity should be developed through leadership seminars, personal
coaching and other professional development opportunities.
Recommendation 21:
In order to facilitate the establishment of the new university, with a distinct and
unique vision, mission, culture, ethos and academic model, a change management
strategy and process must be formulated and instituted.
xix
Recommendation 22:
The process of establishing the new university and its incorporation of the Medunsa
campus of the University of Limpopo should be guided by the Department of Higher
Education and Training's Higher Education Restructuring and Transformation:
Guidelines for Mergers and Incorporations (DoE 2003) and Governance, Academic
and Administrative Guidelines for the Establishment of a New University (DHET
2013).
Recommendation 23:
The new health and allied sciences university will require a unique and preferential
funding allocation within the national higher education funding framework, including
earmarked funding and drawing upon the National Skills Fund.
Recommendation 24:
Transitional arrangements for the incorporation of the Medunsa campus into the new
health and allied sciences university should be governed by a Protocol for
Engagement between the Council of the University of Limpopo and the Interim
Council of the new health and allied sciences university, with the Department of
Higher Education and Training acting as facilitator.
Recommendation 25:
The separation of the Medunsa campus from the University of Limpopo and its
incorporation into the new health and allied sciences university should be facilitated
by the establishment of Joint Specialised Teams, involving members of both the
Turfloop and Medunsa campuses, tasked with conducting audits of all academic
programmes, human resources, finances, ICT and student and support structures
pertaining to the Medunsa campus, undertaking SWOT analyses, determining
priorities, developing action plans and making recommendations to be considered by
the Interim Council of the new university. All public submissions made to the JTT
should be referred to these Joint Specialised Teams for consideration.
Recommendation 26:
Given the multiple and wide-ranging academic, practical, financial and operational
implications of establishing the new health and allied sciences university
incorporating the Medunsa campus, and the many stakeholders at the national,
provincial and local levels who need to be involved or considered, the Interim Council
of the new university should, where it deems necessary, further engage with internal
and external stakeholders and other interested parties to ensure that the best possible
arrangements are in place for the successful operation of the new institution, giving all
due consideration to the optimal manner of implementing and/or further investigating
any or all of the recommendations above.
xx
Introduction
This report was prepared by the Joint Technical Team appointed by the Minister of
Higher Education and Training to advise him and the Minister of Health on the
establishment of a new comprehensive health and allied sciences university
incorporating the Medunsa campus of the University of Limpopo.
The Terms of Reference of the Joint Technical Team, as specified by the Minister, are
given in full detail at the end of this document (see Appendix A). In summary form,
the Joint Technical Team was asked to advise the Minister on, inter alia:
(a) the legal requirements and processes for establishing a new stand-alone
autonomous health sciences university and the incorporation of the Medunsa
subdivision of the University of Limpopo into this new university;
(b) the Advice of the Council on Higher Education (CHE) especially in relation to
quality arrangements for the offering of academic programmes;
(c) the processes that should lead as soon as possible to the gazetting of the new
university;
(d) transitional arrangements such as whether an interim structure should be
developed, the applicability of the Standard Institutional Statute (as per
Section 33(3) of the Higher Education Act of 1997), and the announcement
and composition of any interim council;
(e) transitional governance and management arrangements regarding admission
policies and student fees, rules and regulations, human resource policies and
procedures of appointment, communication strategies, financial governance
and management systems, ICT strategy, academic project, Programme
Qualification Mix and student life and support;
(f) required consultation processes with the University of Limpopo (UL) Council
and Management, representatives from the Medunsa Campus, the National
Department of Health, Gauteng Department of Health and DHET;
(g) a comprehensive turn-around strategy supported by a unique and preferential
funding allocation that involves improved quality, strengthening of
management and governance processes and procedures and, in the long term,
growth in enrolments, human resource capacity, disciplines and a suite of
broadened health related academic programmes at undergraduate level as well
as opportunities for continuous professional development either as formal
offerings or as short learning programmes;
1
(h) the comprehensive cost implications of the establishment of a new stand-alone
health sciences university with health related programmes at its core but with
a broader focus on undergraduate primary and secondary health care
programmes as well as continuous professional development programmes to
ensure the financial viability of the institution, and with the pivotal
involvement and commitment of the HPCSA;
(i) guidelines on the operational requirements to ensure the stability of the
academic project and quality of delivery on both campuses; and
(j) the applicability, purpose and details of a Memorandum of Agreement
between the DHET, the UL (Polokwane Campus) and the Medunsa Campus
setting out the rules of engagement and institutional transitional arrangements
during the interim phase.
A new health and allied sciences university incorporating the Medunsa campus can be
considered to be a significant step in government's ongoing efforts to both address
some of the legacies of the past and improve quality and equity in health care in South
Africa.
By training a new generation of health professionals and retooling current
practitioners with respect to community- and evidence-based and patient-centred
primary health care, such an institution can make a positive contribution to improving
the well-being of the many South Africans still marginalised by poverty and lack of
access to health care.
In order to ensure that the new health and allied sciences university incorporating the
Medunsa campus becomes and remains academically and financially viable, account
must be taken of the wider context which informs its development and its purpose.
There is the national context, framed by the health care challenges and needs in South
Africa today, as well as the strategies intended to address them and the range of health
science programmes currently available at universities across the country. The
country is faced with both increasing demand for, and a shortage of, appropriately
trained health professionals, whose training, development and deployment must
accord with the re-engineered community-based primary health care system.
There is also the international context, consisting of the state of health professional
education and training around the world. In examining this context and the variety of
global responses thereto, the predominant tendency to train health professionals in
medical schools attached to traditional universities can be contrasted against the
training of such professionals in stand-alone health sciences universities.
Of greatest importance is the local context, which consists of all current and proposed
health and allied science programmes, academic models and transitional arrangements
involving both the Medunsa and Turfloop (and proposed Polokwane) campuses of the
2
University of Limpopo. It includes consideration of the districts and communities
from which most of their students will be recruited, and who will be the intended
beneficiaries of the products of teaching and learning. Of special relevance will be the
teaching platform or the academic health complex, which will be the foundation for
all these efforts. This context will also be shaped by various stakeholders at all levels
of government (local, provincial and national), including the Treasury, the
Departments of Higher Education, Health, and Science and Technology, statutory
bodies and the private sector.
Last but not least, there is the costing and funding context and the general feasibility
of the entire enterprise, which requires consideration of increasing enrolments of a
wide range of health professional students, as well as increases in staff capacity and
expansions in programmes over time, together with facilities, equipment, clinical
training platforms, accommodation, student support and other infrastructure.
These are the chief features with which this report concerns itself.
Methodology
The JTT began its substantive work in June 2012 and adopted a multi-pronged
strategy, including meeting with key external and internal stakeholders and other
interested parties, reviewing existing health and higher education policies, and
conducting research into a range of possible academic models and programmes for the
new comprehensive health and allied sciences university.
In October and November 2012 and May 2013 the JTT met with the Council of the
University of Limpopo, and in April 2013 it received a presentation from the UL
Project Steering Committee that is overseeing the establishment of the new academic
health complex in Polokwane. In response to the gazetting of the Minister's intention
to establish a new university incorporating the Medunsa campus (Government Gazette
no. 36492, 28 May 2013) the JTT received a number of written submissions from
stakeholders and other interested parties and members of the public (see Appendix Y
for a consolidated summary of issues arising).
In June 2013, as part of its feasibility study, the JTT inspected the infrastructure on
the Medunsa campus, including its student housing; and also visited the University of
Pretoria’s Faculty of Veterinary Sciences at Onderstepoort. It also consulted with
officials at the national Department of Health on the latest developments and planning
regarding the refurbishment of the Dr George Mukhari Hospital and the building of
the new Soshanguve hospital and the new Polokwane academic health complex; and
collected information from and engaged in discussions with key health staff at several
South African universities with regard to possible clinical training platform
arrangements, including and especially the Director of the School of Medicine at the
University of Limpopo.
On 9 July the JTT accompanied the Ministers of Higher Education and Training and
Health to the Medunsa campus of the University of Limpopo, where it met with the
Campus Management Committee, the heads of academic departments, the labour
unions and the student organisations.
3
In early August the JTT visited the Medunsa campus for a second time, to meet again
with management, unions, students and heads of academic departments, and the
following week it travelled to the Turfloop campus of the University of Limpopo to
meet with management and heads of academic departments. On 22 August 2013
discussions were held with a range of external stakeholders, including the
Chiropractic Association of South Africa, the Medical Research Council, the
Pharmaceutical Society of South Africa, the South African Pharmacy Council, the
South African Society of Psychiatrists and the South African Veterinary Council, and
again on 12 November, with Tshwane University of Technology and the University of
Pretoria. In all instances further submissions and written proposals were invited and in
several cases received (see Appendix Y for a consolidated summary of issues arising).
In the process of developing an academic model for a comprehensive university
offering health and allied science programmes, consultations were held with and data
collected from relevant staff at various health professional councils, universities and
institutions. A review of existing legislation, policy and other relevant documentation
pertaining to the University of Limpopo and Medunsa, both before and after their
merger, was undertaken, along with an appraisal of data and documentation pertaining
to current health science enrolments, foci and academic models at South African
universities, including the current health and allied science Programme Qualification
Mixes on offer on both the Medunsa and the Turfloop campuses of the University of
Limpopo.
At the same time the international literature pertaining to the state of health
professional education and training around the world was reviewed, including the
manner in which health professionals are educated and trained, and the kinds and
range of health and allied science programmes and training platforms available, with a
particular emphasis on institutions similar in nature to what is intended in South
Africa, namely stand-alone or single-purpose health sciences universities.
A feasibility study was commissioned in order to determine the institutional and
resource gaps between the Medunsa campus' current infrastructure, facilities, space
and clinical training platform and the projected needs and what is expected of the new
university, through to 2024.
Transitional governance arrangements for the incorporation of the Medunsa campus
into the new university, as specified in the Higher Education Act and the Standard
Institutional Statute, have been formulated; and a Protocol for Engagement between,
on the one hand, the Council of the University of Limpopo, and on the other hand, the
Interim Council of the new health and allied sciences university, has been developed.
The JTT has also prepared Terms of Reference for the proposed Joint Specialised
Teams intended to facilitate the separation and incorporation process by, among other
things, conducting audits of all academic programmes, human resources, finances,
ICT and student and support structures pertaining to the Medunsa campus,
undertaking SWOT analyses, determining priorities, developing action plans and
making recommendations with regard to the delinking of the Medunsa campus from
the University of Limpopo and its incorporation into the new university.
4
Structure of the report
The report is divided into ten sections.
The first section provides brief background information on the decision to establish a
new health and allied sciences university incorporating the Medunsa campus, and on
the legislative framework governing this process.
The second section examines the South African health care context, with particular
reference to the challenges, needs and strategies indicated in government's Human
Resources for the Health Sector document (HRHS) which is amply supported by
international findings.
The third section, after providing a brief sketch of the nature of health professional
education and training around the world, investigates the kinds of programmes on
offer in other countries, particularly at stand-alone health sciences universities. It
summarises their distinctive features and trends, identifies which programmes are
more or less common, and which unique, and also makes reference to stand-alone
institutions offering both veterinary sciences and health sciences proper.
The fourth section outlines the broad range of health and allied science programmes
currently offered at South African universities in general, and identifies which
programmes are most and least commonly offered.
The fifth section focuses on the number and nature of the particular health and allied
science programmes available at the Turfloop and Medunsa campuses of the
University of Limpopo, noting certain minor discrepancies between the official but
dated Programme Qualification Mix (PQM) and what programmes are actually being
offered.
The sixth section compares what is on offer internationally, nationally and locally
with a view to identifying an academic model and associated range of programmes
which the new institution should consider offering, or continuing to offer, and on this
basis proposes a specific PQM. (A more detailed PQM, including projected student
headcount enrolments, is provided in Appendix X.)
The seventh section details the findings and recommendations of the feasibility study
commissioned by the JTT with regard to the institutional and resource gaps between
the Medunsa campus' current infrastructure, facilities, space and clinical training
platform and what the new university will require if it is to address national needs and
be academically and financially viable. Detailed breakdowns of current and projected
utilisation of space in all existing, new, altered and/or refurbished buildings and
facilities are included in the Appendices together with a Development Implementation
Plan.
The eighth section outlines the projected costs involved in the first five-year phase
(2014-2019) of proposed infrastructural and other building developments (including
both new buildings and extensions, alterations and renewals of existing buildings),
intended to accommodate the planned expansion in programmes and enrolments
5
which are to make the new health and allied sciences university academically and
financially viable.
The ninth section provides guidelines and identifies transitional arrangements for the
incorporation of the Medunsa campus into the new health and allied sciences
university, and identifies the main tasks and activities that will be required of key
stakeholders – particularly, the Council, management and staff of the University of
Limpopo on both the Turfloop and Medunsa campuses as well as the Interim Council
and interim management of the new university – in preparing for, overseeing and
successfully realising the various phases of the incorporation process. The transition
will be governed by a Protocol for Engagement to be entered into between the
Council of the University of Limpopo and the Interim Council of the new health and
allied sciences university, with the Department of Higher Education and Training
acting as facilitator (Appendix Z).
The final section concludes the report and lists the recommendations of the Joint
Technical Team.
6
1. Background
In a joint statement on 26 May 2011, the Ministers of Health and of Higher Education
and Training announced that, in the interests of the expansion of health care training
in the country, a new stand-alone autonomous health and allied sciences university,
incorporating the Medunsa campus of the University of Limpopo, and offering a
comprehensive suite of health care related and professional programmes as its core
operation, is to be established (DHET 2011b).
In 2005, the University of Limpopo had been formed by merging what until that time
had been separate universities, namely, the University of the North (UNIN),
established in 1959, and the Medical University of Southern Africa (Medunsa),
established in 1976. The formation of the University of Limpopo took place on the
basis of the report of the National Working Group on the restructuring of the higher
education system in South Africa, which recommended that a merger of UNIN and
Medunsa would help to overcome various structural inefficiencies and financial
weaknesses in each of these institutions and create a more equitable, sustainable,
productive and generally stronger university (DoE 2002: 41-5).
In late 2010 a Task Team was appointed by the Minister of Higher Education and
Training to review the University of Limpopo merger (DHET 2011a). The Task Team
reported that the merger between UNIN and Medunsa had been of no benefit to either
party, and recommended that it be undone (DHET 2011a: 3). It also recommended
that consideration should be given to incorporating the Medunsa campus into the
University of Pretoria, but that if this were to prove undesirable, that the Medunsa
campus should then continue on as an independent, stand-alone university (DHET
2011a: 4).
In terms of the Higher Education Act (Act No. 101 of 1997) the Minister of Higher
Education and Training submitted the report to the Council on Higher Education
(CHE) for advice. The CHE concurred with the Task Team's finding that the UNINMedunsa merger had not been successful and should be undone (CHE 2011b: 1). It
shared the Task Team's misgivings with regard to incorporating the Medunsa campus
into the University of Pretoria, and recommended instead that it should be established
as a university college which for governance and quality management purposes was
under the trusteeship of another higher education institution.
The Minister of Higher Education and Training and the Minister of Health considered
the recommendations of the Task Team report and the advice of the CHE. The Task
Team recommendation that the Medunsa campus be incorporated into the University
of Pretoria was found to be undesirable and not supported by either of these two
institutions, and it was also noted that the Higher Education Act makes no provision
for the establishment of a university college as envisaged by the CHE.
Accordingly, and also given government's broader commitment to both increase
access to higher education in general, and expand the education and training of health
professionals in particular, the two Ministers were in agreement that a new
comprehensive health and allied sciences university should be established, and that
7
the Medunsa campus of the University of Limpopo should be incorporated into this
new university.
Legislative framework
The establishment of a new health and allied sciences university incorporating the
Medunsa 1 campus falls within the ambit of the following legislation: the Higher
Education Act (Act No. 101 of 1997), the Promotion of Administrative Justice Act
(Act No. 3 of 2000), the National Health Act (Act No. 61 of 2003) and the Standard
Institutional Statute (Government Gazette No. 23065, 27 March 2002).
In terms of the Higher Education Act (Act No. 101 of 1997), Section 20(1), the
Minister of Higher Education and Training may, after consulting the CHE, establish a
public higher education institution, in this case a new stand-alone health and allied
sciences university. Section 20(3) of the Higher Education Act further specifies that
the notice publishing this decision in the Government Gazette must state (a) the date
of establishment of the institution; (b) the type and name of the institution; and (c) the
physical location and official address of the institution (RSA 1997).
In terms of the same Act, Section 24(1), the Minister of Higher Education and
Training may, after consulting the CHE, merge a subdivision of a public higher
education institution (in this case, the Medunsa campus of the University of Limpopo)
with another public higher education institution (the afore-mentioned newly
established health and allied sciences university). Section 24(2) adds that the assets,
liabilities, rights and obligations of the subdivision concerned devolve upon the public
higher education institution with which the subdivision has merged in a manner
agreed by the councils of the public higher education institutions concerned or, failing
such agreement, in a manner determined by the Minister after consulting such
councils (RSA 1997).
Sections 22(2) to (6) and 23(2) of the Higher Education Act apply to this merger of
the Medunsa campus with the newly established health and allied sciences university.
Sections 22(2) to (6) deal with the legal process associated, inter alia, with:
•
•
•
the transfer of immovable property;
the endorsement of title deeds; and
any funds previously vested in the Medunsa campus through trusts, donations
or bequests (RSA 1997).
Section 23(2) requires that the Minister:
•
•
give written notice of his intention to merge the Medunsa campus with the
new health and allied sciences university;
publish a notice giving the reasons for his decision in at least one national and
one regional newspaper in the area concerned;
1
Hereafter in this document all references to 'Medunsa' are to the Medunsa campus of the University of
Limpopo, not to the former Medical University of Southern Africa.
8
•
•
•
give the councils of the public higher education institutions concerned and any
other interested persons an opportunity to make representations within at least
90 days of such notice;
consider such representations; and
be satisfied that the employers at the public higher education institutions
concerned have complied with their obligations in terms of the applicable
labour law (RSA 1997).
Furthermore, the Minister's decision to merge the Medunsa subdivision of the
University of Limpopo with the newly established comprehensive health and allied
sciences university is also governed by, and accords with, the principles of the
Promotion of Administrative Justice Act (Act No. 3 of 2000), which requires that
even though the Minister may decide to merge the subdivision, he must have a sound
rationale for his decision.
In terms of the National Health Act (Act No. 61 of 2003), Section 51, the Minister of
Health may, in consultation with the Minister of Higher Education and Training,
establish academic health complexes consisting of one or more health establishments
and one or more educational institutions working together to educate and train health
care personnel and to conduct research in health services. The academic health
complex in this instance refers to the newly established health and allied sciences
university incorporating the Medunsa campus together with any new or existing
health establishments and training platforms such as the Dr George Mukhari hospital.
Moreover, in terms of Section 52 of the same Act, the Minister of Health may make
regulations in order to, inter alia, ensure the education and training of health care
personnel to meet the requirements of the national health system, and ensure that
adequate resources, planning, development and management structures, and
institutional capacity, are available for this purpose.
The Standard Institutional Statute (RSA 2002), developed in terms of Section 33 of
the Higher Education Act (RSA 1997), provides the framework for the interim
administration and governance of the new health and allied sciences university
incorporating the Medunsa campus.
The new model of a health and allied sciences university is intended to help produce
increasing numbers of a wide range of high quality and socially accountable health
professionals which the country sorely needs. Accordingly, it is expected to offer an
extensive and diversified range of health professional programmes and qualifications,
taking into account both the wide array of health professionals required for a vibrant
national health sector (DHET 2011b) and the need to increase the availability of
health care and health care training especially for the country's underserved, underresourced and rural communities (FHS 2013: 5; DoH 2011: 21).
It follows that the new university can be expected to be comprehensive in both the
vertical and the horizontal senses of this term. It must offer the full range of
qualifications, from certificates and diplomas through undergraduate degrees and
advanced diplomas to postgraduate honours, masters and doctoral degrees; it must
include both technical and professional programmes (normally offered by universities
of technology) and academic programmes (normally offered by traditional
universities); and it must provide health professional education and training in the
9
standard health and allied scientific fields (such as medicine and dentistry) as well as
in health-related fields (such as health information technology and hospital
management).
The new institution will also be aligned with the national priority of improving
universal access to quality health care for all, and the related need to 're-engineer' and
consolidate primary health care as the main mode of health care delivery focusing on
the prevention of disease and the promotion of health, in the context of the
implementation of National Health Insurance (DoH 2011: 20-1). As the Minister of
Health noted in his Preface to the Human Resources for the Health Sector strategy
document:
We have a vision to improve access to health care for all and health outcomes in
the short and medium term, with a particular focus on improving maternal and
child health. To realise this vision we require the human resources to implement
re-engineered Primary Health Care and ensure the service capacity for a health
system with improved financing through National Health Insurance (DoH 2011: 7).
In particular, the creation of a new health and allied sciences university will contribute
to the planning, development and management of human resources for health, and
focus on two of government's Human Resources for the Health Sector strategic
priorities, namely, Strategic Priority 4: to upscale and revitalise education, training
and research; and Strategic Priority 5: to create the infrastructure for workforce and
service development – Academic Health Complexes and nursing colleges (DoH 2011:
73, 77).
10
2. The South African health care context
South Africa today is faced with an extensive and increasing burden of disease, a
general shortage and mal-distribution of health professionals, and an undersupply of
new and appropriately trained health science graduates.
This health care context is aptly summed up in the Department of Health's Human
Resources for the Health Sector (HRHS) strategy document (DoH 2011). In terms of
the burden of disease, the HRHS notes that:
•
•
•
•
•
Mortality rates amongst mothers, infants and children under five are high and
rising.
There has been a rapid increase in infectious diseases, such as tuberculosis
which, together with HIV/AIDS, interpersonal violence and road traffic
injuries, is among the leading causes of death in South Africa.
The population is ageing.
Mental health problems add to the burden of disease.
Poverty and certain lifestyle-related activities (such as alcoholism, and unsafe
sex) increase the risk of loss of health (DoH 2011: 13-15; see also Chopra et al
2009: 1023-6).
As a result of these challenges, the country is unlikely to meet a number of healthrelated Millennium Development Goals, especially with regard to maternal, infant and
under-five mortality rates, even though there appear to have been significant
improvements in recent years (Bamford 2013: 49-51; English and Padarath 2013: xi;
StatsSA 2010: 60, 67). The importance of benchmarking against and meeting these
global indicators is further accentuated by the need to remain in step with post-2015
development planning, particularly the Sustainable Development Goals currently
being formulated under the auspices of the United Nations. 2
At the same time, the scope, distribution and number of health professionals equipped
to deal with these and other challenges is far from sufficient to meet demand.
According to the HRHS:
•
•
•
•
There was stagnant to negative growth in public sector clinical posts during
the ten years up to 2006.
In all key health professions, where positions are available, attrition rates are
high (up to 25% p.a.), with poor working conditions and management
relationships among the main causes of low retention.
Graduates, though recently beginning to increase in number, are not being
sufficiently absorbed into the public sector, where vacancies are high despite
the limited number of posts.
Health professionals are poorly distributed between rural and urban areas and
public and private sectors.
2
See UN, Millennium Development Goals, http://www.un.org/millenniumgoals/, and Sustainable
Development Knowledge Platform, http://sustainabledevelopment.un.org/rio20.html, accessed 26 April
2013.
11
•
•
The country has a low density of health professionals per 10 000 of its
population, as well as poorer health outcomes, compared to similar countries.
The recruitment of foreign health professionals has not been managed
efficiently or effectively (DoH 2011: 20-37).
Health professional output in South Africa has been largely stagnant for the past 15
years, with the country's universities currently producing an average of 3 173 new
health profession graduates (excluding nurses) per annum, of which about 1 300 are
medical graduates. There has also been a gradual decline in the production of nurses
with specialist qualifications in intensive care, operating theatre, advanced midwifery
and psychiatry; and there is a need for more clinical and public health medicine
specialists, community health workers, academic clinicians, mid-level workers (such
as emergency medical care technicians, radiographer assistants, pharmacy technicians,
and forensic pathology assistants), and non-clinical professionals (such as health
economists, actuaries and managers through data analysts and epidemiologists to
medical scientists), especially given the planned implementation of National Health
Insurance. The training of health professionals is also inequitably distributed around
the country; and the quality of clinical training infrastructure and supervision needs to
be improved (DoH 2011: 40-48).
In response to the challenges facing health care and health education in South Africa,
and also drawing on international findings (outlined in the following section), the
South African Department of Health has developed a multifaceted policy and strategy,
concentrating on the training, development and deployment of more and better health
professionals, the enhancement of health workforce planning, facilities and
infrastructure, and the improvement of health care working environments (DoH 2011:
20ff, 40ff, 57ff).
The Department of Health's ten national strategic priorities (or 10 Point Plan) for
2009-2014 consist of the following:
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
Provision of strategic leadership and creation of a social compact for better
health outcomes;
Implementation of a National Health Insurance Plan (NHI);
Improving quality of health services;
Overhauling the health care system and improve its management;
Improving human resources planning, development and management;
Revitalization of physical infrastructure;
Accelerated implementation of HIV & AIDS and Sexually Transmitted
Infections National Strategic Plan 2007-11 and increased focus on TB and
other communicable diseases;
Mass mobilisation for better health for the population;
Review of the drug policy; and
Strengthening research and development (DoH 2010: 20).
Of particular relevance with regard to the establishment of a new health and allied
sciences university incorporating the Medunsa campus are several of the sub-priorities
associated with Priorities (v) and (vi) above. Priority (v) calls, inter alia, for a focus on
the training of primary health care personnel and mid-level health workers, and an
assessment and review of the Health Professional Training and Development Grant
12
and the National Tertiary Services Grant; while Priority (vi) calls, inter alia, for the
construction, refurbishment and maintenance of hospitals, particularly tertiary
hospitals (DoH 2010: 21). It must be noted, too, that in terms of Priority (ii), the
implementation of National Health Insurance, the human resource and service
capacity of the health system as a whole will need to be strengthened, with particular
regard for professionals skilled in health management and administration, health
finance, health economics, health information technology and health data analysis
(DoH 2011: 93).
Most pertinently, government's vision to improve health care for all and health
outcomes depends on the development of education and training platforms in order to
produce the health professionals who can prevent disease and promote health through
the re-engineered primary health care (PHC) system, in the context of the
implementation of NHI.
The re-engineering of Primary Health Care requires a priority attention on maternal,
child and women’s health, maintaining the HIV and AIDS focus and an emphasis
on community based care and preventative health care (DoH 2011: 65).
The PHC system emphasises district-level delivery of health services through District
Clinical Specialist Teams, School Health Services and Municipal Ward-based PHC
Teams (DoH 2011: 10, 17; Matsoso and Fryatt 2013: 26). District Clinical Specialist
Teams (DCSTs) will comprise "four experienced medical specialists (Family
Physician [or generalist doctor], Obstetrician and Gynaecologist, Paediatrician and
Anaesthetist) and three advanced nursing professionals (Advanced Primary Health
Care Nurse, Advanced Midwife and Advanced Paediatric Nurse)" (DoH 2011: 67),
along with pharmacy assistants, environmental health officers, and various mid-level
workers (like health care workers who specialise in the care of the elderly, laboratory
assistants, rehabilitation assistants and clinical associates) (DoH 2011: 67-9).
It follows from the general shortages of health professionals listed above, as well as
the need for specific kinds of health professionals to implement the PHC system at
district, ward and school levels, and to implement and service the NHI, that the
planned new comprehensive health and allied sciences university should give
consideration to training as many of these professionals as is academically possible
and economically feasible.
In addition, for qualification, programme and curriculum planning purposes, it is
important that the competencies of all new health professionals should include
"patient-centered care, interdisciplinary teams, evidence-based practice, continuous
quality improvement, use of new informatics, and integration of public health" (DoH
2011: 99; Frenk et al 2010: 99). In this context, an experiential, reflective,
community-based service learning approach should figure prominently in all curricula
(FHS 2013: 16-17). Moreover, "research skills should be taught and a culture of
critical inquiry developed" (DoH 2011: 99); and the process of Continuing
Professional Development (CPD) needs to be better regulated and overseen, and made
a requirement for professional re-registration (DoH 2011: 119).
The health challenges listed above, and the official responses thereto, are not unique
to South Africa, as the following section will show. Equally widespread around the
13
world is a belief that new kinds of health professionals are needed to meet the
particular demands of the 21st century, and that the training of these new professionals
may require new forms of pedagogy and practice, and new configurations of
institutional and instructional design (Frenk et al 2010: 8-13). In order to get a
comprehensive picture of the possible kinds and range of programmes which might be
offered by the new health and allied sciences university in South Africa, it is
important to consider, first, what kinds of programmes are on offer at health science
education and training platforms elsewhere in the world, and specifically at
institutions similar in nature to what is intended in South Africa, namely stand-alone
or single-purpose health sciences universities. Second, it is also necessary to examine
what kinds of health and allied science programmes are currently being offered in
South Africa, including on the Medunsa campus itself, given that the latter is intended
to become a key component of the new institution.
14
3. Health care and health science education and training internationally
Most of the health issues facing South Africa are not exceptional in a global context.
Almost all countries, rich and poor alike, are being forced to confront growing health
challenges with insufficient numbers of suitably trained health professionals, and the
models of health science education currently in place are often outdated and
ineffective. This section first sketches the state of health professional education and
training around the world, and then surveys the manner in which health professionals
are educated and trained along with the kinds and range of health science programmes
generally available.
The international health care context
The report of the Commission on Education of Health Professionals for the 21st
Century (Frenk et al 2010) makes clear that shortages of health professionals who are
also appropriately trained are common across the world. In the face of gaps and
inequities in health care both within and between countries, compounded by new
infectious, environmental and behavioural risks at a time of rapid global demographic
and epidemiological transitions, the education and training of health professionals
internationally is fragmented, uncoordinated and even, in some cases, obsolete:
The problems are systemic: mismatch of competencies to patient and population
needs; poor teamwork; persistent gender stratification of professional status;
narrow technical focus without broader contextual understanding; episodic
encounters rather than continuous care; predominant hospital orientation at the
expense of primary care; quantitative and qualitative imbalances in the
professional labour market; and weak leadership to improve health-system
performance (Frenk et al 2010: 1).
Summing up recent reports on the education of the global health workforce, nursing
education, public health education and medical education, the Commission
recommended the reform of health science education to emphasise "patient and
population centredness, competency-based curriculum, interprofessional and teambased education, IT-empowered learning, and policy and management leadership
skills" (Frenk et al 2010: 20). Its vision is that "all health professionals in all countries
should be educated to mobilise knowledge and to engage in critical reasoning and
ethical conduct so that they are competent to participate in patient and populationcentred health systems as members of locally responsive and globally connected
teams" (Frenk et al 2010: 2-3).
As the World Health Organization report, Scaling Up, Saving Lives (WHO 2008),
indicated, the global health workforce crisis can be addressed in part by, among other
things, implementing "an immediate and huge increase in community- and mid-level
health workers – trained, paid, supervised and able to refer on to more skilled workers
– alongside the expansion of education and training for all groups of health workers",
and by ensuring that curricula "are focused on the health needs of the country, are
community- and team-based, draw on the resources of the public and private sectors
and the skills of international partners, and make greater use of innovative means to
increase training capacity, such as information and communication technologies and
15
regional approaches" (WHO 2008: 1-2). These are precisely the kinds of solutions
embedded in South Africa's focus on developing the human resources required for its
re-engineered primary health care strategy.
In 2011, South Africa's National Planning Commission remarked that "successfully
addressing poverty will have a positive impact on the nation's health" (NPC 2011:
303). It is no less true that improving the nation's health will also assist in the
reduction of poverty:
Health, spending on healthcare, economic growth and poverty alleviation are
closely related. Good health, nutrition, reproductive health policies and effective
health services are critical links in the chain that allows countries to break out of
the vicious circle of poverty, high birth rate, poor health and low economic growth,
replacing it with a virtuous circle of greater productivity, low fertility, better health
and rising incomes (WHO 2008: 14).
Indeed, a clear correlation has been found between a country's gross domestic product
(GDP) and infant mortality rate: "the lower the infant mortality rate, the higher the
GDP growth rate" (WHO 2008: 14). It is thus of crucial importance, for both health
and broader socio-economic reasons, that more and better health professionals are
trained in innovative ways such as to be embedded in, and responsive to the health
needs of, the communities they are to serve.
In most parts of the world, as in South Africa, the training of health practitioners takes
place in a medical school which is attached to a traditional university (whether public
or private) usually also offering programmes in non-health science disciplines. Standalone universities dedicated to the teaching of health sciences – known as health
sciences or medical universities – are the exception rather than the rule, except in
parts of Eastern Europe, Ukraine, Russia, Iran and increasingly in India and Pakistan. 3
According to the 2012 QS World University Rankings for Life Sciences and Medicine,
only five of the top 100 universities (all of which are located in developed countries,
with the possible exception of Hong Kong) – the (private) Mayo Medical School,
Karolinska Institute, Medical University of Vienna, Taipei Medical University and
University of Texas MD Anderson Cancer Center – are stand-alone health sciences
3
Precise information on the total number of universities worldwide, let alone the number of health
sciences or medical universities, is difficult to come by, in part because different international
organisations (such as UNESCO, the International Association of Universities, the World Health
Organisation and the Foundation for Advancement of International Medical Education and Research)
and the various global ranking systems (such as QS, Shanghai and THES) use different criteria to
determine what is or is not a university and, even if so, whether it merits inclusion on their lists. Given
these provisos, a preliminary scan of the available information (as of January 2013) suggests that, out
of approximately 21 000 higher education institutions in the world (including some 2 400 medical
schools, most of which are attached to a parent university), only a few hundred (or around 2% to 3%)
are stand-alone universities dedicated to the teaching of health sciences. See Cybermetrics Lab,
http://www.webometrics.info/; International Association of Universities, http://www.iau-aiu.net/;
Avicenna, http://avicenna.ku.dk/database/medicine; Foundation for Advancement of International
Medical Education and Research, http://www.faimer.org/resources/mapping.html; Frenk et al 2010: 23,
http://healthprofessionals21.org/images/healthprofnewcentreport.pdf; Universities Worldwide,
http://univ.cc/; QS, http://www.topuniversities.com/university-rankings/; Shanghai,
http://www.shanghairanking.com/; and THES, http://www.timeshighereducation.co.uk/worlduniversity-rankings/; all accessed during March and April 2013.
16
universities. 4 As the Task Team Review Report of the University of Limpopo merger
noted, "[t]here are very few good universities that are single faculty focused around
the world, except in higher education systems that have professional schools at postgraduate level" (DHET 2011a: 24).
In the USA, most health and allied health professional schools, including almost all
the top ranked medical schools, are affiliated with a university. The same applies to
most academic health centres or complexes in the USA which – as in South Africa
(DoH 2011: 105) – are entities which include "an allopathic or osteopathic medical
school, one or more other health professional schools or programs (such as nursing,
public health, or pharmacy), and one or more teaching hospitals" (Anderson et al 1994:
147; AAHC 2009: 1). However, there are also approximately 21 stand-alone health
sciences universities (defined as "universities that are not related to a parent system,
have at least one medical school, and do not offer a comprehensive set of academic
programs" such as liberal arts or engineering) (Vagelos 2002: 38).
In order to review the range of academic programmes on offer at stand-alone health
sciences universities around the world, electronic searches for 'stand-alone',
'freestanding', 'comprehensive' and/or 'autonomous' 'health sciences' and 'medical'
universities were undertaken using Google, Google Scholar, PubMed, EBSCOHost,
Academic Search Complete, Health Source and Medline search engines and databases,
and further refined by consulting the Avicenna (previously World Health
Organisation) global directory of medical schools as well as the QS World University
Rankings and the Shanghai Academic Ranking of World Universities.
The institutions listed (alphabetically, by country) in the following subsection are all
stand-alone health sciences universities (with a few exceptions). It must be noted that
this is not a representative sample, but is simply a list of institutions that appeared or
were mentioned most frequently in the electronic searches and/or in the health science
literature that the searches revealed.
In addition, a conscious effort has been made to give a reasonable spread of health
sciences universities from both developed and developing countries, and across all
continents; and to include both institutions with a select or limited programme
repertoire as well as those with an extensive range of programmes on offer (and which
invariably also have strong research programmes).
All of these institutions offer undergraduate programmes, and most offer postgraduate
programmes as well. Moreover, as far as can be ascertained, these are all public and
publicly-funded institutions, though many also generate revenue through the services
their attached or affiliated hospitals and clinics provide, not to mention through tuition
fees.
The few exceptions incorporated into this list of stand-alone health sciences
universities include: an instance of a medical school having developed into a fullyfledged university (Gondar); an institute of technology with a subspeciality in medical
science and technology (Kharagpur); and a university which includes several
4
See http://www.topuniversities.com/university-rankings/world-university-rankings/2012/subjectrankings, accessed 19 February 2013.
17
traditional academic disciplines even while maintaining a primary focus on health
sciences (UMST).
Stand-alone health sciences universities
Antigua
The University of Health Sciences Antigua concentrates on medicine and nursing
with an emphasis on primary health care. 5
Austria
The Medical University of Vienna, formerly the medical school of the University of
Vienna, became an independent university in 2004. Ranked 60th in the world on the
2012 QS World University Rankings for Life Sciences and Medicine, its programmes
include medicine, dentistry, medical informatics and applied medical sciences. 6
The Private Universität für Gesundheitswissenschaften, Medizinische Informatik und
Technik (Private University for Health Sciences, Medical Informatics and Technology,
UMIT), established in 2001 at Hall in Tirol, Austria, is in fact wholly owned by the
Tyrolean provincial government. It offers undergraduate and postgraduate
programmes in healthcare business management, biomedical informatics, nursing,
psychology and physiotherapy, and additional postgraduate programmes in nutrition,
gerontology, sports medicine and public health. 7
China
China Medical University, in Shenyang, China, has programmes in medical science,
public health, biomedical engineering and pharmacy. 8
Cuba
The Instituto Superior de Ciencias Médicas de La Habana (Higher Institute of
Medical Sciences of Havana) offers medicine, nursing, dentistry and health
technology. 9
Another well-known stand-alone Cuban health sciences university is the Escuela
Latinoamericana de Medicina (Latin American School of Medicine, ELAM), which
teaches medicine to thousands of international students. 10
Ethiopia
5
See http://www.uhsa.ag/, accessed 27 February 2013.
See http://www.meduniwien.ac.at/studienabteilung/content/studium-lehre/studienangebot/uebersicht,
accessed 27 February 2013.
7
See http://www.umit.at/page.cfm?vpath=universitaet&switchLocale=en_US, accessed 27 February
2013.
8
See http://www.cmu.edu.cn/eng/index.htm, accessed 28 February 2013.
9
See
http://www.altillo.com/universidades/cuba/Instituto_Superior_de_Ciencias_Medicas_de_La_Habana.as
p, accessed 27 February 2013.
10
See http://www.sld.cu/sitios/elam/, accessed 27 February 2013.
6
18
While the University of Gondar, Ethiopia, is not a stand-alone health sciences
university, it is included here because it is an unusual instance of a medical school
having developed into a fully-fledged university covering all traditional disciplines.
Initially (in 1954) a Public Health College, it was awarded university status in 2004,
having already added a Faculty of Management Sciences in 2001 and Faculties of
Natural Sciences, Social Sciences and Veterinary Medicine in 2003; it then added a
Faculty of Law in 2005 and a Faculty of Agriculture and Schools of Technology and
Education in 2009. 11
Germany
Hannover Medical School, Germany, is a stand-alone health sciences university
established in 1965, offering programmes in medicine, dentistry, biomedicine,
biochemistry, public health and midwifery. It is ranked 247th in the world on the 2012
QS World University Rankings for Life Sciences and Medicine. 12
India
The All India Institute of Medical Sciences, headquartered in New Delhi, India, offers
an extensive range of medical, para-medical, nursing and dentistry programmes at
both undergraduate and postgraduate levels. 13
The Indian Institute of Technology at Kharagpur focuses mainly on engineering and
its subdisciplines but also offers programmes in humanities and social sciences and,
most pertinently, biotechnology. It's School of Medical Science and Technology
admits only MBBS graduates into its Masters programme of the same name, and aims
to develop "a new breed of medical professionals who can fuse together medicinal
science with technology and can bridge the two disciplines". In this context the
School emphasises medical imaging and image analysis, medical instrumentation,
tissue engineering, biomaterials, bio-MEMS, reproductive biology, cancer drug
design, medical statistics and informatics, nuclear medicine, radiation therapy, health
care management, and herbal medicine and bio-engineering. 14
Maharashtra University of Health Sciences, India concentrates on both modern
(Western) and Indian systems of medicine, and oversees all health sciences education
in the state of Maharashtra. It offers undergraduate and postgraduate programmes in
medicine, biomedical technology, nursing, ayurveda, unani, homeopathy,
physiotherapy, occupational therapy, audiology and speech language pathology,
prosthetics and orthotics. 15
The Rajasthan University of Health Sciences, Jaipur, India, which began operating in
2006, incorporates eight public and private medical facilities offering programmes in
medicine, dentistry, nursing, pharmacy and paramedical sciences. 16
11
See http://www.uog.edu.et/index.php/about-uog, accessed 27 February 2013.
See http://www.mh-hannover.de/ueberblick_service.html?&L=1, accessed 18 February 2013.
13
See http://www.aiims.edu/aiims/departments/depart.htm, accessed 27 February 2013.
14
See http://www.iitkgp.ac.in/academics/?page=acadunits&&dept=MD, accessed 27 February 2013.
15
See http://www.muhs.ac.in/showpdf.aspx?src1=dept_links1.aspx, accessed 18 February 2013.
16
See http://www.ruhsraj.org/, accessed 27 February 2013.
12
19
The Sikkim Manipal University, a public-private partnership located in Gangtok,
India, and consisting of a number of institutes of technology and medicine, was
established in 1995. It appears to give equal emphasis to engineering, information
technology and medicine, and with regard to the last offers programmes in medicine,
medical biotechnology, medical laboratory technology, nursing, physiotherapy,
business administration (including hospital administration), and various applied
sciences. 17
Mongolia
The Health Science University of Mongolia consists of schools of medicine, dentistry,
nursing, biomedicine, public health, pharmacy and traditional medicine. 18
Nepal
B.P. Koirala Institute of Health Sciences (BPKIHS) is a university situated in eastern
Nepal. It has four colleges, Medical, Dental, Nursing and Public Health, along with a
700-bed teaching hospital, and offers degrees in anaesthesiology, clinical
pharmacology and therapeutics, dermatovenerology, ENT, internal medicine,
orthopedics, pediatrics, psychiatry, radiodiagnosis and surgery. 19
Pakistan
Established in 2002, the University of Health Sciences Lahore, in Pakistan, offers a
full range of programmes in medical, dental, nursing and allied health sciences, as
well as biomedical engineering, pharmacology, paramedic education, human genetics
and molecular biology, behavioural sciences and medical jurisprudence. 20
Sudan
The University of Medical Sciences and Technology (UMST), in Khartoum, Sudan,
has a primary and extensive focus on health sciences (medicine, pharmacy, dentistry,
nursing, laboratory sciences, radiological sciences, and anaesthetics), while also
offering programmes in Engineering (including biomedical engineering), Information
Technology, Business Administration, Economic, Social and Environmental Studies,
and Law. 21
Sweden
The Karolinska Institute, in Stockholm, Sweden, is a health sciences university which
was ranked 20th in the world on the 2012 QS World University Rankings for Life
Sciences and Medicine and 11th in the world on the 2012 Shanghai Index of
universities offering Clinical Medicine and Pharmacy. Its wide range of health science
programmes, both undergraduate and postgraduate, include medicine, nursing,
17
See http://www.smu.edu.in/, accessed 27 February 2013.
See http://www.cmuc.edu.mn/#/members/s2/, accessed 27 February 2013.
19
See http://bpkihs.edu/introduction.html, accessed 27 February 2013.
20
See http://www.uhs.edu.pk/academics.php, accessed 27 February 2013.
21
See http://umst-edu.com/, accessed 27 February 2013.
18
20
dentistry, occupational therapy, audiology, biomedicine, public health science, speech
and language pathology, optometry, psychology, radiography and physiotherapy. 22
Taiwan
Sharing the same name with a health sciences university in mainland China, China
Medical University in Taiwan offers medicine, dentistry, Chinese medicine, pharmacy,
cosmeceutics, public health, occupational safety and health, nursing, physical therapy,
medical laboratory science, biotechnology, biomedical imaging, radiology, sports
medicine, nutrition, respiratory therapy and health administration. 23
Taipei Medical University in Taiwan, ranked 64th in the world on the 2012 QS World
University Rankings for Life Sciences and Medicine, offers programmes in medicine,
oral medicine, pharmacy, nursing, public health, nutrition, biomedical technology and
health care specialisations, as well as humanities and social sciences. 24
Tanzania
Muhimbili University of Allied Health Sciences, Dar es Salaam, Tanzania, was
inaugurated in 2007, having developed out of the Dar es Salaam School of Medicine
at the University of Dar es Salaam. It offers medicine, pharmacy, dentistry, nursing,
public health, environmental health and radiotherapy technology, and has its own
teaching hospital currently under construction (Mkony 2012; see also Kaaya 2012).
United Arab Emirates
The Ras Al Khaimah Medical and Health Sciences University, in the United Arab
Emirates, was established in 2006, and offers medical, dental and pharmaceutical
sciences and nursing. 25
United States of America
The Georgia Health Sciences University (formerly the Medical College of Georgia)
was, until recently, a stand-alone health sciences university, composed of Colleges of
Allied Health, Dental Medicine, Graduate Studies and Nursing as well as the Medical
College of Georgia. In 2012 it merged with Augusta State University to form Georgia
Regents University, and the new institution now also includes Colleges of Business,
Education, Science and Mathematics, and Arts, Humanities and Social Sciences. 26
The Medical University of South Carolina, in Charleston, USA, is an academic health
sciences centre, providing a full range of educational and clinical services and
biomedical research. It consists of colleges of medicine, dentistry, nursing, pharmacy,
22
See http://ki.se/ki/jsp/polopoly.jsp?d=600&a=105506&l=en, accessed 22 February 2013.
See http://english.cmu.edu.tw/academics/undergraduate.php, accessed 28 February 2013.
24
See http://www.tmu.edu.tw/english/main.php, accessed 1 March 2013.
25
See http://www.rakmhsu.com/, accessed 20 February 2013.
26
See http://www.georgiaencyclopedia.org/nge/Article.jsp?id=h-1199, and
http://www.georgiahealth.edu/, accessed 27 February 2013.
23
21
health professions (including health administration, physical therapy, occupational
therapy and physician assistance) and graduate studies. 27
With the creation of the Texas Tech University System in 1996, the Texas Tech
University Health Sciences Center became a separate university. Spread across six
campuses, it includes two medical schools, two schools of nursing, and schools of
allied health sciences, pharmacy and biomedical sciences. 28
In addition, in 2012 the Texas Tech University System initiated a process of
establishing a new stand-alone health sciences university in El Paso, Texas, bringing
together an already existing medical school, school of nursing, children’s hospital and
women’s hospital. The new entity will join Texas Tech University, Texas Tech
University Health Sciences Center and Angelo State University as a part of the Texas
Tech University System. 29
The University of Medicine and Dentistry of New Jersey, in Newark, New Jersey, is a
multicampus health sciences institution which gained autonomous university status in
1981. It includes schools of dentistry, nursing, biomedical sciences, public health and
health related professions. It is currently in the process of being integrated into
Rutgers University, which offers the full range of traditional academic disciplines
(including health sciences). 30
The freestanding Oregon Health and Science University, in Portland, Oregon, was
established in 1974, out of a merger of the University of Oregon's schools of medicine,
nursing and dentistry. It later added a school of pharmacy and an institute of
technology. Apart from offering an extensive range of programmes associated with
these schools, it also trains nutritionists, medical technologists and paramedics. It is
ranked 300th in the world on the 2012 QS World University Rankings for Life
Sciences and Medicine. 31
University of Texas Southwestern Medical Center, part of the University of Texas
system, was ranked 108th in the world on the 2012 QS World University Rankings for
Life Sciences and Medicine, and sixth in the world on the 2012 Shanghai Index of
universities offering Clinical Medicine and Pharmacy. It has a medical school, a
graduate school of biomedical sciences and a school of health professions (offering
biomedical communications, clinical nutrition, emergency medical services, medical
laboratory sciences, physical therapy, physician assistant studies, prosthetics-orthotics,
radiation therapy, and rehabilitation). 32
Also part of the University of Texas system is the University of Texas MD Anderson
Cancer Center, which was ranked 72nd in the world on the 2012 QS World University
Rankings for Life Sciences and Medicine. It offers undergraduate programmes in
27
See http://dev.musc.edu/musc/about/history.html, accessed 25 February 2013.
See http://www.ttuhsc.edu/hsc/welcome.aspx, accessed 27 February 2013.
29
See http://www.texastech.edu/stories/12-05-board-approves-process-for-freestanding-hsc.php,
30
See http://www.umdnj.edu/, accessed 27 February 2013; http://ru-umdnjtogether.rutgers.edu/,
accessed 27 February 2013; and Vagelos 2002.
31
See http://www.ohsu.edu/xd/education/schools/other-healthcare-programs.cfm, accessed 25 February
2013.
32
See http://www.utsouthwestern.edu/, accessed 28 February 2013.
28
22
clinical laboratory science, cytogenetic technology, cytotechnology, diagnostic
imaging, histotechnology, medical dosimetry, molecular genetic technology, radiation
therapy and nursing; and postgraduate programmes in immunology, cancer biology,
genes and development, molecular carcinogenesis, medical physics, biomathematics
and biostatistics, experimental therapeutics, and virology and gene therapy. 33
Finally, while many traditional universities include veterinary sciences, and there are
also several dozen stand-alone universities of veterinary science, the Lithuanian
University of Health Sciences appears to be one of the few stand-alone health
sciences universities which trains both doctors and veterinary surgeons (LUHS 2012).
Oregon Health and Science University also offers undergraduate and postgraduate
veterinary programmes at its Oregon National Primate Research Center.
To sum up:
•
•
•
•
•
•
•
•
•
The most common programmes on offer at the stand-alone health sciences
universities listed above are medicine, dentistry, pharmacy and nursing,
although many of these institutions offer far more than these and a few offer
only one or two of them.
Programmes in public health are also widespread, across both developed and
developing countries.
Programmes in allied health professions such as homeopathy and chiropractic
are among the least likely to be on offer.
Several stand-alone health sciences universities also teach (non-health-specific)
basic science programmes, and sometimes even applied sciences.
A prominent trend at institutions offering a large number of programmes, as
well as at institutions figuring on the QS World University Rankings, seems to
be the offering of transdisciplinary programmes such as biomedical
technology, bioengineering and medical informatics.
Worthy of particular mention are the number of institutions with a combined
focus on engineering, technology and medicine, such as the Indian Institute of
Technology and Sikkim Manipal University in India, the University of
Medical Sciences and Technology in Sudan, and Oregon Health and Science
University in the US.
Several of the above-mentioned universities, and others (such as the Medical
University of South Carolina, and the universities in Taiwan), also emphasise
health management and/or administration.
While stand-alone universities of veterinary science are not uncommon, few
stand-alone health science institutions offer programmes in both veterinary
sciences and health sciences proper.
Among the more unique programmes are traditional medicine (though
relatively common at institutions in Asia), herbal medicine, sports medicine
and medical jurisprudence.
This overview of programmes on offer at stand-alone health sciences universities
internationally can now be compared to the range of health science programmes
offered at South African universities in general, and to the health science programmes
offered on the Medunsa campus in particular.
33
See http://www.mdanderson.org/, accessed 2 March 2013.
23
4. Health science programmes at South African universities
All public universities and a few private higher education institutions in South Africa
currently offer some or other kind of health science programme. Scrutiny of the
websites of the 23 public universities and of the various health professions councils
and associations (statutory or otherwise) 34 suggests that:
20 universities offer nursing (including UL, which offers nursing on both campuses);
9 offer pharmacy (although one of these offers only pharmacy support; UL offers
pharmacy on both campuses);
9 offer dentistry (although three of these train only dental assistants and/or
technologists);
9 offer dietetics or nutrition;
8 offer medicine (specifically, the MBChB);
8 offer physiotherapy;
8 offer occupational therapy;
8 offer radiography (with another three offering radiology);
8 offer biomedical technology (in addition, Rhodes and VUT offer biotechnology);
8 offer sport science (and several others offer human movement studies, kinetics, etc.);
7 offer public health (including UL, which offers this on both campuses);
7 offer environmental health;
4 offer optometry;
4 offer speech and language pathology (SLP) and audiology;
4 offer clinical technology (in addition, TUT offers veterinary technology);
4 offer emergency medical care;
4 offer somatology;
2 offer chiropractic;
2 offer homeopathy;
2 offer health promotion;
1 offers Chinese medicine, acupuncture, naturopathy, phytotherapy and unani-tibb;
1 offers podiatry; and
1 offers veterinary science. 35
In addition, at least three private higher education institutions (Monash South Africa,
Foundation for Professional Development and Health Science Academy) offer various
diplomas, bachelors degrees and/or short courses in areas such as public health,
HIV/AIDS management, general practice and aesthetic medicine.
Thus – leaving aside both nursing, which is offered at practically every university as
well as at several nursing colleges or schools, and the almost equally ubiquitous sport
sciences and human movement studies – the most common health and allied science
34
The Allied Health Professions Council of South Africa (AHPCSA), the Chiropractic Association of
South Africa, the Health Professions Council of South Africa (HPCSA), the South African Dental
Technicians Council (SADTC), the South African Nursing Council (SANC), the South African
Pharmacy Council (SAPC), the South African Society of Psychiatrists (SASOP), and the South African
Veterinary Council (SAVC).
35
Note: this list does not include disciplines such as psychology and social work, which at some South
African universities (eg. UWC, NMMU, WSU, NWU and UNIVEN, as well as UL at Turfloop) are
located within the health sciences faculty.
24
programmes on offer at South Africa's universities include pharmacy, dentistry,
dietetics, medicine, physiotherapy, occupational therapy, radiography, biomedical
technology, public health and environmental health. Programmes in professions such
as optometry, somatology, chiropractic and homeopathy are much less common,
while only one public university (UWC) caters for Chinese medicine, and one other
(UP) for veterinary science. 36
In terms of the range of health and allied science programmes being offered, South
Africa's health science faculties can therefore be said to be on a par with stand-alone
health sciences universities. Apart from a relative paucity of programmes in allied
health professions, if there is any programme area where South Africa might be
comparatively under-represented, this would be traditional health or traditional
medicine, an area whose practitioners are considered by the Department of Health to
be (in collaboration with Community Outreach teams) "the first line of care in many
parts of the country" (DoH 2011: 31) but which is difficult to regulate due to a lack of
standardisation of the practices involved. Even at the international level, however,
traditional medicine remains underprovided for, with the World Health Organisation
only recently urging its members to consider including traditional medicine and its
counterparts, complementary and alternative medicines, in their planning, training,
qualification and accreditation systems. 37
36
While UP is the only university in the country which currently offers a full range of veterinary
science programmes (including veterinary nursing, veterinary technology, veterinary industrial
pharmacology and animal health) at both undergraduate and postgraduates levels, NWU, TUT and
Unisa also offer diplomas and/or degrees in veterinary technology and animal health.
37
See World Health Organisation, 2009,
http://www.who.int/medicines/areas/traditional/trm_benchmarks/en/, accessed 26 March 2013.
Traditional, complementary and alternative medicines, by their very nature, often fall outside the
formal knowledge bounds of (modern and predominantly Western) health science, which in turn keeps
them at arm's length from consumer protection and patient safety regulations and hampers their and
their practitioners' integration into existing health science training and accreditation structures.
25
5. Health and allied science programmes at the University of Limpopo
Health and allied science programmes at the University of Limpopo are offered on
both of its campuses, Turfloop and Medunsa.
Beneath an overarching Faculty of Health Sciences, the Turfloop programmes are
grouped together under a School of Health Sciences, while the more numerous and
diverse Medunsa programmes fall under the auspices of Schools of Medicine,
Pathology and Pre-Clinical Sciences, Oral Health Sciences, and Health Care Sciences.
However, while a single Faculty of Health Sciences oversees programmes on both
campuses, and some of the programmes (specifically: nursing, pharmacy and public
health, as well as basic sciences) are offered on both campuses, 38 the two sets of
campus-specific programmes are completely separate, taught by separate staff with
separate resources and examinations (DHET 2011: 15; UL Project Steering
Committee presentation, 4 April 2013).
Moreover, in terms of both the number of health science programmes available and
the number of health science students enrolled on each campus, the Medunsa campus
is by far the larger of the two: as of 2010, 3 837 (or 78%) of the 4 940 health sciences
students at the University of Limpopo were on the Medunsa campus (UL 2010a).
Health and allied science programmes on the UL Turfloop campus
In terms of the Turfloop Programme Qualification Mix (PQM) as of December 2005
(updated February 2008), 39 the following undergraduate and postgraduate
programmes were on offer:
Undergraduate:
Bachelor of Science (general)
Bachelor of Science (Medical Science)
Bachelor of Nursing Education and Administration
Bachelor of Nursing Science and Arts
Bachelor of Optometry
Bachelor of Pharmacy
Bachelor of Nutrition
Diploma in Nursing Administration
Diploma in Nursing Education
Postgraduate:
Higher Postgraduate Diploma in Health Education
Bachelor of Science (Honours)
Master of Pharmacy
Master of Science (Medical Sciences)
38
According to the University of Limpopo website, Turfloop offers programmes in nursing, pharmacy,
public health, optometry and health promotion, of which only the last two are not also offered on the
Medunsa campus. See http://www.ul.ac.za/index.php?Entity=Faculty%20of%20Health%20Sciences,
accessed 1 March 2013.
39
UL Turfloop PQM data supplied by the DHET.
26
Master of Science (Occupational and Environmental Health)
Master of Nursing
Master of Nutrition
Master of Optometry
Master of Public Health
Master of Science (Clinical Psychology)
Doctor of Science in Agriculture
Doctor of Pharmacy
Doctor of Philosophy
According to the Programme Qualification Mix above, the Turfloop School of Health
Sciences offers undergraduate degrees and diplomas in nursing, pharmacy, optometry,
nutrition and occupational and environmental health, as well as a general Bachelor of
Science. It also offers postgraduate degrees and diplomas in nursing, pharmacy,
optometry, nutrition, health education, occupational and environmental health, public
health, clinical psychology and agriculture.
As shown in the following subsection, the health and allied science programmes
offered on the Turfloop campus are relatively few when compared with those on the
Medunsa campus. Nevertheless, Turfloop's programmes in optometry and health
education (or health promotion) are unique to this campus.
Health and allied science programmes on the UL Medunsa campus
In terms of the Medunsa Programme Qualification Mix (PQM) as of December 2005
(updated February 2008), 40 the following undergraduate and postgraduate
programmes were on offer:
Undergraduate:
Bachelor of Science (general)
Bachelor of Dental Therapy
Bachelor of Radiography (Diagnostic)
Bacclaureus Curationis (in I et A, and Administration)
Bacclaureus Curationis
Bachelor of Advanced Nursing Science
Bachelor of Dental Surgery (old curriculum)
Bachelor of Dental Surgery (new curriculum)
Bachelor of Science (Dietetics)
Bachelor of Science (Occupational Therapy)
Bachelor of Science (Physiotherapy)
Bachelor of Speech and Language Pathology and Audiology
Bachelor of Veterinary Medicine
Diploma in Nursing
Diploma in Oral Hygiene
Postgraduate:
40
UL Medunsa PQM data supplied by the DHET.
27
Postgraduate Diploma (in HIV/AIDS Management, Maternal and Child Health, and
Public Health)
Postgraduate Diploma (in Dentistry, and Hospital Pharmacy Management)
Bacclaureus Curationis Honoribus
Bachelor of Science (Honours)
Bachelor of Science (Medicine)(Honours)
Magister Curationis
Master of Dental Science
Master of Dentistry
Master of Medicine (in Family Medicine, and Neurology)
Master of Occupational Therapy
Master of Science (Clinical Psychology)
Master of Science (Dietetics)
Master of Science (Medicine)
Master of Science (Physiotherapy)
Master of Science
Master of Veterinary Medicine
Masters in Public Health
Doctor of Medicine
Doctor of Public Health
Doctor of Veterinary Science
Doctor Philosophiae
Philosophiae Doctor
According to the Programme Qualification Mix above, the four Medunsa campus
Schools of Medicine, Pathology and Pre-Clinical Sciences, Oral Health Sciences and
Health Care Sciences offer undergraduate degrees and diplomas in medicine, dentistry,
oral hygiene, pharmacy, nursing, radiography, dietetics, occupational therapy,
physiotherapy, speech and language pathology, audiology and veterinary medicine, as
well as a general Bachelor of Science. They also offer postgraduate degrees and
diplomas in medicine, dentistry, nursing, hospital pharmacy management, HIV/AIDS
management, maternal and child health, clinical psychology, dietetics, occupational
therapy, physiotherapy, public health and veterinary science.
However, the c.2008 PQM with respect to the Medunsa campus appears to be
incomplete in certain respects, when one takes into account Medunsa campus student
registration and performance data for 2010 (UL 2010a; UL 2010b) as well as
information on the University of Limpopo website. 41
For instance:
•
•
Postgraduate programmes in pharmacy are not specifically listed in the c.2008
Medunsa PQM, but Medunsa campus students were registered for such
programmes in 2010 (UL 2010a: 23).
While the c.2008 PQM makes no mention of full programmes in areas such as
sports medicine and rehabilitation, nutrition or human genetics, Medunsa
41
According to the University of Limpopo website, Medunsa offers programmes in medicine, dentistry,
nursing, pharmacy, anaesthesiology, occupational therapy, physiotherapy, radiography, dietetics,
speech and language pathology, audiology, public health and environmental health. See
http://www.ul.ac.za/index.php?Entity=Faculty%20of%20Health%20Sciences, accessed 1 March 2013.
28
•
•
•
campus students were registered for such programmes or at least modules in
these areas in 2010 (UL 2010a: 50-1, 65).
The c.2008 PQM lists a Diploma in Nursing, a Bachelor of Nursing (Bcur), a
Bachelor of Nursing (Bcur IetA), and a Postgraduate Diploma in Dentistry,
but none of these are specifically mentioned in Medunsa campus student
registration and performance data as having any students registered from 2008
to 2010 inclusive (UL 2010a).
Conversely, in 2010 there were Medunsa campus students registered for a
Postgraduate Diploma in Oral Health (UL 2010a: 23), and separately for a
Bachelor of Dental Science (UL 2010a: 17, 32), but neither of these particular
programmes are listed in the c.2008 PQM.
Furthermore, whereas the c.2008 PQM indicates that both undergraduate and
postgraduate veterinary science programmes are offered on the Medunsa
campus, there is no mention of any students taking them from 2008 to 2010
inclusive (UL 2010a). 42 (However, on the Turfloop campus, the School of
Health Sciences has had students taking a module in Basic Veterinary
Pharmacology – UL 2010a: 58.)
These relatively minor discrepancies aside, what can be gleaned from the above is that
the Medunsa campus offers more programmes than it did at the time of its merger
with UNIN, the primary exception being veterinary science.
42
In 1999 the Faculty of Veterinary Science at Medunsa amalgamated with the Faculty of Veterinary
Science at the University of Pretoria, under the auspices of the latter, and since then Medunsa has not
offered programmes in this field. See DoE 2000.
29
6. Proposed programmes and academic model for the new university
Given the health and allied science programmes already in place at the University of
Limpopo, particularly those being offered on the Medunsa campus, and also in the
light of the kinds and range of health and allied science programmes being offered in
the rest of the country as well as internationally, one can begin to identify which
programmes could potentially be offered by the new health and allied sciences
university.
In terms of health and allied science programmes offered at South African universities
in general, the Medunsa campus's range of programmes is one of the most extensive
in the country; it is also one of only eight universities offering the MBChB. 43 For the
most part, too, the Medunsa campus offers very similar kinds of programmes to what
is available at stand-alone health sciences universities internationally.
However, the Medunsa campus does not appear to offer any programmes of the sort
which were found to be increasingly prominent internationally, such as biomedical
technology, bioengineering or medical informatics.
The Medunsa campus also does not appear to offer programmes in optometry, health
education (or health promotion) or social work (which are available only on the UL
Turfloop campus), prosthetics, laboratory or clinical medical technology, paramedical
and emergency medical services, or many allied health professional programmes; and
since 1999 it has not offered programmes in veterinary science.
Despite the absolute and relative shortages in almost all categories of health
professionals in South Africa (DoH 2011: 134-5), including most categories of
veterinary professionals (Working Group 2011: 15-18), 44 and the fact that the scope
of the programmes offered by the new health and allied sciences university are
intended to be comprehensive and extensive, it might nevertheless be argued that the
new institution should avoid offering programmes for which substantial sources of
supply (whether actual or potential) already exist, and particularly to avoid
unnecessarily duplicating any programmes being offered by other universities in
relatively close proximity.
Apart from the distance education University of South Africa, there are currently six
public universities within approximately 300km of the location of the new university
at the Medunsa campus: NWU, TUT, UJ, UP, Wits and UL (Turfloop campus). 45
According to Department of Health data (DoH 2011: Annexure A, Tables 6 & 7), in
2008 these universities produced new health and allied science graduates in:
43
The planned new academic health complex in Polokwane will include the country's ninth medical
school (see Appendix B).
44
A slightly earlier (2009) report by the University of Pretoria anticipated that the shortage of
veterinarians (but not of veterinary nurses) would be eliminated 'within 5-7 years': see UP 2009: 14.
45
Apart from these six institutions, at a slightly greater distance are VUT and UNIVEN, which have
comparatively few students or limited programme offerings. DoH data for 2008 (DoH 2011: Annexure
A, Tables 6 & 8) suggests that VUT produced only biotechnologists and community nurses, and
UNIVEN only nurses. In addition, the National Health Laboratory Service (NHLS), in conjunction
with a range of universities, also helps to train biotechnologists at MMed level.
30
•
•
•
•
•
•
pharmacy and radiography (NWU);
biomedical technology, clinical technology and radiography (TUT);
EMS, biomedical technology and optometry (UJ);
MBChB, dentistry, physiotherapy, occupational therapy, SLP and audiology
and radiography, not to mention veterinary science (UP);
MBChB, dentistry, pharmacy, physiotherapy, occupational therapy, and SLP
and audiology (Wits); and
pharmacy and dietetics (UL, from both the Turfloop and Medunsa campuses).
In the same year, the Medunsa campus produced graduates in MBChB, dentistry,
pharmacy, physiotherapy, occupational therapy, SLP and audiology, dietetics and
radiography.
Note that all of these institutions/campuses bar two (NWU, and the UL Turfloop
campus) are located in Gauteng, which province already produces the most health
science graduates (over 6000 graduates annually across almost the full range of health
science programmes – DoH 2011: Annexure A, Table 7).
It should also be borne in mind that plans are underway to establish a new academic
health complex in Polokwane, under the auspices of the University of Limpopo
(DHET 2011a: 18-21; DoH 2011: 17). A business plan and financial model has been
drafted, curricula and teaching timetables have been prepared, study guides for the
first two years have been written, venues and libraries have been prepped and stocked,
a dissection hall and a teaching hospital are being prepared and regional hospitals
have been identified, accommodation and administrative offices have been
refurbished, Memoranda of Agreement have been entered into with the Limpopo,
North West and Gauteng Departments of Health, and offers of support have been
received from other institutions (such as UCT and WSU) (UL Project Steering
Committee presentation, 4 April 2013). This new facility will offer the MBChB
(although, given that it is only scheduled to begin operating in 2015, it will take
several years before the first new doctors graduate).
In other words, all current programmes offered by the Medunsa campus, and probably
also most programmes which might be envisaged for the new university, are already
being catered for, at least formally in terms of graduates and pipeline students, by
other nearby institutions. This means that practically all programmes likely to be
offered by the new university will unavoidably duplicate what is already being offered
within a 300km radius; and this also has implications for the availability of staff and
the provision of clinical training platforms needed to service these programmes.
Nevertheless, this in itself should not be taken to be a reason not to offer them,
because current production of graduates in almost all health science professions is far
from being sufficient to meet demand.
As noted above, the HRHS makes specific reference to the slight and inadequate rate
of increase in the output of health professionals, and hence to the need for more
medical doctors, public health medicine specialists, community health workers,
academic clinicians, mid-level workers (MLWs) (especially emergency medical care
technicians, radiographer assistants, pharmacy technicians and forensic pathology
assistants), professional nurses, midwives and PHC trained nurses (DoH 2011: 44, 45,
48, 67). A slightly earlier study had already warned that the growth rate of 4% per
31
annum from 1999 to 2005 in new medical practitioners would not meet government's
2014 targets, concluding that "we need generalist medical practitioners the most,
followed by internal medicine specialists … [and] we could also experience a
shortage of surgeons" (Breier 2008: 95).
To meet these needs, and align itself with national and local priorities, the new health
and allied sciences university must aim to:
•
•
•
•
increase the absolute number of health and allied science graduates;
increase the number of graduates in particular health and allied science
professions, especially but not only in identified scarce skill or high need areas;
improve the overall throughput rate; and
improve the quality of graduates, particularly with regard to their clinical
training and their conformity with the re-engineered PHC system.
It follows that, first, and leaving aside for the moment all consideration of costs and of
infrastructural and staff capacity, the new health and allied sciences university should
strive to offer as wide a range of programmes as possible; and should only consider
omitting – or, better, temporarily suspending or capping – programmes producing
professionals of whom there are currently no shortages. 46
Moreover, and notwithstanding expanding, diversifying and increasing the number of
programmes on offer, the new university must ensure that its student intake increases
beyond the current enrolment numbers on the Medunsa campus. It is estimated that,
for the new institution to be economically viable, it must in the short to medium term
almost double its current (Medunsa campus) student enrolment, by increasing it to 7
000 or more students (DHET 2011a: 30) over the next five years, and aim at an intake
of 10 000 students within the next 15 to 20 years (FHS 2013: 7). In order to address
urban bias through innovative training programmes which promote work in
marginalised regions, students should be recruited from communities with the greatest
health care needs (FHS 2013: 14; DoH 2011: 66; Frenk et al 2010: 37).
However, the viability of the new institution depends not only on achieving, as soon
as possible, a critical mass of student enrolments. It will depend also on its capacity to
offer and attract students to a range of programmes, particularly high-return
postgraduate degrees and diplomas as well as Continuing Professional Development
programmes and short courses. Furthermore, the new university's viability will be
enhanced by fostering and strengthening its culture of research and research
productivity (DoH 2011: 99; DHET 2011a: 4; FHS 2013: Addendum I), by initiating
and attracting research programmes along with high quality research staff and
students and associated funding and subsidies. Not least, the sustainability of this
enterprise will require consistent and reliable funding streams, and the generation of a
46
According to the HRHS, professionals of whom there are currently no shortages include:
audiologists; environmental health practitioners; nutritionists/dieticians; occupational therapists;
optometrists; physiotherapists; podiatrists; psychologists; social workers; dental assistants; oral
hygienists; dental practitioners; dental technicians; dental therapists; enrolled nurses; nuclear medicine
specialists; developmental paediatricians; and rheumatologists (DoH 2011: 134-5). However, as the
HRHS warns, the available data is not always complete or consistent (DoH 2011: 12, 21); moreover, to
say that there is currently no shortage in a particular health profession should not be taken as equivalent
to the existence of a surplus.
32
significant amount of sustainable third-stream funding over and above any initial
capital injection.
At the same time, second, the new health and allied sciences university should give
thought to trends and programmes at stand-alone health sciences universities
internationally, including the prominence of transdisciplinary programmes in
biomedical technology, bioengineering and medical informatics, the frequently
combined focus on engineering, technology and medicine (often in conjunction, too,
with health management and administration), and the existence, albeit uncommon, of
institutions offering both veterinary and health sciences.
Third, the new health and allied sciences university must ensure that all of its
programmes directly target and address the health needs of the majority of the South
African population, particularly at a district and community level, and also take into
account the need to implement and service the planned National Health Insurance. In
concert with the transdisciplinary and multidisciplinary approaches mentioned above,
emphasis should be given to the development of integrated programmes involving
teams which include health professionals from a variety of health and allied sciences,
and incorporate health education and clinical training facilities at all levels (from local
communities through to specialised hospitals). Not only upon graduation but also
during their studies and clinical training, the new health science professionals must be
immersed in the communities they will be serving, to whom they must be accountable,
and amongst whom they will work to prevent disease and promote health. Social
accountability should not be seen as a mere curricular add-on, but as an integral
component of health practitioners' competencies (FHS 2013: 16-17). The communityfocused and socially accountable ethos of the new institution's programmes must
therefore give especial emphasis to producing more mid-level workers – such as
clinical associates, pharmacy and rehabilitation assistants, laboratory technicians,
those specialising in the care of the aged and, in the context of veterinary science,
animal health technicians and laboratory animal technologists – who can
simultaneously promote the well-being of defined local populations, support
government's team-based PHC strategy and help to service the NHI (FHS 2013: 13-17
and Addendum I; DoH 2011: 45, 48, 93; and on veterinary teams, see Working Group
2011: 7-8).
In short, and ideally, the new health and allied sciences university should continue to
offer programmes in
public health, environmental health and basic sciences (a general BSc),
and should also consider offering programmes in
33
as well as additional programmes in natural, technological, managerial, human and
social scientific fields which have or can be given a specific health science focus,
such as
research).
Naturally, and wherever feasible, consideration must be given to (a) developing all the
programmes listed above (both those already on offer and those only envisaged) from
the undergraduate level right through to postgraduate and postdoctoral levels, (b)
complementing them with a range of Continuing Professional Development
programmes and short courses, and (c) establishing research programmes and
developing research capacity, especially in clinical research and the development of
datasets and prevalence studies of infectious and non-communicable diseases,
violence and injury, and maternal and child mortality (DoH 2012: 5-8). While an
integrated and concerted focus on research will help to address the problem of the
greying of academia by training future and attracting additional high quality academic
clinicians and researchers, the strengthening of the basic science programmes to be
offered by the new institution is equally important, because they are the foundation
which not only underpin almost all other health science programmes – including inservice training and Continuing Professional Development programmes – but which
also make it possible to attract additional students, ensure high quality mid-level
worker training and groom future academic staff.
Drawing on the above discussion, the proposed Programme Qualification Mix of the
new health and allied sciences university is listed in broad outline below, together
with the actual 2011 student headcount enrolment for each programme and a
projected 2019 headcount enrolment (see also Appendix X for greater detail). While
the proposed Programme Qualification Mix focuses on diploma and degree
programmes, and hence does not list the full range of Higher Certificates and
Advanced Certificates that might be offered across the various programme areas, the
new university may well wish to consider offering these at a later or more opportune
moment.
The programmes are grouped in terms of the following categories: Medicine; Nursing;
Pharmacy; Physiotherapy; Speech, Hearing and Sight; Dietetics and Nutrition;
Occupational Therapy; Public Health; Oral Health; Science, Medical Technology; and
Veterinary Science. In the tables below, all programmes listed in black are
programmes that the Medunsa campus currently offers. All programmes listed in red
are new programmes, i.e. programmes not currently offered on the Medunsa campus
of the University of Limpopo.
The current and proposed new programmes in Medicine are shown in Table 1.
Table 1: Medicine Programmes
2011
Headcount
1 255
2019
Headcount
1 360
34
(MBChB) (incl. ECP)
Bachelor of Radiography (Diagnosis)
91
120
Bachelor of Science Honours in Medical Sciences –
various
16
110
-
60
293
545
-
5
Master of Science in Medicine – MSc (Medicine)
0
20
Master of Science in Medicine – MSc (in various
specialisations)
33
115
MSc (Clinical Psychology)
42
50
MSc (Counseling Psychology)
-
20
Doctor of Medicine (MD in General Surgery)
1
5
Doctor of Medical Science
1
5
19
30
Bachelor of Science in Medical Sciences
Master of Medicine – MMed (in various specialisations)
Master of Science in Medical Sciences
47
Phd (in various specialisations)
The flagship programme of all fully-fledged medical schools is the MBChB, and
enrolments naturally need to increase under the auspices of the new university and in
order to meet the country's demand for specialist medical practitioners. At the same
time, however, the various MMed and MSc medical specialisations are prime
candidates for expansion; enrolments at doctoral level should be increased to enhance
the institution's research profile; and it is proposed that new programmes in Medical
Sciences (at both Bachelors and Masters levels) and in Counseling Psychology be
introduced.
Table 2: Nursing Programmes
2011
Headcount
Diploma in Nursing (240c)
2019
Headcount
-
25
Diploma in Occupational Health Nursing
21
40
Baccalaureus Curationis (BCur) (I et A)
212
240
31
60
Advanced Diploma in Occupational Health Nursing
0
20
Bachelor of Nursing Science Honours (in various
specialisations)
9
60
Master of Nursing Science (in various specialisations)
22
35
PhD in Nursing Science
15
20
Bcur – in Nursing Education, Community Health
Nursing, Midwifery, Psychiatry or Health Services
Administration
Bachelor of Advanced Nursing Science
47
Where this programme already exists, enrolments should be increased.
35
Enrolments in Nursing programmes should increase across the board, assisted by the
offering of a range of new BCur specialisations also to be made available at
postgraduate level. A new 240-credit Diploma in Nursing will contribute to the
training of the many more mid-level workers needed. 48
Table 3: Pharmacy Programmes
2011
Headcount
Diploma in Pharmacy (240c)
2019
Headcount
-
25
229
260
21
30
Postgraduate Diploma (Authorised Pharmacy
Prescriber)
-
20
Postgraduate Diploma (Pharmacovigilance)
-
10
59
40
2
5
Postgraduate Diploma (Hospital Pharmacy
Management)
Master of Pharmacy
PhD in Pharmacy
While Pharmacy programmes are currently offered on both the Turfloop and Medunsa
campuses of the University of Limpopo (and, in the case of the Bachelor of Pharmacy,
in collaboration with TUT), there is room at the new university for increased
enrolments, particularly at the undergraduate level, and also to take advantage of the
recent professional focus on Authorised Pharmacy Prescribers and Pharmacovigilance.
Table 4: Physiotherapy Programmes
Bachelor of Science in Physiotherapy (4 year)
2011
Headcount
2019
Headcount
166
180
Bachelor of Exercise Science and Sports Medicine
-
40
Master of Science in Physiotherapy
2
10
12
20
Master of Science in Physiotherapy (Sports Medicine
and Rehabilitation)
Physiotherapy-related programmes can be expanded and supplemented with an
undergraduate focus on exercise science and sports medicine.
Table 5: Speech, Hearing and Sight Programmes
Bachelor of Speech Language Pathology
2011
Headcount
2019
Headcount
93
40
Bachelor of Logopaedics
-
40
Bachelor of Audiology
-
80
48
Additional 240c and 360c diplomas should also be considered where necessary, taking into account
the revised Higher Education Qualifications Sub-Framework.
36
Bachelor of Optometry
-
70
Master of Optometry
-
15
Doctor of Optometry
-
5
The established discipline of Speech Language Pathology and Audiology can be
differentiated into separate programmes; and undergraduate and postgraduate
programmes in Optometry will be new additions to the Medunsa campus, having until
now been offered only at the Turfloop campus of the University of Limpopo.
Table 6: Dietetics and Nutrition Programmes
2011
Headcount
2019
Headcount
Diploma in Food Safety
-
25
Bachelor of Science in Dietetics
177
90
Bachelor of Science in Nutrition
-
90
Master of Science in Dietetics
-
10
Master of Science in Nutrition
-
10
Dietetics, another long-established set of programmes, can be differentiated and
supplemented by programmes specifically focused on Nutrition, as well as a Diploma
in Food Safety.
Table 7: Occupational Therapy Programmes
Bachelor of Occupational Therapy
2011
Headcount
2019
Headcount
156
180
-
15
Master of Occupational Therapy
There should be a natural increase in the student intake into Occupational Therapy
programmes.
Table 8: Public Health Programmes
2011
Headcount
2019
Headcount
Diploma in Tropical Medicine and Hygiene
-
10
Bachelor of Science in Health Promotion
-
60
Postgraduate Diploma in Health Promotion
-
10
Postgraduate Diploma in Primary Health Care
-
10
Postgraduate Diploma in HIV/AIDS Management
-
10
85
40
-
40
18
25
Master of Public Health
Master of Science in Health Promotion
Doctor of Public Health
37
Public health, and primary health care and health promotion in particular, are crucial
components of the Department of Health's long-term strategy, and given the demand
for both specialists and mid-level workers in these areas, the Medunsa campus's
existing postgraduate offerings in the field need to be increased and expanded and
also supplemented with undergraduate qualifications.
Table 9: Oral Health Programmes
2011
Headcount
Diploma in Oral Hygiene
2019
Headcount
27
40
-
40
Bachelor of Dental Sciences
239
300
Bachelor of Dental Therapy
36
145
-
60
Advanced Diploma in Community Dentistry
13
20
Postgraduate Diploma in Dentistry
12
20
Bachelor of Science Honours in Dental Sciences
1
5
Master of Dental Surgery
0
5
Master of Dentistry (MDent) (various specialisations)
10
30
Master of Science in Dentistry
21
30
3
5
Diploma in Dental Assistance
Bachelor of Oral Hygiene
PhD in Dentistry
Enrolments in Oral Health programmes should increase across the board, along with
new undergraduate programmes in Dental Assistance and Oral Hygiene.
Table 10: Science Programmes
2011
Headcount
Bachelor of Science – Chemistry, Physics (previously
Physical Sciences), Biochemistry, Botany, Zoology,
Mathematics, Statistics, Information Technology
2019
Headcount
604
1 250
Bachelor of Science Honours (specialisations as
above)
40
100
Master of Science (specialisations as above)
26
60
8
15
PhD (specialisations as above)
Given the dependence of almost all health science programmes on the basic science
disciplines, the existence of science service modules and programmes on both the
Turfloop and Medunsa campuses, and the already significant enrolments in these
areas, it stands to reason that the science programmes should be expanded and
increased, and also supplemented by programmes in information technology (which
in turn will underpin some of the planned new medical technology programmes).
Table 11: Medical Technology Programmes
2011
2019
38
Headcount
Headcount
Bachelor of Science in Health Informatics
-
40
Bachelor of Science in Biotechnology
-
40
Bachelor of Science in Clinical Technology
-
40
Bachelor of Biomedical Engineering
-
40
The introduction of medical technology programmes is in accordance with
international trends.
Table 12: Veterinary Science Programmes
2011
Headcount
2019
Headcount
Diploma in Veterinary Nursing
-
18
Diploma in Veterinary Technology
-
18
Diploma in Animal Health (Veterinary Technicians)
-
50
Certificate in Animal Welfare
-
18
Bachelor of Animal Health (Veterinary Technicians)
-
120
Bachelor of Veterinary Technology
-
60
Bachelor of Veterinary Nursing
-
70
Bachelor of Veterinary Science (Vet)
-
220
Bachelor of Animal Health Honours (Veterinary
Technicians)
-
10
Bachelor of Veterinary Technology Honours
-
10
Bachelor of Veterinary Nursing Honours
-
10
Master of Animal Health (Veterinary Technicians)
-
5
Master of Veterinary Technology
-
5
Master of Veterinary Nursing
-
5
Programmes in veterinary science are envisaged as an important component of the
new health and allied sciences university. However, for various reasons related to
costs (both the costs of new veterinary infrastructure and everyday operating costs)
and location (such as the availability of clinical training opportunities), further
discussion and investigation of possible synergies amongst all roleplayers in the
veterinary field needs to take place, particularly with regard to the optimal extent (the
number and kind of programmes to be offered) and level (undergraduate and/or
postgraduate) of the veterinary science programmes to be offered. 49
Finally, the increased number of programmes in general, and the expansion or
addition of certain health-related disciplines in particular (such as public health and
49
For a more detailed discussion of various options with regard to veterinary clinical training
opportunities, see Section 7 below.
39
medical technology, as well as veterinary science) will require a revised academic
specialisation structure.
Table 13: Proposed Academic Organisational Structure
School of Medicine
School of Health Care Sciences
School of Oral Health Sciences
School of Pathology and Pre-Clinical Sciences
School of Science and Technology
School of Veterinary Sciences
School of Humanities
In addition to the four Schools already extant on the Medunsa campus, three
additional Schools can be envisaged: a School of Veterinary Sciences, a School of
Science and Technology (to accommodate the expanded basic science programmes
and the medical technology programmes) and a School of Humanities (incorporating
psychology, social work, language and education service or specialisation
programmes).
This proposed Programme Qualification Mix, based as it is on a review of
programmes offered at stand-alone health sciences universities and their comparison
with programmes offered in South Africa and more specifically on the Medunsa
campus, thus indicates the main areas where, in principle, the new comprehensive
university incorporating the Medunsa campus could consider expanding, extending
and increasing its academic offerings through various different qualification types and
levels.
Notwithstanding the proposals above, the precise nature and contents of the new
university's Programme Qualification Mix and academic organisational structure
should be determined by its Interim Council after further investigation and on the
basis of clear and agreed upon criteria.
Moreover, any expansion or diversification of programmes to be offered and increases
in student enrolments must take into account and carefully plan for the infrastructural,
space and clinical training platform requirements of such expansions and increases.
Additional infrastructure (both new, refurbished and better utilised) will be needed,
and existing clinical training platforms will need to be expanded, improved,
supplemented and better managed. The next section begins to address these elements.
40
7. Infrastructure, space and clinical training
In the light of the proposed expansion in programmes and enrolments, the JTT
commissioned a feasibility study of the institutional and resource gaps between the
Medunsa campus' current infrastructure, facilities, space and clinical training platform
and what the new university will require if it is to both realise national development
and policy priorities and be academically and financially viable.
This section deals in turn with campus infrastructure, assignable space and the clinical
training platform (including the veterinary clinical training platform). It is informed
by a number of on-site inspections of the Medunsa campus, a visit to the University of
Pretoria’s Faculty of Veterinary Sciences at Onderstepoort, several meetings with
external and internal stakeholders, current (2011) and projected student Full-Time
Equivalent (FTE) data, current (2011) and projected Programme Qualification Mix
(PQM) data, enrolment planning data, contact time information, space classification
and use data and norms, national policy directives regarding space provision in future
hospitals, architectural plans and clinical training platform information, most of which
was supplied or facilitated by the University of Limpopo, the Department of Health
and/or the Department of Higher Education and Training and further researched and
developed by the JTT. In due course any proposals made here will need to be
considered for funding by the National Treasury.
Campus infrastructure
On-site inspections of the Medunsa campus (see Appendix C) revealed that the
academic buildings are mostly well-built and in a fair condition. Moreover, even
though the Medunsa campus has not offered veterinary programmes since 1999, the
infrastructure of the production unit complex on the campus is intact and in
reasonable condition. On the other hand, the student residences, while also well-built,
are in a poor condition; the previous veterinary academic hospital (which was separate
from the production unit) has been largely demolished; and there are a number of
other serious defects and shortcomings that will require attention.
First, the electricity supply from Eskom is shared with the hospital (60%/40%) and
the two transformers are located within the hospital site. One of the two transformers
was planned as a backup, with only one being in operation at any one time. Currently,
however, both transformers are in use in parallel, which places both the hospital and
the university at risk. (The cost of the electricity for both the hospital and the
university is carried by the university in terms of the Joint Establishment agreement
between the provincial government and the university, in terms of which joint staff
(clinicians and administrative support staff) are paid by the provincial government
with the university contributing 30% of this salary bill.) The University of Limpopo
plans to contract Eskom to refurbish the transformers, to allow for Notified Maximum
Demand (the maximum demand agreed between the customer and Eskom) to increase
to 10MVA at a supply voltage of 33kV, but this refurbishment is only expected to be
executed in 2014. Moreover, Eskom has notified UL that, due to its electricity
generation, transmission and distribution constraints as well as stability constraints on
its interconnected power system, capacity will be severely constrained for the next
seven to ten years.
41
Second, extensive damage and costs have been incurred as a result of the theft or
vandalising of copper cabling, brass items and steel elements. For example, the
repeated theft of brass fittings from the pressure-reducing valve on the main water
supply has led to pipe bursts; while the theft of copper cabling from the airconditioning plant supplying the Clinical Pathology building has resulted in a
proliferation of personal air-conditioners, which in turn increases running costs.
Third, in terms of the geotechnical profile, the upper 3-4 metres of the soil on which
much of the campus is built is subject to heave and is a poor founding material. As a
result, most large buildings have had to be built on excavated platforms some 3
metres below natural ground level. Certain single-storey buildings which have not
been built on reinforced concrete platforms have failed and are uninhabitable. Other
effects of the heaving soil are that the main water supply ring main, made from fibrecement, has become brittle and is subject to breakages; and the construction of
occupied levels below natural ground level means that sewerage needs to pumped up
to the level of the main sewer.
Fourth, as noted above, the student residences are in poor condition (except one that
was recently refurbished at a cost of about R14.1 million). The Medunsa campus
currently has a total student residence capacity of 3 333 beds, which represents 72%
of the current student headcount (approximately 4 650 students). Most of the
residences are purpose-built internal (on-campus) residences, which together with a
number of houses provide 2 333 of all the bed-spaces; the remaining 1 000 beds are in
external residences – Ikhaya Junction and South Point – which are located in the
Pretoria CBD (see Table 14).
Table 14: Current capacity of Medunsa campus student residences
Residences
Bed-count
1A (Women)
253
1B (Women)
241
1C (Women)
66
1D (Women)
185
2B (Women)
295
Internal residences
4B (Block JKL) (Men)
304
5A (Men)
315
5B (Men)
313
Green House
8
Lost City
170
Medunsa City
183
Total capacity: internal residences
2 333
Ikhaya Junction (leased)
200
External residences
South Point (leased)
800
Total capacity: external residences
1 000
Total capacity: all residences
3 333
The student housing in the 'Lost City' area is subject to cracking due to both the soil
and the high water table, caused by the presence of a dam on the upper slope. Houses
in the 'Medunsa City' area, used by staff and students, have not suffered structural
42
defects due to heaving soils; however, they are not of a suitable standard and should
be demolished if and when the site is needed for new student housing.
Students from the two external residences are bussed to the campus each day at a
reported cost of about R800 000 per month. UL plans to remove this operating cost by
inviting developers to join it in a Public-Private Partnership agreement to design,
construct, manage and transfer 2 500 new beds (possibly by 2016). It also plans to use
a R60 million DHET infrastructure grant to build a new residence, which could
reasonably add another 180 beds (possibly by 2015). Should these two plans be
realised, on-campus student housing capacity will be 5 000 beds (or 108% of the
current headcount).
Fifth, while the facilities in the veterinary production unit (comprising stabling for 20
horses and other specialist equine facilities, a pig unit, a poultry unit, a sheep unit, a
dairy unit, a large animal unit complete with clinic, laboratories, seminar rooms,
stores and offices, and a service compound with bulk feed storage capacity, stores,
garages, workshops, offices and staff quarters; see also Appendix E) are intact, the
unit will need to be cleared of all temporary occupants and refurbished before it can
become operational.
Finally, although the lifts appear to be in good condition and are inspected regularly,
frequent stoppages are being experienced; and the campus roads are aging and in very
poor condition.
In summary, the following items are likely to need large-scale funding:
•
•
•
•
•
•
•
•
•
Refurbishment of the student residences (except for the one recently
refurbished);
Refurbishment of the veterinary production unit complex;
Installation of a new electricity transformer to separately supply the hospital,
thus allowing the existing transformers to supply only the university and to be
used as originally designed (one being a backup);
Relocation of the main water supply pressure reducing valve to within the
security fence;
Replacement of the water ring mains with HDPVC pipes;
Refurbishment of the main air-conditioning plants to the six major academic
buildings, taking precautions against future vandalism and theft;
Refurbishment and replacement of the approximately 18 lift controls (not
necessarily the lifts themselves), as required;
Construction of a cut-off drain below the upper dam to divert sub-surface
water; and
Resurfacing of campus roads to a higher specification.
In addition, all future planning with regard to student residences should aim to house
at least 80% of students on-campus, as recommended by the Ministerial Report on
Student Housing (DHET 2011c: xvi). For a future planning scenario of 7 000
headcount students by 2019, 5 600 beds will be required, which means that, after the
realisation of UL's two plans described above, there will still be a shortfall of 587
beds to be made up. For a future planning scenario of 10 000 headcount students by
2024, a shortfall of 2 400 beds will need to be made up. In making up these shortfalls
43
consideration should simultaneously be given to providing tailored housing for
graduate students as well as for mature students attending mid-career training
programmes (see, for example, Appendix U).
Furthermore, all future planning with regard to veterinary facilities and associated
programmes shall need to accommodate the fact that the veterinary academic hospital
has been largely demolished and taken over by other university functions. In
particular, it will be necessary to carefully consider the implications of this for the
clinical training needs of veterinary programmes (for more details of the proposed
veterinary clinical training platform, see below).
Lastly, investigations should be conducted as to the advisability of rebuilding,
partially rebuilding or demolishing the unstable single-storey buildings, and into the
merits of re-laying the main sewer pipes such that pumping from buildings can be
avoided (or opting, alternatively, to install dual pumps and maintaining them
regularly).
Assignable space
An analysis of Medunsa campus student FTE data (for 2011) indicated that the total
existing assignable space within buildings (including circulation, mechanical,
custodial and/or structural space) on the Medunsa campus exceeds the space
generated in accordance with DHET space norms by a substantial margin. 50 Moreover,
this excess space is not consistent when broken down by space category. As Figure 1
shows, there are noticeable excesses (of actual space over norm-generated space) in
respect of office space (space-use category 1300) and classroom space (1100) as well
as, though to a lesser extent, general-use space (1500-1700), some excesses in respect
of laboratory space (1200) and health care space (1800), and underprovision with
regard to study space (1400).
Figure 1: Current space shortfalls and surpluses (2011)
50
It must be noted that two buildings – the Dentistry South and Health Sciences South buildings – are
in fact built on hospital land and are not reported as university space (and hence are excluded from all
calculations here of the total existing assignable space within buildings on the Medunsa campus).
These buildings accommodate hospital functions although they are the site of clinical training in these
disciplines.
44
Note: Space-use category 1100: classroom space; 1200: laboratory space; 1300: office space; 1400:
study space; 1500-1700: general-use space; and 1800: health care facilities space.
Office space
There are two primary reasons for the excess in office space (or space-use category
1300). First, the number of staff that should be generating office space derived from
the student FTE count for 2011 is 468, based on the assumed ratios of FTE staff to
FTE students for a given CESM (Classification of Educational Subject Matter).
However, Medunsa campus space records indicate that 868 staff are occupying office
space, while the number of staff generating office space as reflected by the
university’s staff list is 608. It follows that the appointment of professional staff by
the Departments of Health and by the University of Limpopo – i.e. staff in joint
appointment posts – together with the directive that they be accommodated in
university space is a partial cause of the excess in office space. The second reason for
the excess is that the size of individual offices together with the office service and
conference spaces exceeds the DHET norm for office space (i.e., office, office service,
conference and conference service) of 1 staff FTE to 15.0 ASM (Assignable Square
Metres).
Examples of some of the average allocations of office space in the larger buildings on
the Medunsa campus are as follows:
Clinical Pathology North
Clinical Pathology South
Skills Centre
Basic Medical Sciences North
Basic Medical Sciences South
Basic Sciences
Dentistry North
Health Science North
18.98 ASM
21.75 ASM
18.93 ASM
21.98 ASM
15.88 ASM
18.94 ASM
22.28 ASM
16.32 ASM
45
Figure 2 below indicates what can be achieved by modifying office space to a more
appropriate standard. The lower row, consisting in this example of four offices
occupied by a professor and three senior lecturers (thus accommodating a total of 4
staff), is the current situation; while the upper row shows how available office space
can be increased simply by subdividing overly large offices and housing more junior
staff in slightly smaller or shared offices (and hence accommodating a total of 6 staff).
Figure 2: Potential office space modifications
The net effect of the modification of office space in the above example is that for
every four existing office spaces, six offices can be created – a 50% increase in
capacity.
Classroom space
The excess in classroom space is attributable to the manner in which classrooms are
allocated for utilisation: of the 111 spaces on the Medunsa campus classified as
classrooms, 98 are in the academic hub (the campus' double row of large academic
buildings) and, of these, only 31 – less than a third – are centrally allocated to
programmes. Of these 31 classrooms, 4 are permanently assigned to departments or
programmes (eg. Pharmacy or the MBChB fifth year). The remaining 27 classrooms
are underutilised with regard to both frequency (the number of course allocations to a
particular venue per week expressed as a percentage of 55 (i.e. 11 periods per day
over 5 days per week) and occupancy (the average number of seats occupied in a
venue by classes allocated to the venue expressed as a percentage).
If a notional allocation of classes is made to bookable hub venues at a frequency of
about 75%, the picture that emerges is of a wide margin between classes to be booked
and venues available, except at the 220- to 250-seater range. The graph below (Figure
3) shows the occupancy expressed as a percentage of each venue and the occupancy
equal to or greater than 75% in the 250 and 320-seat classrooms.
46
Figure 3: Model of classroom occupancy
While it is accepted that smaller venues within departments, of a capacity of up to 30
seats, might be held and booked out by a single department (eg. for staff and
postgraduate seminars), it is not acceptable that venues of a capacity of over 100 (of
which there are two), or over 200 (of which there is one), are not centrally allocated.
Inevitably, venues allocated to a department will not be efficiently used or meet the
conventional norm of 75% frequency and 75% average occupancy.
Laboratory space
An analysis of the utilisation of undergraduate Science laboratories (assuming two
sessions per day for five days) revealed that the first-year Chemistry and Biology
laboratories are at or near capacity, but that the second- and third-year laboratories
have spare capacity (see Table 15 below).
Table 15: Utilisation of key undergraduate Science laboratories
Laboratory
Stations
Stations/sessions Programmes
Chemistry I lab
100
1 000 BSc
B Cur
BSc (Physio)
BSc (Diet)
MBChB
Chemistry II & III
80
800 BSc
Biology I
96
960 BSc
BSc (Physio)
BSc (Diet)
BBChB
BDS
BDT
Total enrolment
870
160
927
47
Biology II & III
Biophysics I
76
80
Biophysics II & III
64
BOH
760 BSc
800 B Cur
B OT
B Rad (Diag)
BSc (Physio)
MBCh
640 BSc
161
418
88
Similarly, an analysis of the utilisation of undergraduate Medical Science laboratories
(assuming a grouping of six students around a single cadaver) showed that there is
substantial over-provision of space in these laboratories (see Table 16 below).
Table 16: Utilisation of undergraduate Medical Science laboratories
Laboratory
Stations
Stations/sessions Programmes
Gross Anatomy I
24 (tables)
1 440 B Cur
BSc (Physio)
BSc (Diet)
B OT
B Rad (Diag)
MBChB
BDT
BOH
BSLP
Gross Anatomy II
24 (tables)
1 440 MBChB
Total enrolment
261
257
Study space
While office, classroom and laboratory spaces are in many respects under-utilised,
there is a substantial shortfall in study space (in the order of 1 956 ASM). For the
purposes of this report, 'study space' is not limited to space under the control of the
University Librarian but rather refers to all space provided for students from a range
of disciplines in an unprogrammed learning environment (including, for example, an
open access computer lab open to all students).
Health care facilities space
At the same time there is an apparent overprovision of health care facilities (i.e.,
space-use category 1800). DHET space norms make provision for student health
facilities such as a nurse's station, an observation room and consultation rooms, and in
terms of student FTE data all these amount to only 56 ASM; however, the Student
Health Service is currently assigned 135 ASM. Of the total area within this space-use
category (1 685 ASM), the balance (1 550 ASM) consists of spaces in university
buildings which serve hospital functions (such as the NHLS) or where patients are
examined or treated. The objective should rather be to limit space use in university
buildings to student health services.
In summary, a more appropriate distribution of assignable space within existing
buildings on the Medunsa campus would involve reducing and/or better utilising the
48
excess space accorded to offices, classrooms, laboratories and health care facilities,
and increasing the space available for student study.
Assignable space: needs and projections
The conventional method of establishing projected space needs is to follow DHET
norms. On the basis of these norms, which are derived entirely from student FTE
projections, calculations were made using the proposed expanded PQM and the
enrolment plans to 2019 and 2024 with target student headcounts of 7 000 and 10 000,
respectively, being the first and second planning horizons for this report (see
Appendix X).
The calculations were made at the level of programmes whereby a first-time entering
cohort in each programme, as established from current and projected intentions, was
projected to a full headcount using notional success rates. This total headcount was
then converted to an FTE count based on data from previous years or from other
universities when it was a new course on offer. This FTE count per programme was
then spread into the various levels and CESM groups based on data from previous
years or from other universities. Finally, the data was assembled into the matrix of
levels and CESM categories that feeds into the space generation model of DHET
space norms.
On the basis of these calculations, the projected shortfalls and surpluses in 2019 are as
indicated in Figure 4 below.
Figure 4: Projected space shortfalls and surpluses after proposed expansion in
enrolments (2019)
Figure 4 shows that, taking into account the proposed expansion in programmes and
enrolments (see Appendix X) by 2019, it is possible to achieve a situation in which
49
the generated space exceeds the existing space in respect of laboratory space (1200),
study space (1400) and general-use space (1500-1700).
Over and above these projected space needs premised on the proposed increase in
student numbers to 7 000 by 2019, there is a strong case to be made for the complete
reorganisation and/or relocation of academic and administrative departments,
including the construction of a number of new buildings, extensions to existing
buildings, and provision of other facilities, not least in order to accommodate the
planned expansion or addition of programmes in areas such as basic sciences, medical
technology, information technology and veterinary science.
In the first place, and notwithstanding the slight overprovision of classroom space
(see Figure 4 above) in terms of student FTE projections, the increase in enrolments
will increase average class sizes and thus put pressure on available large venues.
Accordingly, there is a need to:
•
•
•
•
Increase the number of large venues by adding two classrooms in the 250- to
300-seater range (thus supplementing the three existing venues which can
accommodate over 100 students);
Alter the profile of existing flat-floor classrooms on the lower levels of
buildings by increasing their capacity to form group-learning venues of
approximately 100-seat capacity;
Take all existing classrooms that are not in the central academic hub of the
campus out of commission; and
Institute a regime of centrally allocating all classrooms with a capacity of
more than 30 seats.
Second, all academic functions that are currently spread across the Medunsa campus
should ideally be accommodated in the central hub of academic buildings. These
include the Department of Languages (currently located in the old security buildings
near the main entrance gate), the Department of Psychology (in a security building at
the west gate) and the Departments of Public Health and Mathematics and Statistics
(in temporary accommodation on the north side of the campus). Between them these
departments generate about 570 ASM of space, and their relocation needs to be
prioritised, taking into account proposed space-use changes in existing buildings and
the development of new space.
Third, a new administration building needs to be constructed. Not only do the campus'
managerial and administrative staff and functions currently occupy valuable academic
space in a highly serviced building, namely, the fifth level of the Clinical Pathology
building, but being in this location means that senior management lack visibility and
administrative facilities are remote from visitors, suppliers, contractors and potential
staff arriving at the campus. A new, purpose-built building located near the entrance
to the campus will simultaneously promote access and visibility and be slightly
removed from the major campus concourse. The relocation of campus administration
will also ease the pressure from new and expanded programmes for academic space,
by releasing 2 753 ASM in the Clinical Pathology building; of this space, 1 597 ASM
can be reassigned to academic purposes (small classrooms, postgraduate workrooms
and laboratory space in the south wing) and 1 156 ASM allocated to academic staff
50
offices in the north wing, following the established pattern of space distribution in the
building.
Furthermore, the new administration building would be able to provide
accommodation for the following university entities:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Office of the Vice-Chancellor.
Senate Room.
Institutional Planning Unit.
Development Office.
Research Office.
Communications and Marketing.
Financial Administration (including Procurement).
Academic Staff Development.
Personnel Administration (including Recruitment).
Academic Administration (Directorate and Examinations Office).
Information and Communication Technologies.
Business Administration (including Campus Control).
Offices for official labour unions.
Archives.
The proposed location of the new administration building is shown in Appendix D,
and a detailed schedule of accommodation is indicated in Appendix P.
Fourth, and for similar reasons, there is also a need for a new student building to be
constructed. Student facilities and administration currently occupy potential academic
space in highly serviced buildings; student registration is located at a distance from
the main campus arrival point; there is a substantial shortfall in study space and social
learning space for students; and student merchandising is unnecessarily scattered
across various academic buildings. A new student building will also provide
accommodation for the following university entities:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Student Administration (Registration and Student Finance).
Student Affairs Directorate.
International Student Office.
Student Advice Office.
Student loan agencies.
Campus Health (including health promotion, psychological services and a student
disability unit).
SRC Offices.
Student clubs and societies (including lockers and workspace).
SRC, club and society meeting rooms.
Campus Radio.
E-learning studio.
Student food services.
Student lounge/social learning space (with WiFi).
Merchandising (Post Office, banks, tuck shop and book shop).
Staff lounge and dining room.
51
The proposed location of the new student building is shown in Appendix D, and a
detailed schedule of accommodation is indicated in Appendix Q.
Fifth, the current shortfall in laboratory space needs to be met by a new science and
technology building. This building will incorporate new large classrooms and
laboratories for teaching the 'dry' sciences – mathematics, statistics, computer science,
physics, electrical engineering and biomedical engineering. Office space will be
provided only for the staff in the departments using the laboratories in the building.
This move will release laboratory and office space in the existing basic sciences
building for the expansion of chemistry, biochemistry, botany, zoology and other 'wet'
disciplines, for which the laboratories will be converted.
The proposed location of the new science and technology building is shown in
Appendix D, and a detailed schedule of accommodation is indicated in Appendix R.
In all proposed alterations to new uses space-use optimization should be pursued
rigorously. Apart from the rationalisation of offices as outlined in the previous section,
the anatomy laboratories should be reconfigured and equipped to contemporary
standards, including a physiology laboratory as well as study space.
Sixth, most proposed veterinary science programmes will require the construction of
certain new facilities. However, these new programmes should be introduced
gradually and phased-in over time, and given that some purpose-designed veterinary
facilities already exist and are intact, the primary need will be for the refurbishment of
the existing production unit facilities. This will permit the animal health programmes
(viz. the Diploma in Animal Health, the Certificate in Animal Welfare and the
Bachelor of Animal Health), which are oriented largely towards production animals,
to commence immediately. In addition, the following facilities will need to be
constructed either as new structures or as conversions to existing accommodation:
•
•
•
•
•
•
Two indoor demonstration and/or lecture facilities, one of which one needs to
accommodate 60 students and into which live animals can be brought as
needed;
A gross anatomy laboratory;
An anatomy (dissection) laboratory with microscopy facilities and museum;
A skills laboratory that allows students to practice procedures on models;
Group study spaces (which can also be used as meeting rooms); and
Offices for academic and support staff.
The proposed location of the new veterinary science building incorporating the new or
converted facilities listed above is shown in Appendix E, and a detailed schedule of
accommodation is indicated in Appendix S.
Seventh, while the planned new Level 3 Academic Hospital, which is to be funded by
the national Department of Health, will follow a separate planning track, it is
important to make mention of its salient features here. A Feasibility Study for the new
hospital is expected to be submitted to the National Treasury by June 2014; and if
funding is approved, the building should be complete by 2019. The multi-storey
hospital building with a footprint of about 16 500m2 is expected to be designed,
52
constructed and possibly managed as a public-private partnership. Although NHLS
functions will be provided with accommodation in the new hospital, there will be no
provision of offices for clinical staff on joint appointments. However, seminar rooms
in the new hospital will be available for the use of staff, registrars and senior MBChB
and other students.
Since clinicians must be in close proximity to the new hospital even while remaining
on university property, and it must be possible for patients undergoing surgery in, say,
the Dentistry building to be safely and easily moved to the new hospital and to the
remodelled (Dr George Mukhari) Level 2 hospital, four possible locations of the
academic hospital present themselves. A location south of and some distance from the
Dentistry and Health Care buildings (as originally envisaged and for which
earthworks have been done to reduce the building platform), with the clinicians
remaining in offices in the north wing of the Clinical Pathology building, will not
satisfy either of these criteria, even though the building site is clear and site
enablement has been done. Locating the new hospital immediately south of but
adjacent to the Dentistry and Health Care buildings will still mean that it will be some
distance from the Clinical Pathology offices; while locating it immediately south of,
adjacent to and connected to the Clinical Pathology building will satisfy both criteria
but require extensive demolition of existing hospital facilities, which is not acceptable.
The solution is therefore to locate the new academic hospital immediately south of the
Dentistry and Health Care buildings but extending it westwards and northwards close
to the boundary of the hospital site and at the same time erecting a new office block
for clinical staff (see Appendix D and also Appendix T) immediately north of the
hospital wing and connected to it at all levels. 51 In campus design terms, the new
building will help to frame the major pedestrian space in front of the library; it will
also incorporate the audio visual unit in its basement, thus placing it as close as
possible both to the hospital where most of its work is done and to the major lecture
theatres adjacent to the Clinical Pathology building. More importantly, both criteria
will be satisfied. The westward extension will require four existing hospital ward
blocks to be demolished, but such demolition will be in line with the planned
reduction in size of the Dr George Mukhari Hospital from 1 500 beds to 800 beds. In
addition, if a long view is taken of a campus expanding to 10 000 students, the office
space will be required.
The proposed locations of the new academic hospital building and of the new office
block for clinical staff are shown in Appendix D, and a detailed schedule of
accommodation for the latter is indicated in Appendix T.
It needs to be re-emphasised that all planning around the precise location of the new
academic hospital, and whether and where the proposed office block for clinical staff
will be located, is subject to and dependent on the outcome of negotiations between
the new university, the national Department of Health and the Gauteng Department of
Health; and these negotiations need to be taken forward and resolved at the earliest
convenience of the stakeholders concerned so as to ensure that the functioning of the
51
Alternatively, the new office block could be erected on the eastern end of the new hospital, on
university land; however, this would still leave the offices of clinicians remote from the pathology
departments and the university enterprise more generally.
53
new university and its incorporation of the Medunsa campus are not negatively
affected or unnecessarily delayed.
Eighth, the substantial shortfall in study space will be addressed, in the first instance,
by expanding the Library building vertically by one level. This proposed expansion
has already been tested by an architect and a structural engineer and found to be
feasible. Over and above this increase in library space, additional study spaces will be
made available in the proposed new and refurbished buildings. Furthermore, once
alternative accommodation for the audio visual unit is available in the new academic
hospital, the space it currently occupies should also be made available for student
study purposes. The new Library level will provide 1 465 ASM of additional space
and the vacated audio visual space a further 678 ASM.
Student e-learning and social learning spaces are planned in the new student building
(500 ASM) as well as in the new science and technology building (300 ASM).
Alterations to and the renewal of the lower levels of existing academic buildings will
provide additional space (such as 400 ASM in the basic medical sciences building) for
computer studios and social learning. However, after all these new spaces have been
provided and existing space converted there will still be a shortfall in study space of 1
200 ASM.
Finally, with a much larger number of students living on the campus the need for
recreational facilities becomes particularly important. During the first five years
recreation, which should take precedence over formal sports facilities (such as sports
halls), should include three additional soccer fields located close to the student
housing (both existing and new).
Table 17 below summarises the various construction and space management changes.
Table 17: Planned building alterations, extensions and constructions by spaceuse category
Space-use category
1100
Projected actual
Generated – 7 000 Headcount
Additions to Basic MS Bldg
Removed from L0 Basic Sciences Bldg
Altered L0 Basic Sciences Bldg
Altered space in Basic MS Bldg
Altered space L5 Clin Path N
NHLS to lab space Clin Path S
Altered space Dentistry N
Altered space Health Sciences N
Altered space Basic MS N
Office to lab space Clin Path L5
AVU moved out of Library
Additional floor to Library
New Student Bldg
1200
1300
8 378
6 383
21 775
20 637
18 885
10 964
396
988
270
773
400
316
372
1400
15-1700
6 844
8 044
12 632
13 520
133
89
440
762
400
765
135
81
81
1 195
149
62
63
1 195
1 597
149
62
63
1 597
65
507
1800
678
1 465
500
449
957
54
132
New Veterinary Science Bldg
New Administration Bldg
New Science and Technology Bldg
New Office Block
SHORTFALL(-)/SURPLUS
220
320
700
3 500
1 995
1 138
272
1 758
300
1 176
7 920
799
400
318
-1 200
-888
Notes: MS = Medical Sciences. AVU = Audio visual unit. Clin Path = Clinical Pathology. N = North. S
= South. L = Level. Space-use category 1100: classroom space; 1200: laboratory space; 1300: office
space; 1400: study space; 1500-1700: general-use space; and 1800: health care facilities space.
Once these building developments (including all alterations, extensions, constructions
and other space-use revisions) have been achieved, the following are the expected
space shortfalls and surpluses in the various space-use categories in 2019 (Figure 5).
Figure 5: Projected space shortfalls and surpluses after proposed building
development (2019)
Figure 5 shows that, by 2019, and taking into account both the proposed expansion in
programmes and enrolments and the reorganisation of and additions to assignable
space, generated space now exceeds the existing or actual space in respect of study
space (1400) and general-use space (1500-1700), the use of classroom space (1100),
health care facilities space (1800) and especially laboratory space (1200) is much
more consistent with DHET norms, and there is in fact a healthy excess of actual
office space (1300) in relation to generated space.
Nevertheless, projected continued increases in student enrolments up to 2024, the
second planning horizon, will require further provision of space. Generated space
needs on the basis of a planned 10 000 student headcount in 2024 translates into 7 892
55
44
FTEs and 84 994 ASM, which is 16 348 ASM more than the space after development
for the 2019 scenario (see Table 18).
Table 18: Projected space shortfalls and surpluses in 2024
Space-use category
1100
Actual (all 1st 5-yr projects complete)
Generated
SHORTFALL(-)/SURPLUS
1200
1300
1400
8 378
9 015
21 775
29 495
18 885
15 682
6 844
11 443
15-1700
12 632
19 232
133
126
-637
-7 720
3 203
-4 599
-6 600
6
It follows that additional facilities in the form of classrooms (1100), laboratories
(1200) and study space (1400) will be required. Additional student housing will also
be needed (as mentioned in the previous section, a 10 000 student headcount will
result in a shortfall of 2 400 beds). During a second phase of infrastructural
development, these needs could be addressed through the construction of: two large
laboratory-dominated academic buildings with considerable areas set aside for study
(as indicated in Appendix D); four new residences (along the lines proposed in
Appendix U); as well as new indoor sports facilities to correct the imbalance in the
provision of this category of space (1500-1700).
Appendix M indicates the proposed sequence of implementation of all building
development projects on the campus as well as the construction of the new academic
hospital. It assumes that the National Treasury will approve the funding of the capital
works, in whole or in part, by November 2014, so as to allow for the appointment of
professionals and the commencement of briefing and design.
Appendix N indicates the projected development costs for the first five-year phase,
2014-2019.
Ideally, different design teams ought to be appointed for the various large projects
(with the exception of the six small CTP student housing projects which would ideally
be designed and built by the same team). It must be noted that the appointments and
briefings for the large projects cannot practically be done simultaneously, and the
same applies to launching the building projects and to the process of completing,
furnishing and equipping and handing over to client departments.
Clinical training platform
Almost all health science programmes require undergraduate students to spend time
practicing their clinical skills and gathering experience under supervision in approved
professional settings. The clinical training platform which currently supports
programmes offered on the Medunsa campus of the University of Limpopo includes,
in the main, the nearby Dr George Mukhari Hospital, as well as health facilities in the
Polokwane area close to the university's Turfloop campus.
The expansion of programmes and increased enrolments on the Medunsa campus in
the context of its incorporation into the new health and allied sciences university
means that additional places and facilities will need to be found for the clinical
training of the new institution's students, while at the same time the establishment of a
56
1800
new School of Medicine in Polokwane under the auspices of the University of
Limpopo means that the clinical training facilities in this area will no longer be
available to such students. This general rethinking and reorientation of the clinical
training platform for the new university must also take account of the fact that the
proposed veterinary science programmes will require their own specific range of sites
and facilities where students can gain practical experience, either on- or off-campus or
both.
South Africa's specific health care context, and the need to train health professionals
who can not only serve the health care needs of diverse communities but who are
themselves trained in the same kinds of localities from which they originate and
where they may end up working as part of the country's re-engineered primary health
care system, also requires that the experiential clinical training of students be
community-based and service-oriented as well as particularly attentive to the needs of
rural populations. Important innovations at other medical schools and health faculties
in South Africa also suggest a shift from more hospital-centred clinical training
approaches to more community focused approaches which are nevertheless evidencebased, technologically-informed and research-driven (for just one example, see
Appendix I).
A more rural and community focus requires, however, that attention be given to
accommodation for students and supervisory staff, and to transport and travel
arrangements. In addition, students will need to be placed where they can best learn
and practice requisite skills, and hence especially at Level 1 and Level 2 hospitals
rather than mainly at Level 3 academic hospitals. Account must also be taken of the
clinical training needs and footprints of other nearby universities, including
possibilities for cooperation and collaboration and the avoidance or reduction of
competition.
Not least, the finalisation of the envisaged clinical training platform must be
integrated with the ongoing planning and construction of new health facilities by the
national and provincial Departments of Health. Joint Implementation Committees
(with representatives from the DoH, DHET, National Treasury, the universities and
the Development Bank of Southern Africa) and Transaction Advisors are currently
busy with feasibility studies of the clinical, financial, technical, legal and academic
aspects of refurbishing the Dr George Mukhari Hospital (which refurbishment is
dependent on the construction of the new Soshanguve hospital, near to the Medunsa
campus, by the Gauteng Department of Health) and building the new Polokwane
academic health complex. Planning is well advanced and all feasibility studies are
expected to be completed before the middle of 2014.
Given these premises, it is proposed that:
•
the new university's clinical training platform should largely be confined to
hospitals, community health centres and clinics north and west of the Medunsa
campus, and hence to the Bojanala District of North West Province and
Regions 1 and 2 of the Tshwane metropolitan area in Gauteng Province (see
Appendix G), to which the new university ought to have preferential access
for clinical training purposes;
57
•
•
•
•
a substantial proportion of students' time, especially clinical training time,
ought to be spent in facilities other than the planned new Level 3 Academic
Hospital or its equivalents, and at least 10% of students' time should be spent
in rural facilities;
all clinical training facilities located further than a half-hour's travel time from
the university campus will need to provide accommodation, preferably on the
grounds of that facility, so that students can gain the full experience of health
care work at all hours;
all health care facilities that provide hospital beds, no matter how close to the
Medunsa campus, should provide some accommodation for students; and
the fleet of buses operated by the new university will need to be requisite to
the tasks above.
It is also proposed that, of three possible options with regard to the physical
relationship between the clinical training facilities and the hospital – students and
supervising academics working from consulting, treatment and seminar rooms and
offices adjoining the hospital, or from rooms and offices integrated into the hospital,
or being accorded no dedicated space – the most cost-effective option is the third (no
dedicated space) but, depending on the circumstances, the second option (integrated)
could also be acceptable (see Appendix K) .
Table 19 below lists the main components 52 of the new university's proposed future
clinical training platform. (See also Appendix G for an indication of the proposed
geographical extent of the clinical training footprint of the new university as well as
of UL's new medical school in Polokwane; and Appendix H for the geographical
locations of the regional and district hospitals listed below.)
Table 19: Proposed clinical training platform
District or
Patient
Health Care Facility
Level
sub-district
beds
North-West Province, Bojanala District:
Rustenburg
Job Shimankana Tabane Regional
2
290
Hospital
Tlhabane Community Health Centre
Bafokeng Community Health Centre
Boitekong Community Health Centre
Kgetleng
Swartruggens District Hospital
1
32
Koster District Hospital
50
Regional Training Centre
Madibeng
Brits District Hospital
1
215
Letlhabile Community Health Centre
Bapong Community Health Centre
Moses Kotane Moses Kotane District Hospital
1
167
Mabeeskraal Community Health Centre
Mogwase Community Health Centre
Gauteng Province, City of Tshwane Region 1:
Ga-Rankuwa Dr George Mukhari Regional Hospital
2
600 54
52
53
Student
beds
33 53
10
30
30
3
40
Clinics are not included here.
It is proposed that this number be increased to 100.
58
Soshanguve
Mabopane
Temba
Soshanguve Regional Hospital
2
Odi District Hospital
1
Gauteng Province, City of Tshwane Region 2:
Jubilee District Hospital
1/2
200 55
215
?
?
?
?
In terms of this proposed clinical training platform, which will need to be phased-in
over time, the Job Shimankana Tabane Hospital will act initially as a sub-campus
which provides accommodation to students and act as the base for academic staff
providing supervision to students sent to the surrounding Level 1 hospitals, such as
the Swartruggens District Hospital (Appendix J). Student accommodation at Job
Shimankana Tabane Hospital should be increased to a total of 100 beds, i.e., 67
additional rooms will need to be constructed (see, for example, Appendix W).
While each of the surrounding Level 1 hospitals currently has a number of student
beds, accommodation will need to be provided or constructed at the nearby
community health centres, for a few (perhaps three) students who are on after-hours
duty (see, for example, Appendix V).
Once completed (c. 2019), the new Soshanguve Level 2 hospital, which is within a
half-hour's driving distance from the main campus, will also be able to act as a subcampus, so long as planning includes the construction of approximately 30 beds for
students on after-hours duty.
Partnerships with regard to the clinical training of health science students will need to
be established between the national Department of Health, the Department of Higher
Education and Training, the relevant provincial Departments of Health and the public
higher education institutions within a province or region, based on a shared vision and
a coordinated strategy. As a recent strategy document points out, despite these
departments' and institutions' sometimes different and competing mandates, they have
a common national obligation to produce high quality health graduates, and hence
must standardise and regulate aspects such as clinical teaching and training, the
number of students to be trained, the capacity of each training facility, the placement
of new graduates and other human resource matters (NCGTT 2013: 23, 38).
In particular, close cooperation and joint planning is needed with the hospital
authorities in both the Gauteng and North West provinces to ensure that the balance of
clinicians to students is acceptable to the provincial health authorities and the HPCSA,
and that the various responsibilities and costs to be borne by either the university or
the hospital authorities are clearly understood and budgeted for. Such costs will
include any university contributions to the staffing costs of joint appointment
clinicians, student supervisory and administrative staffing costs, accommodation
operating costs, catering costs and transport costs.
Veterinary clinical training platform
54
The Dr George Mukhari Hospital, which currently consists of 1 500 beds and effectively functions as
a combined Level 1, 2 and 3 hospital, is expected by 2019 to have been refurbished and refocused as a
600-bed Level 2 facility, with some of its former functions taken over by the construction of a new
Level 3 academic hospital.
55
Assumed, once completed c.2019.
59
The compulsory clinical training aspects of veterinary programmes are usually
addressed in a veterinary academic hospital, 56 where students under supervision can
gain experience treating sick and injured animals of all major species. However, the
veterinary academic hospital that serviced veterinary programmes on the Medunsa
campus until 1999 (when these programmes were moved to the University of
Pretoria's nearby veterinary faculty at Onderstepoort) has been largely demolished.
To re-establish and equip a veterinary academic hospital and associated infrastructure
on the Medunsa campus would be, in the first place, a very costly enterprise, in
addition to the high operational costs of running a veterinary faculty: in 2009 the
University of Pretoria estimated that the cost of duplicating the existing Onderstepoort
Faculty of Veterinary Sciences would require R1.25 billion (in 2009 Rands) in the
year of commencement (UP 2009: 15).
In the second place, such a new veterinary academic hospital may end up competing
with Onderstepoort for the same clients (and particularly for companion animals), to
the detriment of both universities. At Onderstepoort, currently, sufficient numbers of
companion animals (such as dogs, cats and small exotic animals) to maintain student
caseloads are usually brought to the veterinary academic hospital; but a sufficient
caseload of production animals (both farm animals and game) is only achieved by
taking the students to these animals. 57
On the other hand, although a veterinary academic hospital no longer exists on the
Medunsa campus, some purpose-designed veterinary facilities – primarily the
veterinary production unit facilities – are still intact, and only require refurbishment.
Not only will this permit the immediate commencement of certain certificate, diploma
and degree programmes in animal health, but the possibility also exists of establishing
a comprehensive animal house – for both human health science, and human-animal
interface, research purposes – in the existing production unit facilities, on which basis
the training of laboratory animal technologists and perhaps veterinary technologists
could take place.
Furthermore, there is substantial student demand (not to mention national need) for
veterinary qualifications, even though the proximity of the new university to
Onderstepoort may negatively affect the availability of staffing and of clinical training
opportunities at both institutions. Indeed, proximity to Onderstepoort may in certain
respects be an advantage, allowing veterinary programmes at the new university to
easily draw on the experience and expertise of relevant University of Pretoria staff.
Nevertheless, such an advantage needs to be weighed up against other possible
advantages, such as those of locating a new veterinary faculty elsewhere in the
56
The facilities of a basic veterinary academic hospital normally include: a reception for outpatients;
consulting rooms; diagnosis area; procedure rooms; ultrasound; an x-ray suite; an operating theatre
suite with prep and recovery rooms; a pharmacy; seminar rooms for student groups; write-up spaces for
students; offices for management and academic staff; and service and storage spaces. If production
animals are also treated, then in addition such a hospital needs: stalls for animals; procedure rooms; an
operating theatre; an anaesthetising room for horses; and wash up rooms.
57
The limited availability of production animals is due in part to reduced stock farming – in turn the
result of increased urbanisation and industrialisation – in the immediate vicinity of Onderstepoort.
Farmers are also tending to treat their animals themselves, given the high costs of transport, and
competition from several private veterinary clinics further affects availability.
60
country (such as where a different climate, agriculture, animals and disease patterns
might allow alternative specialisations to those in northern Gauteng).
Given the costs of re-establishing a veterinary academic hospital (the primary purpose
of which is to provide a clinical training platform for veterinary programmes) on the
Medunsa campus, a number of alternatives present themselves:
1. Establishing a satellite hospital in a town in a cattle farming area at some distance
from the Medunsa campus, staffed by university academic staff with students
rotating in modules; or
2. Partnering with several selected existing veterinary practices, with an academic
staff member seconded to each practice and providing on-site teaching to students
who rotate through and gain experience of a mix of practice types (urban/rural and
production/companion animals); or
3. Requiring students to work in an approved veterinary practice of their choice under
the supervision of both a trained practitioner and a visiting academic staff member;
or
4. Utilising mobile clinics operating from the Medunsa campus.
The cost of establishing a satellite veterinary hospital is unlikely to be any less than
that of a veterinary hospital on campus (along with the capital, operating, logistical
and student accommodation costs attendant on the former) (Option 1). Similar
logistical and travel costs may be assumed with regard to mobile clinics (Option 4). It
appears, therefore, that a combination of Options 2 and 3 would offer the most costeffective solution for clinical training purposes.
Hence, in accordance with the Ministerial directive that veterinary sciences be
included in the programme offerings at the new university, but in awareness of the
lack of a veterinary academic hospital on the Medunsa campus, the following scenario
should be considered in order to address veterinary clinical training needs at the new
university:
• On the advice of the Department of Agriculture, Forestry and Fisheries (DAFF)
and the South African Veterinary Council (SAVC), identify, approve and select up
to 20 diverse remote veterinary practices (both urban and rural, with both
companion and production animals, and with at least one specialising in game
animals) (see Appendix L for the number of private veterinary practices in the
North West, Limpopo and Mpumalanga provinces and the greater Pretoria area);
• Make arrangements with these selected veterinary practices regarding student
clinical training placements, supervisory academic visits and supervisory training
of practitioners;
• On the advice of DAFF and SAVC, enter into negotiations with NWU, TUT, UP
and Unisa regarding the possible establishment of a shared rural satellite veterinary
teaching farm and clinic located amongst stock farms;
• Exploit the fact that basic science modules, which make up the early years of all
veterinary programmes, are already being offered on the Medunsa campus, and
that many necessary facilities – such as lecture theatres, laboratories, technologies
and the library – are already available and can be shared, at least in the initial
startup period;
61
• Take advantage of the fact that a comprehensive animal house can be established
in the existing production unit facilities, with opportunities for both human and
human-animal research and to underpin certain veterinary programmes;
• While taking cognisance of the need to avoid unnecessary competition with UP's
Onderstepoort facility (particularly in terms of staffing and clinical training), take
advantage of
o possible complementarities with Onderstepoort in the form of a focus
on undergraduate rather than postgraduate studies, and on production
and wild animals rather than companion animals;
o the new university's proximity to and potential collaboration with the
Onderstepoort Veterinary Institute (belonging to the Agricultural
Research Council) and Onderstepoort Biological Products (which
produces animal vaccines); and
o the opportunity to develop important and unique new foci, such as on
food security, food production, the human-animal interface, game
animals, disease detection and control, and research in the disciplines
of virology, molecular virology, epidemiology and immunology as
these relate to animals; and
• Investigate better programme articulation between all institutions offering
diplomas and degrees in animal health or veterinary technology and which require
SAVC registration as a veterinary technician or veterinary technologist, including
NWU, TUT, UP, Unisa and the new university.
The scenario above is premised on the assumption that veterinary science
programmes will be offered at the new university, and is thus aimed at addressing
these programmes' clinical training needs. It is also cognisant of the several
challenges that veterinary science programmes on the new university campus would
face (from their proximity to and possible competition with Onderstepoort in relation
to staffing and clinical training, to the expense of establishing and operating such
programmes, with or without building a new veterinary hospital).
However, and notwithstanding the scenario above, much more intensive discussion
and dialogue must take place nationally among all roleplayers in the veterinary field;
and further investigations must be undertaken as to the feasibility and costs of
establishing and operating a veterinary faculty at the new university, including
research into (a) exactly which categories of veterinary professionals are in short
supply, and to what extent, (b) whether and where new graduates in these fields can
be placed, absorbed or better distributed, (c) how and by which programmes and host
institutions the demand for veterinary training might be best addressed, and (d) in
which part or parts of the country such programmes, and indeed an entire new
veterinary faculty, along with the associated clinical training requirements, would be
best located.
62
8. Cost implications
The cost implications of the proposed infrastructural and other building developments
(including both new buildings and extensions, alterations and renewals of existing
buildings), intended to accommodate the planned expansion in programmes and
enrolments which are to make the new health and allied sciences university
academically and financially viable, are outlined below. These projected development
costs are for the first five-year phase, 2014-2019, only; the costs of accommodating
any projected continued increases in student enrolments up to 2024, the second
planning horizon, are not included here.
The feasibility study commissioned by the JTT, having identified the infrastructural,
space and clinical training platform needs of the new university and having scoped
and programmed these over time as shown in the Development Implementation Plan
(see Appendix M), calculated the costs as follows.
First, schedules of accommodation were developed for the proposed new buildings
and set out in the format prescribed by the DHET for Infrastructure and Efficiency
funding applications. This converted planned assignable square meters (ASMs) into
Standard Cost Units (SCUs) using the appropriate factors and then a Rand value for
the year of completion was applied to arrive at a replacement cost of each new
building including fees and VAT. (It must be noted that the Rand value of the SCU is
as provided by the DHET for the years 2013, 2014 and 2015, but beyond 2015 a
constant percentage increase was applied: see Appendix O).
However, experience over recent years has indicated that the SCU value does not
reflect the actual cost of building a contemporary academic building. The base value
was established some years ago before more recent requirements such as electricity
supply security (generators), water supply security (water storage tanks), personal
safety security (access control and CCTV), universal access (ramps and lifts for
wheelchairs) and sustainability (solar heat gain control). Accordingly, an additional
allowance of 15% was added to the project cost of all new buildings (with the
exception of residential buildings, where the SCU value makes adequate cost
provision for construction).
Second, the total project cost includes a further allowance for Land Improvements
Other Than Buildings (LIOTB) that is conventionally set as a 13% surcharge on the
replacement value of the building. This makes allowance for roads, parking areas,
pathways, external lighting and services to and from the buildings provided that none
of these are beyond a reasonable distance. In this case, however, while the buildings
are in close proximity to water ringmains and each other, the founding conditions are
poor and special provision must be made for excavations in the foundations. A 2%
surcharge was applied as recommended by the DHET.
Lastly, the cost of extensions and alterations to and renewal of space in existing
buildings was established by calculating the replacement cost of the space using the
above method and then applying a factor. In the case of the vertical extension of the
Library a 10% surcharge was applied due to the complications of building over
existing, occupied space. In the case of adaptations for new users a notional 50%
63
reduction was generally applied which is a low-risk view of the scope of works that
are unknown at this stage. In the case of alterations to office space this reduction was
increased to 66% due to the apparent simplicity of the conversion.
Table 20: Projected costs of new buildings and other construction, 2014-2019
ASM Year
Project description
Total building cost (Rand)
Diversion of entrance road
4 000 000
2
625.00
Administration Building
2017
94 470 389
1
726.00
Student Building
2017
60 327 980
4 998.00
Science and Technology Building
2017
244 425 843
1 491.00
Hospital Office Portion
2018
59 524 625
812.00
Veterinary Science Building
2016
35 243 946
8 168.00
Student Housing (590 beds)
2016
225 109 728
Sports fields (3)
2017
1 350 000
Notes: For more details, see Appendix N, of which this is an abridged section. ASM = Assignable
Square Metres. Year = expected year of completion.
Additional student housing will constitute almost half of all newly constructed oncampus assignable space. The most expensive new building, however, will be the
science and technology building, at almost a quarter of a billion Rand. The proposed
new veterinary science building may be considered to be comparatively cheap,
assuming that the construction of a veterinary hospital facility is not envisaged. 58
Table 21: Projected costs of new off-campus housing for clinical training
purposes, 2014-2019
Project description
ASM
Year Total building cost (Rand)
984.50
Job Shimankana Tabane Hospital
2015
23 651 145
68.50
Tlhabane CHC
2015
1 652 163
68.50
Bafokeng CHC
2015
1 652 163
68.50
Boitekong CHC
2015
1 652 163
68.50
Letlhabile CHC
2015
1 652 163
68.50
Mabeeskraal CHC
2015
1 652 163
68.50
Mogwase CHC
2015
1 652 163
Square Metres. Year = expected year of completion. CHC = Community Health Centre.
The provision of new housing for students and supervisors on clinical practice at
surrounding hospitals and community health centres (above all, at the Job
Shimankana Tabane Hospital, intended to act as a hub until such time as this function
can be supplemented or taken over by other facilities, such as the new Soshanguve
Level 2 hospital) is scheduled to be completed in 2015 and expected to cost (in total)
in the region of R33 million.
58
It is worth noting that the cost of a brand new veterinary hospital would constitute one of the largest,
if not the largest, single item of expenditure on the new university. In 2009, the University of Pretoria,
using DHET building and cost norms, estimated that the cost of duplicating the existing Onderstepoort
Faculty of Veterinary Sciences would require R1.25 billion (in 2009 Rands) in the year of
commencement. This figure was broken down into: ground, buildings and land improvements (R760
million); animal hospital equipment (R255 million); laboratory equipment (R50 million); and annual
operating expenditure (R185 million) (UP 2009: 15).
64
Table 22: Projected costs of extensions, alterations and renewals, 2014-2019
Project description
ASM
Year Total building cost (Rand)
1 465.00
Library (vertical extension)
2016
40 655 728
1 597.00
Clinical Pathology Bldg (ex Admin space)
2017
36 156 282
400.00
Medical Sciences Bldg (study space)
2017
5 692 375
773.00
Basic Science Bldg (lab space)
2018
19 744 739
762.00
Basic Science Bldg (study space)
2018
12 234 367
340.00
Basic Science Bldg (office space)
2017
2 903 111
1
195.00
Clinical Pathology Bldg (ex NHLS space)
2018
30 523 885
678.00
Library (ex audio-visual space)
2018
10 885 697
4 271.91
Veterinary Production Unit (all space)
2015
21 795 749
Square Metres. Bldg = Building. Year = expected year of completion.
In terms of extensions, alterations and renewals to existing buildings, such as the
Basic Science, Medical Sciences and Clinical Pathology buildings, where much space
will have been freed up due to the relocation of administrative functions and of space
formerly utilised by the NHLS, the most costly single development will be the
alterations and renewals to the Clinical Pathology building, followed by the vertical
extension of the Library. All together, extensions, alterations and renewals are
estimated to cost just over R180 million, with most scheduled to be completed in
2017 and 2018.
The total cost of all new buildings and extensions, alterations and renewals of existing
buildings for the first five-year phase, 2014-2019, is estimated at approximately R939
million (see Appendix N). While such an initial capital injection into the new health
and allied sciences university would be followed on an annual basis by university
funding, it will be essential for the new university to generate a significant amount of
third stream funding, in order to move as quickly as possible towards financial selfsufficiency.
Over and above this total building cost, foreseeable additional costs are likely to be
incurred in the process of ensuring that existing buildings and facilities continue to be
maintained and/or are repaired or refurbished to meet the new university's needs. This
will be particularly necessary with regard to the existing student residences and
current electricity, water and sewerage reticulation, as noted in the previous section.
It has not been possible to determine the exact cost of all such maintenance, repair or
refurbishment, in part because they each require further investigation not only as to
their costs but also their feasibility in relation to the other proposed infrastructural
developments (new buildings, extensions, alterations and renewals) for the first fiveyear phase. In addition, certain refurbishments may require high-level engagements
between national and provincial government departments, such as the refurbishment
of existing and/or installation of new electricity transformers (which may require
liaison with the provincial health authorities) and Eskom's electricity distribution and
capacity constraints (which may require engagement with the Department of Public
Enterprises as well as the Presidential Infrastructure Coordinating Commission and its
Strategic Infrastructure Plan 14). It can be estimated, however, that if the 7 student
65
residences (those that were not recently refurbished) were to be refurbished at the
same cost as the one that was recently refurbished (R14.1 million), the cost would be
in the region of R100 million.
In similar vein, the JTT was unable to obtain sufficient usable financial data in order
to determine the current operating costs of the Medunsa campus or to calculate the
likely future operational costs of the new university. Such operating costs, for UL as a
whole, for the Medunsa campus in particular, and for the new university once
established, need further and fuller investigation; and a financial audit or due
diligence should be a chief priority for the Joint Specialised Teams which, it is
proposed (see Appendix AA), will work out the actual details of the delinking and
incorporation process, under the oversight of the Interim Council of the new
university.
66
9. Guidelines for incorporating the Medunsa campus into the new university
The Department of Higher Education and Training's guidelines for mergers and
incorporations (DoE 2003) outline the main tasks and processes that must be taken
into account in incorporating the Medunsa subdivision into the newly established
health and allied sciences university.
It is important to emphasize that, in legal terms, the establishment of the new health
and allied sciences university will precede the incorporation of the Medunsa
subdivision, and consequently, all policies, procedures and structures on which the
new university is to be based, including its culture and ethos, should be pertinent and
uniquely relevant to it as a new institution, and should not draw in any large measure
on the culture and ethos of either the former Medical University of Southern Africa,
the former University of the North or the current University of Limpopo. This is to
ensure that the policies and culture of the past do not dominate or preempt the nature
of the new university but instead are reflexively absorbed (where deemed necessary
and desirable) by the new and inclusive institutional leadership and taken forward into
a brand new future.
Two main phases in the incorporation process can be distinguished: an interim phase
and a final phase.
Table 23: Phases of incorporation
Phase
Date
Interim phase
January/February
2014 to July/August
2014 (prolonged if
necessary to
January/February
2015)
Final phase
July/August 2014 to
January/February
2015
Description
Formal establishment of the new
university.
Appointment of an Interim Council
(followed by appointment of interim
management and preparatory work to
facilitate the incorporation of the Medunsa
campus).
Formal incorporation of the Medunsa
campus into the new university.
Dissolution of the Interim Council.
Council of the new university takes office
with full powers and responsibilities.
The interim phase will begin on the date on which the Minister formally promulgates
the new health and allied sciences university. The phase will be overseen by an
Interim Council appointed by the Minister for this task for a maximum initial period
of six months (which may be extended by one further six month period).
The Interim Council, appointed by the Minister from nominations received from the
incorporating institutions (but which may not include members of these institutions),
consists of a chairperson and four other members. The Interim Council must coopt
three members of the interim management (with no voting powers) appointed by the
Council for running the new institution's day-to-day activities (RSA 1997: Section 23
(7-11)).
67
The Interim Council has all the powers of a full council, aside from the right to make
an institutional statute and the right to delegate its own powers (DoE 2003: 29). The
primary responsibilities of the Interim Council will be to:
•
•
•
•
•
appoint the interim management for running the day-to-day activities of the
new institution;
constitute the various governance structures as contemplated by the Standard
Institutional Statute (RSA 2002);
ensure that a new Council is appointed;
facilitate the general operations of the new institution; and
initiate, take forward and, where possible, conclude any preparatory
investigations to facilitate the implementation process, such as:
o the preparation of a Memorandum of Agreement;
o the establishment of an incorporation office and the development
of an overall incorporation plan;
o determining an admission policy;
o determining fee and financial aid structures;
o determining processes to accommodate pipeline students;
o determining operational priorities and an institutional operating
plan;
o determining conditions of service for new employees;
o deciding on a disciplinary code and rules;
o determining, in consultation with the Senate, the language policy of
the new institution; and
o setting up audit, finance and human resources committees (DoE
2003: 7, 29, 32).
The interim management appointed by the Interim Council, in carrying out all
preparatory investigations intended to facilitate the incorporation, must undertake or
take forward:
•
an audit of all existing academic programmes, structures, staff, students,
facilities and space, as well as of quality assurance systems (DoE 2003: 37);
•
an audit of all student support systems and services, including student
governance structures, financial aid, student academic administration,
international office, accommodation, catering, discipline, health, special needs,
recreation, support and counselling, admissions and registration, calendar and
fees (DoE 2003: 44-7);
•
an audit of human resources, including staff distribution, levels of appointment,
qualifications, age, gender, race, terms of employment, conditions of service
and benefit structures (DoE 2003: 52-3);
•
an audit of the current financial situation of the incorporating institutions,
including their financial obligations, assets and risk profiles (i.e., a due
diligence study), and all current financial management and administrative
systems, policies and procedures (DoE 2003: 58-9);
68
•
the development of an institutional operating plan, and the introduction of a
uniform resource allocation and budget process (DoE 2003: 58-9);
•
an audit of the existing ICT landscape, from infrastructure, systems, hardware,
software, data migration and administrative systems, through teaching support
and desktop and laptop equipment, to services and licensing and procurement
contracts; and at the same time make provision for reporting on historical
information (i.e., for providing academic transcripts of students of the former
institution) (DoE 2003: 67-9); and
•
an audit of all library and information services, including management, human
resources, policies and procedures, client services, technical services,
collections, space, model (centralised or decentralised), information
technology, and budgets, costs and cost implications (DoE 2003: 74-82).
The Interim Council and, through it, the interim management, must pay close
attention to some of the complexities associated specifically with areas such as
academic and human resources planning. For instance, with regard to academic
planning, quality assurance and research, the Interim Council should appoint a Senate
committee backed up by a planning unit headed by a Director of Academic Planning,
normally reporting to a Deputy Vice Chancellor (Academic) (DoE 2003: 40). On the
basis of the data gathered in the audit, this committee must develop an academic plan
that makes clear what programmes will be offered, through what structures and at
what location. Each teaching and research unit should be given a specified period in
which to put forward its proposals in respect of existing programmes – which should
remain unchanged, which should change and how, and which should be phased out
and why (DoE 2003: 41).
It must be noted that the Medunsa campus, the institutional subdivision being
incorporated, must continue to offer all existing programmes under their existing rules
until the programmes and rules are amended or restructured by the new Council (RSA
2002: Section 62). Any new programmes, or programmes in areas not already
approved in terms of the existing Programme Qualification Mix, will need to be
approved by the DHET and accredited by the HEQC; moreover, should 50% or more
of an existing programme be reconfigured, it will need to be resubmitted to the HEQC
for accreditation (DoE 2003: 35, 41).
With regard to human resources, the Interim Council should establish a committee to
consider implications for employment and conditions of service for existing
employees, processes to be set in place to align staff complements with the
requirements of the new institution, the framework for industrial relations developed
on the basis of the existing agreements with trade unions and staff associations, and
any transitional arrangements needed for new employees (such as conditions of
service, or disciplinary rules) (DoE 2003: 49). It must be noted that
on the date of incorporation all rights and obligations of the incorporated campus
devolve upon the receiving institution. This means that on the date of incorporation
all staff of the incorporated campus are assured of employment as per their existing
contracts and that all staff will retain their existing conditions of service and
benefits, including their salaries …. [S]hould it be considered necessary for
69
operational reasons to re-align the staff complement on the incorporated campus,
all processes in relation to personnel restructuring must be within the parameters of
the Labour Relations Act (DoE 2003: 54).
Similar committees or specialised task teams should be established to coordinate
planning, on the basis of data gathered through the various audits, with regard to
student support systems and services, financial management and administration,
information and communication technology, and library and information services.
The final phase in the incorporation process begins from the moment the Interim
Council has completed its work and hands over full powers to the Council of the new
university, or within six months of the formal promulgation of the new university, or
on a date specified by the Minister for the incorporation of the Medunsa campus into
the new university, whichever comes first. On this date, the Interim Council is
dissolved and the new Council takes office with full powers and responsibilities as
specified in the Higher Education Act and the Standard Institutional Statute. The
primary task for the new, fully empowered Council is to appoint the senior
management as defined in the Standard Institutional Statute (DoE 2003: 32), namely,
the Principal, the Vice-Principal/s, the Registrar/s, the Deans of Faculties and the
administrative positions equivalent to the positions of the Deans of Faculties (RSA
2002: Section 48).
Throughout both phases of the incorporation process, the role of the Department of
Higher Education and Training will lie in the provision of financial and technical
support and guidance, and in monitoring the process at an institutional level.
Managing and implementing the incorporation will be the responsibility of the new
university (DoE 2003: 9). Only expenditure incurred by the new institution as a direct
and necessary consequence of its incorporation of the Medunsa campus, such as
expenditure incurred to ensure the financial viability of the new institution, will be
considered for financial support and/or reimbursement. Such financial support will be
contingent on the preparation and submission to the DHET, within 12 months of the
incorporation, of an institutional operating plan for the new entity, which details
academic and financial projections, operating and capital budgets, and the
assumptions on which line items of income and expenditure have been estimated. All
such direct costs, including any for expert assistance, the alignment of systems and
processes, extensions or alterations to property, deferred maintenance, application of
taxation legislation, and/or retrenchment or voluntary severance processes, must be
approved by the DHET (DoE 2003: 20-2).
Appendix Z contains a Draft Protocol for Engagement with respect to the
university, which seeks to provide a framework for effective communication,
interaction, planning, preparation, implementation and mutual support between all key
stakeholders during the transitional period in which the Medunsa campus is being
separated, de-linked and unbundled from the University of Limpopo and being joined,
linked and incorporated into the new health and allied sciences university, leading up
to the date of incorporation.
Appendix AA contains the Terms of Reference for the proposed Joint Specialised
Teams intended to facilitate the separation and incorporation process by, among other
70
things, conducting audits of all academic programmes, human resources, finances,
ICT and student and support structures pertaining to the Medunsa campus,
undertaking SWOT analyses, determining priorities, developing action plans and
making recommendations.
71
10. Conclusion and recommendations
In reflecting on the Ministers' vision of a new comprehensive health and allied
sciences university which is to incorporate the Medunsa campus of the University of
Limpopo, the JTT felt the need to locate this vision within the wider national,
international and local context. The first part of this conclusion sums up the main
findings of the JTT with regard to this wider context; on the basis of these findings,
the second part puts forward a number of recommendations.
Summary
The burden of disease in South Africa today, combined with the general shortage of
almost all kinds of health professionals, makes the development and expansion of
health education and training facilities, platforms and programmes essential. In
particular, more health professionals need to be trained, in more appropriate and
innovative ways, in order to realise government's district-, ward- and school-level
primary health care strategy and to help implement the National Health Insurance plan.
The new comprehensive health and allied sciences university incorporating the
Medunsa campus of the University of Limpopo must therefore closely align itself
with these national priorities by offering an extensive range of expanded and
diversified programmes, catering for the full gamut of health and allied health
professions, and at the same time identifying niche areas permitting it to differentiate
itself from other medical schools and faculties of health sciences around the country.
Taking into account the very similar health challenges being faced in most other parts
of the world, along with international research and the models of health science
education and training being developed in response to these challenges, the
programmes at the new university – undergraduate and postgraduate, technical,
professional and academic – must foster teamwork, community- and patientcenteredness, service learning, interdisciplinarity, and the use of evidence and
research.
South Africa's health science faculties and the range of programmes they offer are on
a par with health sciences universities around the world. The range of programmes on
the Medunsa campus of the University of Limpopo, in particular, is one of the most
extensive in the country. However, the establishment of the new health and allied
sciences university provides an opportunity to expand and extend this range even
further, and to consider offering additional programmes of the sort which are both
internationally prominent and locally relevant.
Nevertheless, the feasibility of thus increasing and extending the Programme
Qualification Mix of the new university must be carefully considered, particularly the
capacity of the Medunsa campus' currently available infrastructure, facilities, space
and clinical training platform, as well as its academic and support staff, equipment
and technology, to deliver these programmes and accommodate the increased student
enrolments they will entail. The new institution thus requires a concerted strategy
which coordinates all aspects of its enterprise, from students and staffing through
curricula, teaching, learning and research to infrastructure and funding.
72
Although the academic buildings on the Medunsa campus are mostly well-built and in
a fair condition, a number of infrastructural aspects – particularly student residences
and electricity, water and sewerage reticulation – are likely to require large-scale
funding, and at the same time various excesses and shortfalls of space need to be
addressed in order to accommodate the increased enrolments and expanded
programmes. This will require the construction of a number of new buildings,
extensions to existing buildings, and provision of other facilities such as
accommodation at the existing and planned hospitals, community health centres and
clinics to the north and west of the new university which will constitute its dedicated
clinical training platform. The success of many of these endeavours will require
effective partnerships between government departments (at both national and
provincial levels) and nearby higher education institutions.
Veterinary clinical training constitutes a special case, given the new university's
proximity to an existing veterinary hospital (at Onderstepoort). In order to avoid the
expense of duplicating such a hospital, the most cost-effective alternative would
appear to be to partner with selected and approved veterinary practices (both urban
and rural, with both companion and production animals, and with at least one
specialising in game animals) where students can be taught and supervised by
seconded or visiting academic staff and/or specifically trained practitioners. This
scenario, however, including the issue of whether veterinary sciences are best located
at the new university, needs further investigation, involving all roleplayers in the
veterinary field nationwide.
All in all, the new health and allied sciences university (including all new buildings
and extensions, alterations and renewals of existing buildings for the first five-year
phase, 2014-2019) is likely to require a minimum initial capital injection of almost R1
billion. However, additional costs are likely to be incurred in the process of ensuring
that existing buildings and facilities continue to be maintained and/or are repaired or
refurbished to meet the new university's needs.
Upon the formal promulgation of the new health and allied sciences university, an
Interim Council will appoint an interim management and undertake preparatory work
to facilitate the incorporation of the Medunsa campus. Once the Medunsa campus has
been officially and effectively incorporated into the new university, the Interim
Council will dissolve and the Council of the new university will take office with full
powers and responsibilities.
Recommendations
In the light of the above findings, the JTT is of the opinion that the new health and
allied sciences university, in order to both align itself with national and local priorities
in health professional education and training and become and remain economically
viable, must aim to:
•
design and introduce innovative, integrated, transdisciplinary and socially
accountable programmes which address the health needs of, and encourage
work in, marginalised and impoverished communities in South Africa;
73
•
•
•
•
•
•
expand, diversify and increase the number of programmes on offer, at all
levels, taking into account both local needs and international trends;
increase headcount student enrolments to at least 7 000 over the next five
years, paying particular attention to admitting suitable students from
communities with the greatest health care needs (broadly defined);
give especial emphasis to producing more mid-level workers, from clinical
associates, pharmacy and rehabilitation assistants and laboratory technicians
through to those specialising in the care of the aged and, in the context of
veterinary science, animal health technicians and laboratory animal
technologists;
immerse students in the communities they will be serving, to whom they must
be accountable, and amongst whom they will work to prevent disease and
promote health;
foster and strengthen research productivity and the culture of research; and
attract consistent and reliable funding, especially third-stream funding.
Accordingly, the JTT makes the following recommendations: 59
Recommendation 1:
The new health and allied sciences university incorporating the Medunsa campus
should continue to offer, and where possible expand, extend and diversify,
programmes in
public health, environmental health and basic sciences,
Recommendation 2:
The new university should also consider offering programmes in
Recommendation 3:
59
These recommendations are put forward for the consideration of the Minister of Higher Education
and Training and the Minister of Health. On the basis of the Ministers' final approval, rejection and/or
alteration of these recommendations, the Interim Council, interim management and staff of the new
university should consider the most optimal manner of implementing them, utilising clear and agreed
upon criteria and if necessary after further investigation.
74
In addition to the core health and allied science programmes listed above, the new
university should consider offering programmes in
research),
Recommendation 4:
In the medium to long term, the new university should, where resources allow and
demand exists, give consideration to developing and offering additional allied health
science programmes, including homeopathy, naturopathy, chiropractic, osteopathy,
somatology, acupuncture, Chinese medicine, herbal medicine and various other
traditional, complementary and alternative medicines.
Recommendation 5:
The Interim Council and interim management of the new health and allied sciences
university should, with the assistance of relevant academic staff and on the basis of
clear and agreed upon criteria, investigate various possible academic administrative
and organisational structures for the new university, including the most optimal
manner of housing both new and existing academic programmes and the most
effective form and organisation of Schools and/or Faculties.
Recommendation 6:
Wherever feasible, the new health and allied sciences university should seek to:
•
•
•
develop all programmes from the undergraduate level right through to
postgraduate and postdoctoral levels;
supplement all programmes with a range of Higher Certificates and Advanced
Certificates in corresponding fields and specialisations; and
complement all programmes with a range of Continuing Professional
Development programmes and short courses.
Recommendation 7:
Further investigations and discussions among all roleplayers in the veterinary field
need to take place as to the feasibility and costs of establishing and operating a
veterinary faculty at the new university, including research into (a) exactly which
categories of veterinary professionals are in short supply, and to what extent, (b)
whether and where new graduates in these fields can be placed, absorbed or better
distributed, (c) how and by which programmes and host institutions the demand for
veterinary training might be best addressed, and (d) in which part or parts of the
75
country such programmes, and indeed an entire new veterinary faculty, along with the
associated clinical training requirements, would be best located.
Recommendation 8:
If, after further investigation, the establishment of a veterinary faculty at the new
university should be considered feasible, veterinary science programmes should be
introduced gradually – with an initial focus on undergraduate programmes
(particularly the Diploma in Animal Health, the Certificate in Animal Welfare, the
Bachelor of Animal Health, the Bachelor of Veterinary Nursing and the Bachelor of
Veterinary Science) as well as the Postgraduate Diploma in Veterinary Health – and
close cooperation between UP's Onderstepoort veterinary faculty and the new
veterinary faculty will be essential in order to promote complementarities and avoid
unnecessary competition.
Recommendation 9:
Repairs to and/or renewal of existing infrastructure on the Medunsa campus will be
required in relation to:
•
•
•
•
•
•
•
•
•
the veterinary production unit complex (should a veterinary faculty be
established or, if not, to accommodate a comprehensive animal house);
electricity transformers;
the main water supply pressure reducing valve;
water ring mains;
air-conditioning plants;
lift controls;
a cut-off drain below the upper dam;
campus roads; and
the sewerage system.
Recommendation 10:
The following new buildings will be required:
•
•
•
•
•
•
an administration building;
a student building;
a science and technology building;
a veterinary science teaching building;
an office block for clinical staff; and
a 590-bed student residence.
In addition, the Library building should be expanded vertically by one level.
Recommendation 11:
Assignable space on the Medunsa campus must be (re)organised and utilised in such a
way as to be both consistent with DHET norms and fit for purpose, and all classrooms
containing more than 30 seats should be centrally allocated.
76
Recommendation 12:
Planning already in progress under the auspices of the University of Limpopo with
regard to two new on-campus residences (one in the form of a Public-Private
Partnership) needs to be prioritised and taken further, with the ultimate aim of housing
at least 80% of students on-campus.
Recommendation 13:
All infrastructural and clinical training matters (particularly those pertaining to the
construction of the new academic hospital, the new Polokwane academic health
complex, the new Soshanguve hospital, the refurbished Dr George Mukhari Hospital
and the proposed office block for clinical staff) must be finalised as soon as possible
in joint discussions between the new university, the national Department of Health,
the relevant provincial Departments of Health and, where necessary, regional public
higher education institutions.
Recommendation 14:
All feasibility studies related to the new university (including those pertaining to the
new academic hospital, the new Polokwane academic health complex, the new
Soshanguve hospital and the refurbished Dr George Mukhari Hospital, as well as the
feasibility study for the new university which was initiated by the JTT and informs
parts of this report) should be synchronised, aligned and completed in time (c. July
2014) to be available to be considered simultaneously by Treasury.
Recommendation 15:
The new university's clinical training platform should consist mainly of the hospitals
and community health centres of the Bojanala District of North West Province and
Regions 1 and 2 of the Tshwane metropolitan area in Gauteng Province, where
appropriate accommodation should be built for students.
Recommendation 16:
A substantial proportion of students' time, especially clinical training time, ought to
be spent in facilities other than the planned new Level 3 Academic Hospital or its
equivalents, and at least 10% of students' time should be spent in rural facilities.
Recommendation 17:
Careful consideration should be given to ensuring that an equitable distribution of
practical training and experiential opportunities is afforded to all health professional
students, whether those enrolled or to be enrolled at the new university or at the
various existing medical schools and health faculties in close proximity to it. In this
regard, an overall Human Resources strategy which takes into account the varying
staffing, student and training needs of all the nearby higher educational and health
facilities may need to be formulated.
77
Recommendation 18:
All existing claims upon or rights to the land occupied by the Medunsa campus and
ultimately by the new university must wherever possible be investigated and resolved
by the Interim Council of the new university.
Recommendation 19:
Research and research productivity at the new health and allied sciences university
should be improved by:
•
•
•
•
•
•
•
•
•
establishing research programmes in key areas of national need such as
clinical research and the development of datasets and prevalence studies of
infectious and non-communicable diseases, violence and injury, and maternal
and child mortality;
initiating new niche research programmes in areas such as rural-oriented
primary health care, indigenous medicines, spinal research and food security;
seeking funding and scholarships from national and international donors and
the pharmaceutical industry more broadly for programmes intended to develop
new high quality academic clinical researchers;
exploiting research opportunities arising out of work-integrated and service
learning clinical training practices;
fostering inter-departmental research collaboration;
building mid-level staff research capacity, including but not only at the
existing Clinical Research Unit (MeCRU);
building research leadership capacity;
attracting research funding and support from external bodies, such as that
pledged by the Medical Research Council and others, and generating
additional third stream income through research; and
generally promoting a culture of critical inquiry, hiring additional high quality
research staff, attracting additional postdoctoral students, increasing the
number of research publications and establishing research partnerships with
other institutions.
Recommendation 20:
The new university will require strong leadership, not only at the executive and
administrative levels but also at the Faculty and academic levels, supported by equally
strong leadership at the levels of district hospitals and provincial departments of
health. In keeping with both international trends and the national health policy
emphasis on improving leadership skills so as to improve health system performance,
leadership capacity should be developed through leadership seminars, personal
coaching and other professional development opportunities.
Recommendation 21:
In order to facilitate the establishment of the new university, with a distinct and
unique vision, mission, culture, ethos and academic model, a change management
strategy and process must be formulated and instituted.
78
Recommendation 22:
The process of establishing the new university and its incorporation of the Medunsa
campus of the University of Limpopo should be guided by the Department of Higher
Education and Training's Higher Education Restructuring and Transformation:
Guidelines for Mergers and Incorporations (DoE 2003) and Governance, Academic
and Administrative Guidelines for the Establishment of a New University (DHET
2013).
Recommendation 23:
The new health and allied sciences university will require a unique and preferential
funding allocation within the national higher education funding framework, including
earmarked funding and drawing upon the National Skills Fund.
Recommendation 24:
Transitional arrangements for the incorporation of the Medunsa campus into the new
health and allied sciences university should be governed by a Protocol for
Engagement between the Council of the University of Limpopo and the Interim
Council of the new health and allied sciences university, with the Department of
Higher Education and Training acting as facilitator.
Recommendation 25:
The separation of the Medunsa campus from the University of Limpopo and its
incorporation into the new health and allied sciences university should be facilitated
by the establishment of Joint Specialised Teams, involving members of both the
Turfloop and Medunsa campuses, tasked with conducting audits of all academic
programmes, human resources, finances, ICT and student and support structures
pertaining to the Medunsa campus, undertaking SWOT analyses, determining
priorities, developing action plans and making recommendations to be considered by
the Interim Council of the new university. All public submissions made to the JTT
should be referred to these Joint Specialised Teams for consideration.
Recommendation 26:
Given the multiple and wide-ranging academic, practical, financial and operational
implications of establishing the new health and allied sciences university
incorporating the Medunsa campus, and the many health and educational stakeholders
at the national, provincial and local levels who need to be involved or considered, the
Interim Council of the new university should, where it deems necessary, further
engage with internal and external stakeholders and other interested parties to ensure
that the best possible arrangements are in place for the successful operation of the new
institution, giving all due consideration to the optimal manner of implementing and/or
further investigating any or all of the recommendations above.
79
References
AAHC 2009 Creating the Knowledge Economy. Washington, DC: Association of
Academic Health Centers.
http://www.aahcdc.org/Portals/0/pdf/FG_AHC_Creating_the_Knowlege_Economy_0
4-09.pdf, accessed 27 February 2013.
Anderson, G., Steinberg, E. and Heyssel, R. 1994 The pivotal role of the academic
health centre. Health Affairs, Summer: 146-158.
http://acaho.org/docs_new/AHSCs/Reports/PivotalRoleofAHSCs.pdf, accessed 1
March 2013.
Bamford, L. 2013 Maternal, Newborn and Child Health, in Padarath, A. and English,
R. (eds) South African Health Review 2012/13. Durban: Health Systems Trust.
Breier, M. 2008 The shortage of medical doctors in South Africa. Research report
commissioned by the Department of Labour. March.
https://www.labour.gov.za/downloads/documents/researchdocuments/Medical%20Doctors_DoL_Report.pdf, accessed 1 March 2013.
CHE 2011a Audit Report on the University of Limpopo. July. Pretoria: Council on
Higher Education.
CHE 2011b Advice to the Minister of Higher Education and Training on the
Establishment of a new Public Higher Education Institution and the Incorporation of
the Medunsa Campus of the University of Limpopo into the new Public Higher
Education Institution. Pretoria: Council on Higher Education.
Chopra, M., Lawn, J., Sanders, D., Barron, P., Abdool Karim, S., Bradshaw, D.,
Jewkes, R., Abdool Karim, Q., Flisher, A., Mayosi, B., Tollman, S., Churchyard, G.
and Coovadia, H. 2009 Achieving the Health MDGs for South Africa: Challenges and
Priorities. The Lancet, 374: 1023-1031.
Working Group 2011 Report on Veterinary Science Programmes in South Africa:
Collaboration between Training Institutions. July. Pretoria: University of Pretoria,
North-West University, Tshwane University of Technology and University of South
Africa.
DHET 2011a The Task Team Review Report of the University of Limpopo Merger.
July. Pretoria: Department of Higher Education and Training.
DHET 2011b Joint Media Statement by Minister Nzimande, Minister Motsoaledi and
the University of Limpopo. Pretoria: Department of Higher Education and Training.
http://www.ul.ac.za/application/news_and_publications/Joint%20Media%20statement
%20by%20Ministers_%20Nzimande,%20Motsoaledi%20and%20the%20University
%20of%20Limpopo.pdf, accessed 20 February 2013.
80
DHET 2011c Report of the Ministerial Committee for the Review of the Provision of
Student Housing at South African Universities. Pretoria: Department of Higher
Education and Training.
DHET 2013 Governance, Academic and Administrative Guidelines for the
Establishment of a New University. Pretoria: Department of Higher Education and
Training.
DoE 2000 Speech by the Minister of Education at the Launch of the New National
Faculty of Veterinary Science at the University Of Pretoria, 10 March. Pretoria:
Department of Education.
DoE 2002 The Restructuring of the Higher Education System in South Africa. Report
of the National Working Group. January. Pretoria: Department of Education.
DoE 2003 Higher Education Restructuring and Transformation: Guidelines for
Mergers and Incorporations. April. Pretoria: Department of Education.
DoH 2010 Strategic Plan 2010/11-2012/13. Pretoria: Department of Health.
DoH 2011 Human Resources for the Health Sector: HRH Strategy for the Health
Sector: 2012/13-2016/17. October. Pretoria: Department of Health.
DoH 2012 2011 National Health Research Summit Report. April. Pretoria:
Department of Health.
English, R. and Padarath, A. 2013 Editorial, in Padarath, A. and English, R. (eds)
South African Health Review 2012/13. Durban: Health Systems Trust.
FHS 2013 Proposal: Faculty of Health Sciences Expanded Training Platform.
February. Faculty of Health Sciences, University of Limpopo.
Frenk, J., Chen, L., Bhutta, Z., Cohen, J., Crisp, N., Evans, T., Fineberg, H., Garcia,
P., Horton, R., Yang, K., Kelley, P., Kistnasamy, B., Meleis, A., Naylor, D., PablosMendez, A., Reddy, S., Scrimshaw, S., Sepulveda, J., Serwadda, D. and Zurayk, H.
2010 Health Professionals for a New Century: Transforming Education to Strengthen
Health Systems in an Interdependent World. Originally published in The Lancet, 376:
1923-58. See http://healthprofessionals21.org/images/healthprofnewcentreport.pdf,
accessed 3 April 2013.
Kaaya, E., Macfarlane, S., Mkony, C., Lyamuya, E., Loeser, H., Freeman, P.,
Kirumira, E., Pallangyo, K. and Debas, H. 2012 Educating Enough Competent Health
Professionals: Advancing Educational Innovation at Muhimbili University of Health
and Allied Sciences, Tanzania. PLoS Medicine, 9, 8: 1-5.
LUHS 2012 Self-Evaluation Report. June. Kaunas: Lithuanian University of Health
Sciences. http://www.eaeve.org/fileadmin/downloads/SER/Kaunas_SER_2012.pdf,
81
Matsoso, M. and Fryatt, R. 2013 National Health Insurance: The First 18 Months, in
Padarath, A. and English, R. (eds) South African Health Review 2012/13. Durban:
Health Systems Trust.
Mkony, C. 2012 Emergence of a university of health sciences: Health professions
education in Tanzania. Journal of Public Health Policy, 33, S45-S63.
http://www.palgrave-journals.com/jphp/journal/v33/n1s/full/jphp201251a.html,
NCGTT 2013 Governance of critical matters related to Tertiary Health Service
Delivery and training of the Professional Human Resources required to deliver these
services. Draft document. August. Pretoria: National Conditional Grants Task Team,
Department of Health.
NPC 2011 National Development Plan: Vision for 2030. November. Pretoria:
National Planning Commission.
RSA 1997 Higher Education Act, No. 101 of 1997. Pretoria: Government Printers.
RSA 2002 Standard Institutional Statute. Government Gazette No. 23065, 27 March.
Pretoria: Government Printers.
Senkubuge, F. and Mayosi, B. 2013 The State of the National Health Research
System in South Africa, in Padarath, A. and English, R. (eds) South African Health
Review 2012/13. Durban: Health Systems Trust.
StatsSA 2010 Millennium Development Goals Country Report 2010. Pretoria:
Statistics South Africa.
UL 2010a 2010 Registration and Student Biographical Information. April. University
of Limpopo.
UL 2010b Student Performance Information, Vol.1: Faculty of Health Sciences.
August. University of Limpopo.
UL 2012 Medunsa Student FTEs 2007-2011. March. Data supplied by the University
of Limpopo.
UP 2009 Strategic Positioning of the Faculty of Veterinary Science of the University
of Pretoria. August. Pretoria: University of Pretoria.
Vagelos, R. et al 2002 The Report of the New Jersey Commission on Health Science,
Education, and Training. Trenton, NJ: Commission on Health Science, Education,
and Training. www.state.nj.us/health/hset/hset.pdf, accessed 26 February 2013.
WHO 2008 Scaling Up, Saving Lives: Task Force for Scaling Up Education and
Training for Health Workers. Geneva: World Health Organization and Global Health
Workforce Alliance.
82
Appendix A
UNBUNDLING OF THE UNIVERSITY OF LIMPOPO
TERMS OF REFERENCE FOR THE JOINT TECHNICAL TEAM
The Joint Technical Team, hereby referred to as the JTT, is a high level task team that
is established to advise the Minister on the “unbundling” process of the University of
Limpopo. This process will entail the separation of the Medunsa Campus from the
Turfloop campus of the University of Limpopo. It also has to consider the
establishment of a new stand-alone University that will incorporate the Medunsa
campus.
This JTT is accountable to the Minister of Higher Education and Training with a
dedicated communication line to the Minister of Health which is important to ensure
coherent planning towards the “unbundling” process.
The Joint Technical Team must provide to the Minister of Higher Education and
Training a report within 60 days of establishment.
1. The Joint Technical Team needs to advise the Minister on:
a) The legal requirements and sequence of processes for the “unbundling” of the
University of Limpopo, the establishment of a new university, and the
incorporation of the Medunsa campus into the competency of this new
university.
b) The team should consider the Advice of the Council on Higher Education
especially in relation to quality arrangements for the offering of academic
programmes. It should be noted that the Minister of Health was strongly
opposed to the recommendation of the CHE with regard to the new Medunsa
83
to be initially established as a university college, attached to another university
(probably Wits or a renowned university). The Minister of Higher Education
and Training concurred with this statement. Therefore the advice should also
be considered in terms of alternative proposals.
c) The processes that are identified should lead to the gazetting of the new stand
alone autonomous university incorporating Medunsa as soon as possible,
taking the quality and governance concerns into account.
d) Transitional arrangements need to be fixed with regard to governance,
management and the academic project that will facilitate a process towards the
establishment of a fully functional university into which the Medunsa campus
will be incorporated that will enable the delivery of quality programmes
within the shortest possible timeframe.
e) The transitional arrangements should focus on:
i.
Whether or not an interim structure should be developed and if so the
criteria relevant to enable the transition of the campus into a fully fledged
university.
ii.
The applicability of the Standard Institutional Statute (SIS) which
functions as per Section 33 (3) of the Higher Education Act 101 of 1997
to facilitate the governance of this new entity. The SIS provides a
framework for an interim council and governance of the institution,
including the transitional arrangements for academic programmes and
awarding of qualifications.
iii.
The announcement of an Interim Council and identified relevant expertise
for such an interim council.
iv.
The nomination of an appropriate “campus manager/ administrator/ ProVice Chancellor”.
f) Proper governance and management processes and transitional arrangements
to address aspects such as:
i.
Admission policies and student fees;
84
ii.
Rules and regulations of the new University;
iii.
Human resource policies and procedures of appointment;
iv.
Communication strategies;
v.
Financial governance and management systems;
vi.
ICT strategy;
vii.
Academic project;
viii.
Programme and Qualification Mix (PQM); and
ix.
Student life and support.
g) The required consultation processes with the University of Limpopo (UL)
Council and Management, representatives from the Medunsa Campus, the
National Department of Health, Gauteng Department of Health and DHET.
h) A radical and comprehensive turn-around strategy that has to be supported by
a unique and preferential funding allocation that involves improved quality,
strengthening of management and governance processes and procedures, and
in the long term, growth in enrolments and Human Resources capacity,
disciplines and a suite of broadened health related academic programmes at
undergraduate level as well as opportunities for continuous professional
development as either formal offerings or as short learning programmes.
i) A comprehensive cost implication for the formation of a new medical
institution as a stand-alone university offering health care related programmes
as its core operation, but broaden the focus of the institution towards other
primary and secondary health care programmes at undergraduate level as well
as offering continuous professional development programmes that will ensure
the financial viability of the institution. The involvement and commitment of
the HPCSA is pivotal.
85
j) Guidelines to follow towards the operational requirements needed that will
ensure the stability of the Academic project and quality of delivery on both
campuses.
k) The applicability of drafting a Memorandum of Agreement (MOA) between
the DHET, the UL (Polokwane Campus) and the Medunsa Campus setting out
the rules of engagement and institutional transitional arrangements during the
interim phase. The purpose of the MOA is to facilitate co-operation between
the two campuses in the period prior to the date of the unbundling and, in
particular, to ensure that operational decisions in this period do not adversely
impact on the operational and organisational integrity of Medunsa Campus (as
part of the new envisaged institution). The issues to be covered by such an
agreement would include, amongst others, full disclosure of information,
personnel appointments in relation to vacant posts, renewal of service
contracts, transparency, inclusion and participation of all stakeholders,
effective communication and the utilisation of existing training platforms. The
involvement of the National Department of Health and possibly the Gauteng
Department of Health under which the George Mukhari Hospital currently
falls should be considered with regard to the utilisation of existing training
platforms.
2. Membership of the high level Technical Team:
a) Due to the level of expertise required, it is recommended that individuals from
the Department of Higher Education and Training and the Department of
Health, and external specialists, be appointed to serve as members of the high
level Joint Technical Team.
b) It is recommended that the membership of the Joint Technical Team should
include:
i.
An independent health expert appointed as a project manager of this
process.
ii.
A representative nominated by the HPCSA.
iii.
A Dean of Health Science.
86
iv.
An academic leader who has managed a university with some
knowledge or expertise in health.
v.
DHET representatives at Chief Director level from University
Academic Planning and Management support as well as Financial
Planning and Information Systems.
vi.
Two nominated high level officials from the Department of Health
nominated by the Minister of Health.
vii.
In the event that other expertise such as specialists for Academic
Administration, Legal, Academic Enterprise or Human Resources is
required, such services may be co-opted.
viii.
The JTT meetings will be chaired by the DHET Acting Deputy
Director General, University Branch.
c) A secretariat from the DHET will provide support to the Joint Technical
Team.
87
Appendix B: Members of the Joint Technical Team
Dr D Parker (Chair)
DHET
Dr E van Staden (Deputy Chair)
DHET
Ms B Swart
DHET
Dr B Kistnasamy (Project leader)
DoH
Dr T Carter
DoH
Dr T Fisher
DoH
Prof M Jacobs
UCT
Prof M Lukhele
SAMA
Dr E Madela-Mntla
ICSU
Prof K Mfenyana
HPCSA
Dr E Mhlanga
DoH
Dr A Ngoepe
UL
Prof A Wadee
Wits
88
Appendix C: Site plan of the Medunsa campus
89
Appendix D: Detailed site plan of the academic core buildings on the Medunsa
campus
Appendix E: Detailed site plan of the veterinary production unit on the Medunsa
campus
90
Appendix F: Location of South Africa's nine medical schools (including the
University of Limpopo's planned Polokwane academic health complex)
Medunsa
University of the Free State
University of KwaZulu-Natal
Walter Sisulu University
University of Cape Town
University of Stellenbosch
Appendix G: Proposed extent of clinical training platforms for the new university
incorporating the Medunsa campus and for the University of Limpopo's planned
Polokwane academic health complex
MEDUNSA
Medunsa
91
Appendix H: Proposed clinical training platform: location of regional and
district hospitals
Moses Kotane
District Hospital
+- 120 km
Odi District Hospital,
Mabopane
19km
Jubilee District
Hospital, Temba
63km
Swartruggens District
Hospital
148 km
BOJANELA DISTRICT
Dr George Mukhari
Academic Hospital
Koster District
Hospital
128 km
Job Shimamkane Thabani
Regional Hospital
84 km
New Soshanguve
Regional Hospital
+- 25km
One hour’s driving
distance from Medunsa
New Brits Hospital
23km
Appendix I: Example of a rural and community based clinical training model:
Ukwanda
Note: The Ukwanda Rural Clinical School of the Faculty of Medicine and Health Sciences,
Stellenbosch University, is located in Worcester, which is also the location of a regional/Level 2
hospital, while district/Level 1 hospitals are located in Ceres, Robertson, Swellendam and Caledon.
92
Appendix J: Proposed clinical training platform: phased growth
CLINIC
CLINIC
Borolelo Clinic
Swartruggens
Level 1 Hospital
DISTRICT
HOSPITAL
CLINIC
SUBCAMPUS
DISTRICT
HOSPITAL
REGIONAL
HOSPITAL
Job Shimankana
Tabane Level 2
Hospital, Rustenburg
CLINIC
DISTRICT
HOSPITAL
New Soshanguve REGIONAL
Level 2 Hospital HOSPITAL
ACADEMIC
HOSPITAL
Initial Phase
MEDUNSA
CAMPUS
Future Phase
Appendix K: Proposed clinical training platform: options for infrastructure
H
Adjoining –
Consulting rooms
Treatment/testing rooms
Resource room
Group therapy/seminar room
Offices (no records or pharmacy)
H
Integrated –
Resource room
Seminar room
Offices
H
No dedicated space –
Only clinician/teacher staff
presence
93
Appendix L: Potential veterinary clinical training platform
MEDUNSA
15
17
4
2
82
46
Note: Numerals represent the number of private veterinary practices in a particular area: the circled
numerals indicate private veterinary practices in the greater Pretoria area (82), North West province
(17), Limpopo province (15) and Mpumalanga province (46), while the stand-alone numerals indicate
private veterinary practices in the towns of Rustenburg (4) and Brits (2), respectively.
94
Appendix M: Development Implementation Plan
2013
Action
2014
2015
2016
2017
2018
2019
S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J F M
Governance changes to New University
Submit Feasibility Study to National Treasury
Receive funding approval from National Treasury
Design and tender Veterinary Science Building
Construct Veterinary Science Building
Furnish and equip Veterinary Science Building
Renew Production Unit Structures and facilities
Design and tender Administration Building
Site preparation Administration Building
Construct Administration Building
Move administration entities to New Administration Building
Alter and renew vacated space in Clin Path Building
Design and tender Student Building
Site preparation for Student Building
Construct Student Building
Move Student entities to New Student Building
Alter and renew vacated space in Basic Sciences Building
Design and tender new Science and Technology Building
Site preparation Science and Technology Building
Construct Science and Technology Building
Move science and technology departments into new building
Alter and renew vacated space in Basic Science Building
Design and tender additional level to Library
Construct additional level to Library
Furnish and equip new Library space
NDoH submit Feasibility Study to National Treasury for hospital
NDoH receive funding approval from National Treasury
Design and build new hospital and offices
Equip and furnish new hospital
Move NHLS to new hospital
Move clinicians to hospital office block
Alter and renew vacated space in Clin Path Building
Move audio visual unit to hospital office block
Alter and renew vacated space for Library
Note: This chart excludes current UL projects (including the proposed 180-bed and 2 500-bed PPP student residences and extensions to the Basic Medical Sciences building).
95
Appendix N: Projected development costs, 2014-2019
Project description
Total
Enabling works - Diversion of entrance road
New Administration Building
New Student Building
New Science and Technology Building
New Hospital Office Portion
New Veterinary Science Building
Student Housing - 590 beds
Sports fields - No. 3
CTP Housing - Job Shimankana Thabane Hospital, Rustenburg
CTP Housing - Community Health Centre - lhabane
CTP Housing - Community Health Centre - Bafokeng
CTP Housing - Community Health Centre - Boitekong
CTP Housing - Community Health Centre - Letlhabile
CTP Housing - Community Health Centre - Mabeeskraal
CTP Housing - Community Health Centre - Mogwase
Renewal of Production Unit facilities
Extension to Library - Additional level
Alteration and renewal of Clin Path Bldg - ex Admin space
Alteration and renewal of Medical Sciences Building for study space
Alteration and renewal of Basic Science Bldg - Level -1 - Lab space
Alteration and renewal of Basic Science Bldg - Level -1 - Study space
Alteration and renewal of Basic Science Bldg - Office space
Alteration and renewal of Clin Path Bldg - ex NHLS space
Alteration and renewal of Library - ex audio-visual unit space
ASM
SCU
2 625.00
1 726.00
4 998.00
1 491.00
812.00
8 168.00
2 760.75
1 763.00
7 143.00
1 541.85
1 162.00
8 535.20
984.50
68.50
68.50
68.50
68.50
68.50
68.50
4 271.91
1 465.00
1 597.00
400.00
773.00
762.00
340.00
1 195.00
678.00
1 029.63
71.93
71.93
71.93
71.93
71.93
71.93
3 795.41
1 611.50
2 794.75
440.00
1 352.75
838.20
340.00
2 091.25
745.80
Year of
completion R/SCU
2017
2017
2017
2018
2016
2016
2017
2015
2015
2015
2015
2015
2015
2015
2015
2016
2017
2017
2018
2018
2017
2018
2018
R25 874.56
R25 874.43
R25 874.43
R29 191.66
R22 934.15
R22 934.15
R20 328.00
R20 328.00
R20 328.00
R20 328.00
R20 328.00
R20 328.00
R20 328.00
R20 328.00
R22 935.00
R25 874.43
R25 874.43
R29 192.00
R29 192.00
R25 874.43
R29 192.00
R29 192.00
Building cost
Cost
premium
/discount % LIOTB Total building cost
R4 000 000
R71 433 187
R45 616 620
R184 821 053
R45 009 168
R26 649 487
R195 747 590
R1 350 000
R20 930 217
R1 462 091
R1 462 091
R1 462 091
R1 462 091
R1 462 091
R1 462 091
R77 153 094
R36 959 753
R72 312 563
R11 384 749
R39 489 478
R24 468 734
R8 797 306
R61 047 770
R21 771 394
15%
15%
15%
15%
15%
25%
10%
-50%
-50%
-50%
-50%
-66%
-50%
-50%
15%
15%
15%
15%
15%
15%
13%
13%
13%
13%
13%
13%
13%
13%
R938 608 569
R4 000 000
R94 470 389
R60 327 980
R244 425 843
R59 524 625
R35 243 946
R225 109 728
R1 350 000
R23 651 145
R1 652 163
R1 652 163
R1 652 163
R1 652 163
R1 652 163
R1 652 163
R21 795 749
R40 655 728
R36 156 282
R5 692 375
R19 744 739
R12 234 367
R2 903 111
R30 523 885
R10 885 697
Note: These projects exclude current UL projects. In addition, furniture and equipment costs will be calculated pending project approval.
96
Appendix O: Estimates of Rand values of Standard Cost Units (SCUs) for universities
Estimates of Rand values of standard cost
units (SCUs) for universities
Excluding VAT Including VAT
2013
14 321
16 326.000
2014
15 806
18 018.000
2015
17 832
20 328.000
2016
22 934.154
2017
25 874.430
2018
29 191.665
2019
32 934.186
10.36%
12.82%
12.82%
12.82%
12.82%
12.82%
97
Appendix P: Proposed new administration building
98
99
100
101
102
Appendix Q: Proposed new student building
B5: SPACE INVENTORY FOR PROPOSED NEW BUILDING
NEW UNIVERSITY INCORPORATING MEDUNSA
FUNDING CATEGORY CODE
PROJECT REFERENCE NUMBER:
PROJECT DESCRIPTION
NEW STUDENT BUILDING
* Refer attached motivation
Projected date of completion of building project:
DETAILS OF SPACE IN NEW BUILDING
Space
code
Space category
Proposed use of space
BUREAU FOR STUDENT DEVELOPMENT & ADVICE
1310
Office
Councillor
1310
Office
SEC(ADM L6)
(BUR STUD DEV)
1310
Office
CASUAL (STUDENT AFFAIRS)
1350
Conference
Interview Room, bookable - 4-seat
CAMPUS HEALTH SERVICES
1310
Office
ASST MANAGER (HEALTH AND WELLNESS)
1310
Office
CH PROF NURSE(AX LN3) (CAMP HEALTH)
1310
Office
SR PROF NURSE(AX LN2) (CAMP HEALTH)
PRINC LAB ASST(AX L2) (CAMP HEALTH)
1310
Office
HEALTH PROMOTER (HEALTH & WELLNESS)
1310
Office
HIV/AIDS OFFICER
1310
Office
SEC(ADM L6)
(CAMP HEALTH)
1810
Patient Bedroom
OBSERVATION ROOM
Treatment/Examination CCONSULTING ROOM
1850
1850
1850
1850
Treatment/Examination CDISPENSARY ROOM
1850
Treatment/Examination CGroup therapy room
1850
STUDENT REPRESENTATIVE COUNCIL
1310
Office
SEC(ADM L6)
(SRC)
1310
Office
General office for student leadership
1315
Office Service
Record room
1315
Office Service
Clubs and Societies storage
1350
Conference
Meeting Room, bookable - 20 seats
1350
Conference
1350
Conference
STUDENT ADMINISTRATION
Student Administration (Registration)
1310
Office
CONTR ADM OFF(ADM L9) (STUD ADM)
1310
Office
SR ADM OFF(ADM L8) (STUD ADM)
ADM OFF(ADM L7)
(STUD ADM)
ADM OFF(ADM L7)
(STUD ADM)
ADM OFF(ADM L7)
(STUD ADM)
ASST ADM OFF(ADM L6) (STUD ADM)
June 2017
Stations
ASMs SCU per ASM
SCUs
1
1
1
4
12.00
12.00
12.00
8.00
1.00
1.00
1.00
1.00
1
1
1
12.00
12.00
12.00
1.00
1.00
1.00
1
1
1
12.00
12.00
12.00
8.00
8.00
8.00
8.00
8.00
16.00
16.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
12.00
12.00
12.00
8.00
12.00
12.00
12.00
12.00
12.00
12.00
8.00
8.00
8.00
8.00
8.00
16.00
16.00
1
6
12.00
18.00
8.00
20.00
40.00
20.00
20.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
12.00
18.00
8.00
20.00
40.00
20.00
20.00
1
10
12.00
80.00
1.00
1.00
12.00
80.00
1
1
1
1
1
8
N/A
N/A
SH
SH
SH
SH
SH
SH
103
Space code Space category
1315
Office Service
1315
Office Service
1350
Conference
Student Finance
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office
1310
Office Service
1310
Office Service
1310
Conference
1310
Conference
Residence Administration
1310
Office
1310
Office
Residence Life
1310
Office
1350
Conference
International Office
1310
Office
1350
Conference
Shared facilities
1315
Office Service
DATA CAP OFF(ADM L5)(STUD ADM)
DATA CAP OFF(ADM L5)(STUD ADM)
Strong Room
Records Room
Stations
ASMs
SCU per ASM
SCUs
SH
SH
SH
10.00
12.00
8.00
1.00
1.00
1.00
10.00
12.00
8.00
12.00
40.00
1.00
1.00
12.00
40.00
4
4
12.00
15.00
15.00
10.00
10.00
8.00
8.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
12.00
15.00
15.00
10.00
10.00
8.00
8.00
Manager, Student residences
RESIDENCE ADMINISTRATOR
STUDENT DEVELOPMENT OFFICER
1
4
12.00
24.00
1.00
1.00
12.00
24.00
Student Life Officer
1
4
12.00
8.00
1.00
1.00
12.00
8.00
International Student Officer
Administrative support
1
1
12.00
8.00
1.00
1.00
12.00
8.00
N/A
5.00
1.00
5.00
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
300
30
100.00
25.00
50.00
30.00
30.00
30.00
8.00
20.00
8.00
6.00
200.00
60.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
0.95
0.95
100.00
25.00
50.00
30.00
30.00
30.00
8.00
20.00
8.00
6.00
190.00
57.00
200
609.00
500.00
1 726.00
1.10
550.00
1 763.00
CONTR ADM OFF(ADM L9) (STUD FINANCE)
ASST ADM OFF(ADM L6) (STUD FINANCE)
SR DATA CAP OFF(ADML6)(STUD FINANCE)
DATA CAP OFF(ADM L5) (STUD FINANCE)
Credit controler
Eduloan or other
Eduloan or other
Strong Room
Records Room
Tea kitchen
COMMERCIAL SPACES
1660
Merchandising
BOOKSHOP
1660
Merchandising
POST OFFICE
1660
Merchandising
POST OFFICE
1660
Merchandising
BANK(SANLAM)
1660
Merchandising
Bank (0ther)
1660
Merchandising
Tuck shop
1665
Merchandising Service Store, Tuck shop
1665
Merchandising Service Store, Book shop
1665
Merchandising Service STORE ROOM for Post Office
1665
Merchandising Service POST OFFICE (KITCHEN)
1630
Food facility
Student Dining space
1630
Food facility
Staff Dining space
LEARNING SPACE
1400
Lounge/e-learning space
TOTALS
N/A
N/A
4
1
1
1
1
1
1
1
2
2
SH
SH
SH
SH
N/A
N/A
SH
SH
SH
104
SUMMARY FOR PROPOSED NEW BUILDING
FUNDING CATEGORY CODE:
Space
code
Number of
stations to be
provided
1300
1400
1600
1800
TOTALS
Total
SCUs per
space
code
Total ASMs per space code
66
200
330
13
N/A
Requirements for Land Improvements Other Than Buildings:
587.00
500.00
567.00
72.00
587.00
550.00
554.00
72.00
1 726.00
1 763.00
Replacement
Rand Value
Year of
(inc VAT) per value in year of
Completion
SCU
completion
2017
2017
2017
2017
R
R
R
R
25 874
25 874
25 874
25 874
R
R
R
R
15 188 290
14 230 937
14 334 434
1 862 959
R
45 616 620
R
6 842 493
LIOTB (15%) added as this project as standard site but marginal founding conditions
TOTAL CALCULATED REPLACEMENT COST OF SPACE IN 2017
R 52 459 113
15% added to include equipment and design features that are not contemplated in the DHET cost norms
TOTAL ESTIMATED REPLACEMENT COST OF SPACE IN 2017
R 60 327 980
105
Appendix R: Proposed new science and technology building
106
107
108
Appendix S: Proposed veterinary science teaching building, Phase 1
109
Appendix T: Proposed new clinical staff office building
110
111
112
Appendix U: Proposed new residence for 588 students
B5: SPACE INVENTORY FOR PROPOSED NEW BUILDING
UNIVERSITY:
NEW UNIVERSITY INCORPORATING MEDUNSA
FUNDING CATEGORY CODE
PROJECT DESCRIPTION
New Residence for 588 Students
* Refer attached motivation
Projected date of completion of building project:
DETAILS OF SPACE IN NEW BUILDING
Space code Space category
1310
1310
1310
1310
1310
1310
1350
1350
1650
1650
1650
1650
1650
1650
1910
1910
1910
1910
1910
1910
1910
1910
1910
1919
1935
1920
1920
1920
1920
1920
1920
Office
Office
Office
Office
Office
Office
Conference
Conference
Recreation space
Recreation space
Lounge
Lounge
Lounge
Lounge
Sleep/Study Without Toilet/Bath
Toilet/Bath
Kitchen/Dining/Lounge
Sleep/Study
Sleep/Study
Sleep/Study
Sleep/Study
Sleep/Study
Sleep/Study
64
with Toilet/Bath
with Toilet/Bath
with Toilet/Bath
with Toilet/Bath
with Toilet/Bath
with Toilet/Bath
Reception
Reception
Administration - Manager
Administration - Manager
Warden's Office
Warden's Office
Meeting Room
Meeting Room
Games Room
Games Room
Visitors
Visitors
TV Room - Subdivisable
TV Room - Subdivisable
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Sngle study bedroom
Cluster lounge to study bedrooms
[Totals for cluster]
Clusters (in 2 residences, 34 clusters in each)
Special suite for mobility impaired student
November 2016
Stations
1
1
1
1
1
1
8
8
1
1
1
1
1
1
1
1
1
9
576
1
1
1
1
1
1
ASM's SCU per ASM
10.000
10.000
12.000
12.000
12.000
12.000
18.000
18.000
50.000
50.000
40.000
40.000
90.000
90.000
9.000
9.000
9.000
9.000
9.000
9.000
9.000
9.000
9.000
13.950
16.000
110.950
7 100.80
17.200
17.200
17.200
17.200
17.200
17.200
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
0.95
0.95
0.95
0.95
0.95
0.95
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
1.05
SCU's
10.00
10.00
12.00
12.00
12.00
12.00
18.00
18.00
47.50
47.50
38.00
38.00
85.50
85.50
9.45
9.45
9.45
9.45
9.45
9.45
9.45
9.45
9.45
14.648
16.80
116.50
7 455.84
18.060
18.060
18.060
18.060
18.060
18.060
113
114
Appendix V: Proposed new CTP residence for 3 students
115
Appendix W: Proposed new CTP residence for 60 students
116
117
Appendix X: Proposed Programme Qualification Mix
Code:
School of Medicine
School of Oral Health Sciences
School of Health Care Sciences
School of Pathology and Pre-Clinical Sciences
School of Veterinary Sciences
School of Science and Technology
School of Humanities
Prog
L
F
P
Ex
Cr
F
F+
Ret
HC
Programme
HEMIS level
Full time
Part time
Experiential
HEMIS credits
First Time Entering students
Proposed First Time Entering students
Retention
Headcount
All programmes listed in black are programmes that the Medunsa campus currently offers. All programmes listed in red are proposed new
programmes.
118
Prog
Code
080
158
Qualification Name
Totals
UNDERGRADUATE
DIPLOMA OR
CERTIFICATE
DIPLOMA IN
TROPICAL MEDICINE
AND HYGIENE
DIPLOMA IN FOOD
SAFETY
DIPLOMA IN
PHARMACY
HIGHER
CERTIFICATE IN
PHARMACY
SUPPORT
ADVANCED
CERTIFICATE IN
PHARMACY
TECHNICAL
SUPPORT
DIPLOMA IN
NURSING
DIPLOMA IN
OCCUPATIONAL
HEALTH NURSING
DIPLOMA IN ORAL
HYGIENE
DIPLOMA IN DENTAL
ASSISTANCE
DIPLOMA IN
VETERINARY
NURSING
DIPLOMA IN
VETERINARY
TECHNOLOGY
DIPLOMA IN ANIMAL
HEALTH
CERTIFICATE IN
Institutional
Qualification
Name
Dip (ORAL
HYGIENE)
DVN
L
F
P
Ex
Cr
01
2
2
01
2
2
01
2
2
01
1
01
2
2
01
2
2
01
2
2
01
2
2
01
2
2
01
1
01
2
2
01
3
2
01
1
?
2013
F
-
-
1
2
2019
F+
Ret
2019
HC
6 999
2024
F+
Ret
2024
HC
10 001
10
0.80
18
10
0.80
18
15
0.80
27
15
0.80
27
15
0.80
27
15
0.80
27
15
20
15
20
15
0.80
27
20
0.80
36
15
0.80
27
30
0.80
54
0
15
0.80
27
15
0.80
27
0
0
0.80
0
0
0.80
0
30
0.80
30
40
0.80
40
0
0.80
0
20
0.80
20
0
0.80
0
20
0.80
36
20
0.80
49
30
0.80
73
10
20
-
-
-
-
10
20
119
ANIMAL WELFARE
GENERAL ACADEMIC
1ST BACHELOR'S
DEGREE
BACHELOR OF
SCIENCE
BSC
PMM
BSC
MLM
BSC
MLM
BSC
(CHEMISTRY)
02
3
3
BSC (PHYSICS)
03
3
3
BSC
(BIOCHEMISTRY)
02
3
3
BSC (BOTANY)
04
3
3
BSC (ZOOLOGY)
05
3
3
02
3
3
02
4
02
60
0.80
146
100
0.80
244
40
0.80
98
50
0.80
122
50
0.80
122
100
0.80
244
100
0.80
244
150
0.80
366
50
0.80
122
60
0.80
146
30
60
0.80
146
60
0.80
146
3
3
15
0.80
44
15
0.80
44
3
3
33
45
0.80
110
50
0.80
122
02
4
3
14
15
0.80
44
15
0.80
44
03
3
3
120
0.80
354
150
0.80
443
BSC (STATISTICS)
03
3
3
30
0.80
73
40
0.80
98
BSOCSCI
(PSYCHOLOGY)
03
3
3
30
0.80
73
40
0.80
98
BCUR (I ET A)
03
4
4
45
10
0.80
30
15
0.80
44
03
4
4
"
10
0.80
30
15
0.80
44
03
4
4
"
10
0.80
30
15
0.80
44
BSC
(MATHEMATICAL
SCIENCE)
BSC
(MATHEMATICAL
SCIENCE) ECP
BSC (PHYSICAL
SCIENCES)
BSC (PHYSICAL
SCIENCES) ECP
BSC
(INFORMATION
TECHNOLOGY)
BSC
CMM
BSC
XCM
BSCI
01
BSC
M01
007
-
BACHELOR OF
SOCIAL SCIENCE
PROFESSIONAL 1ST
BACHELOR'S
DEGREE
BACCALAUREUS
CURATIONIS
BCUR (NURSING
EDUCATION)
BCUR (COMM
HEALTH
NURSING SCI)
39
73
-
-
120
BCUR
(MIDWIFERY
NEONAT NS)
BCUR
(PSYCHIATRIC
NS)
BCUR (HEALTH
SERVICE
ADMINISTR)
022
004
003
240
BACHELOR OF
ADVANCED NURSING
SCIENCE
BACHELOR OF
SCIENCE IN
DIETETICS
BACHELOR OF
SCIENCE IN
NUTRITION
BACHELOR OF
SCIENCE IN
PHYSIOTHERAPY
BACHELOR OF
EXERCISE SCIENCE
AND SPORTS
MEDICINE
BACHELOR OF
SCIENCE IN
ORTHOTICS AND
PROSTHETICS
BACHELOR OF
SCIENCE IN HEALTH
INFORMATICS
BACHELOR OF
SCIENCE IN
BIOTECHNOLOGY
BACHELOR OF
SCIENCE IN CLINICAL
TECHNOLOGY
BACHELOR OF
SCIENCE IN HEALTH
PROMOTION
03
4
4
"
10
0.80
30
15
0.80
44
03
4
4
"
10
0.80
30
15
0.80
44
03
4
4
"
10
0.80
30
20
0.80
59
BANS
03
4
4
10
0
0.80
0
0
0.80
0
BSC (DIET)
03
4
4
29
20
0.80
59
20
0.80
59
BSC (NUTRITION)
04
4
4
20
0.80
59
20
0.80
59
BSC
(PHYSIOTHERAP
Y)
03
4
4
45
0.80
133
45
0.80
133
BSM
03
4
4
20
0.80
59
30
0.80
89
03
4
4
15
0.80
44
20
0.80
59
03
4
4
15
0.80
44
20
0.80
59
03
4
4
15
0.80
44
30
0.80
89
03
4
4
15
0.80
44
30
0.80
89
04
4
4
30
0.80
89
40
0.80
118
BSCHP
39
-
-
-
-
-
-
121
005
059
159
012
013
006
001
BACHELOR OF
OCCUPATIONAL AND
ENVIRONMENTAL
HEALTH
BACHELOR OF
OCCUPATIONAL
THERAPY
BACHELOR OF
OPTOMETRY
BACHELOR OF
PHARMACY
BACHELOR OF
MEDICAL SCIENCE
AND BACHELOR OF
LAWS
BACHELOR OF
BIOMEDICAL
ENGINEERING
BACHELOR OF
SPEECH LANGUAGE
PATHOLOGY
BACHELOR OF
LOGOPAEDICS
BACHELOR OF
AUDIOLOGY
BACHELOR OF
SOCIAL WORK
BACHELOR OF
DENTAL SCIENCES
BACHELOR OF
DENTAL THERAPY
BACHELOR OF ORAL
HYGIENE
BACHELOR OF
SCIENCE IN MEDICAL
SCIENCES
BACHELOR OF
DIAGNOSTIC
RADIOGRAPHY
BACHELOR OF
MEDICINE AND
40
0.80
118
40
0.80
118
50
0.80
148
50
0.80
148
20
0.80
59
20
0.80
59
50
0.80
148
50
0.80
148
15
0.80
44
20
0.80
59
15
0.80
44
20
0.80
59
15
0.80
44
20
0.80
59
15
0.80
44
20
0.80
59
40
0.80
118
40
0.80
118
30
0.80
89
30
0.80
89
23
30
0.90
117
30
0.90
117
3
15
30
0.80
73
30
0.80
73
3
3
5
20
0.80
49
20
0.80
49
03
4
4
10
0.80
30
20
0.80
59
BDIAGRAD
03
3
3
30
40
0.80
98
50
0.80
122
MBCHB
03
6
4.9
122
200
0.95
1010
200
0.95
1010
03
4
4
BOCCTHER
03
4
4
BOPTOM
03
4
4
BPHARM
03
4
4
BMedSc-LLB
03
4
4
BSc (BME)
03
4
4
BSLP
03
4
4
BL
03
4
4
BSC (AUDIO)
03
4
4
BSW
03
4
4
BDENTSCI
03
5
4
BDENTTHER
03
3
BOH
03
BSC (MEDICAL
SCIENCES)
1.1
-
33
43
-
-
24
-
-
122
BACHELOR OF
SURGERY
BMC
A01
100
BACHELOR OF
VETERINARY HEALTH
BACHELOR OF
VETERINARY
TECHNOLOGY
BACHELOR OF
VETERINARY
NURSING
BACHELOR OF
VETERINARY
SCIENCE
POSTGRADUATE
DIPLOMA OR
CERTIFICATE
POST GRADUATE
DIPLOMA IN HEALTH
PROMOTION
POST GRADUATE
DIPLOMA IN HEALTH
AND MEDICAL
ADMINISTRATION
POST GRADUATE
DIPLOMA IN
HOSPITAL
PHARMACY
MANAGEMENT
POST GRADUATE
DIPLOMA AUTHORISED
PHARMACY
PRESCRIBER
POST GRADUATE
DIPLOMA PHARMACOVIGILANC
E
POST GRADUATE
DIPLOMA - HEALTH
MBCHB ECP
03
7
1.1
4.9
BVH
03
4
BVT
03
4
BVETCUR
03
3
BVSC
03
6
PG DIP. (HEALTH
PROMOTION)
04
1
1
PG DIP. (HEALTH
AND MEDICAL
ADMINISTRATION
)
04
1
1
PG DIP.
(HOSPITAL
PHARMACY
MANAGEMENT)
04
1
1
04
1
1
04
1
1
04
1
1
50
0.95
252
50
0.95
252
40
0.80
118
70
0.80
207
0
0.80
0
40
0.80
118
40
0
0.80
0
40
0.80
98
140
40
0.95
114
60
0.95
318
15
0.80
12
20
0.80
16
20
0.80
16
30
0.80
24
10
0.80
8
10
0.80
8
10
0.80
8
10
0.80
8
10
0.80
8
10
0.80
8
15
0.80
12
20
0.80
16
51
-
-
-
0
-
-
-
123
PROFESSIONS
EDUCATION
POST GRADUATE
DIPLOMA IN PRIMARY
HEALTH CARE
POST GRADUATE
DIPLOMA IN
GERIATRIC MEDICINE
POST GRADUATE
DIPLOMA IN HIV/AIDS
MANAGEMENT
POST GRADUATE
DIPLOMA IN HEALTH
LAW
POST GRADUATE
DIPLOMA IN PUBLIC
HEALTH
AON
01
160
PDN
01
148
ADVANCED DIPLOMA
IN OCCUPATIONAL
HEALTH NURSING
POST GRADUATE
DIPLOMA IN MEDICAL
SOCIAL WORK
ADVANCED DIPLOMA
IN COMMUNITY
DENTISTRY
POST GRADUATE
DIPLOMA IN
DENTISTRY
POST GRADUATE
DIPLOMA IN
MATERNAL AND
CHILD HEALTH
POST GRADUATE
DIPLOMA IN ANIMAL
HEALTH
POST GRADUATE
DIPLOMA IN
VETERINARY
TECHNOLOGY
PG DIP.
(PRIMARY
HEALTH CARE)
PG DIP.
(GERIATRIC
MEDICINE)
04
1
1
04
1
1
PG DIP. (HIV/AIDS
MANAGEMENT)
04
1
1
PG DIP. (HEALTH
LAW)
04
1
1
PG DIP. (PUBLIC
HEALTH)
04
1
1
AD
(OCCUPATIONAL
HEALTH
NURSING)
04
2
2
PG DIP. (MEDICAL
SOCIAL WORK)
04
1
1
AD (COMMUNITY
DENTISTRY)
04
2
2
PG DIP.
(DENTISTRY)
04
2
PG DIP.
(MATERNAL AND
CHILD HEALTH)
04
PG DIP. (ANIMAL
HEALTH)
04
3
1
PG DIP.
(VETERINARY
TECHNOLOGY)
04
3
1
2
20
0.80
16
30
0.80
24
10
0.80
8
10
0.80
8
20
0.80
16
30
0.80
24
10
0.80
8
10
0.80
8
0
20
0.80
16
30
0.80
24
6
10
0.80
16
20
0.80
32
20
0.80
16
20
0.80
16
0
10
0.80
18
10
0.80
18
1
0
10
0.80
18
10
0.80
18
1
0
10
0.80
18
10
0.80
18
20
0.80
68
40
0.80
136
0
0.80
0
20
0.80
68
-
-
-
-
-
-
-
124
POST GRADUATE
DIPLOMA IN
VETERINARY
NURSING
HONOURS DEGREE
BACHELOR OF
NURSING SCIENCE
HONOURS
076
078
HSC
N01
BACHELOR OF
SCIENCE HONOURS
216
213?
HSC
R01
215
218
HSC
S01
BACHELOR OF
SOCIAL SCIENCE
HONOURS
PG DIP.
(VETERINARY
NURSING)
B NURS SC HONS
(NURSING
EDUCATION)
B NURS SC HONS
(COMM HEALTH
NURSING SCI)
B NURS SC HONS
(ADV MIDWIFERY
NEONAT NS)
B NURS SC HONS
(ADV
PSYCHIATRIC NS)
B NURS SC HONS
(HEALTH
SERVICE
ADMINISTR)
BSC HONS
(CHEMISTRY)
BSC HONS
(PHYSICS)
BSC HONS
(BIOCHEMISTRY)
BSC HONS
(BOTANY)
BSC HONS
(ZOOLOGY)
BSC HONS
(APPLIED
MATHEMATICS )
BSC HONS
(MATHEMATICS )
BSC HONS
(STATISTICS)
BSOCSCI HONS
(PSYCHOLOGY)
04
3
1
0
20
06
1
1
0
10
10
15
15
06
1
1
0
10
10
15
15
06
1
1
0
10
10
15
15
06
1
1
0
10
10
15
15
06
1
1
0
10
10
20
20
06
1
1
7
15
15
20
20
06
1
1
5
15
15
20
20
06
1
1
10
20
20
30
30
06
1
1
0
15
15
20
20
06
1
1
5
15
15
20
20
06
1
1
0
10
10
10
10
06
1
1
0
10
10
10
10
06
1
1
14
15
15
20
20
06
1
1
26
30
30
30
30
-
0
0.80
0.80
68
125
BACHELOR OF
SCIENCE HONOURS
IN MEDICAL
SCIENCES
HMS
C01
212
HMS
F01
069
HMS
H01
071
073
267
BACHELOR OF
SCIENCE HONOURS
IN DENTAL SCIENCES
BACHELOR OF
VETERINARY HEALTH
HONOURS
BACHELOR OF
BSC HONS
(MEDICAL
ANATOMICAL
PATHOLOGY)
BSC HONS
(MEDICAL
ANATOMY
SCIENCE)
BSC HONS (MS)
(MEDICAL
PHYSICS)
BSC HONS (MS)
(MEDICAL
BIOCHEMISTRY)
BSC HONS (MS)
(HUMAN
GENETICS )
BSC HONS (MS)
(HAEMATOLOGIC
AL PATHOLOGY)
BSC HONS (MS)
(MEDICAL
MICROBIOLOGY)
BSC HONS (MS)
(MEDICAL
VIROLOGY)
BSC HONS (MS)
(PHARMACOLOG
Y)
BSC HONS (MS)
(PHYSIOLOGY)
BSC HONS (MS)
(ENVIRONMENTA
L HEALTH)
BSC HONS
(DENTAL
SCIENCES)
06
1
2
1
06
1
2
1
06
1
2
06
1
06
2
0
-
5
0.80
12
10
0.80
24
5
0.80
12
10
0.80
24
1
4
5
0.80
12
10
0.80
24
2
1
0
5
0.80
12
10
0.80
24
1
2
1
0
5
0.80
12
10
0.80
24
06
1
2
1
1
5
0.80
12
10
0.80
24
06
1
2
1
3
5
0.80
12
10
0.80
24
06
1
2
1
5
5
0.80
12
10
0.80
24
06
1
2
1
0
5
0.80
12
10
0.80
24
06
1
2
1
3
5
0.80
12
10
0.80
24
06
1
2
1
0
5
0.80
12
10
0.80
24
06
1
1
0
10
10
15
15
BVH (HONS)
06
1
1
5
5
10
10
BVT (HONS)
06
1
1
5
5
10
10
-
126
178
VETERINARY
TECHNOLOGY
HONOURS
BACHELOR OF
VETERINARY
NURSING HONOURS
MASTERS DEGREE
MASTER OF DENTAL
SURGERY
MASTER OF
DENTISTRY
176
172
173
174
175
177
178
MASTER OF SCIENCE
IN DENTISTRY
MASTER OF
NURSING SCIENCES
-
BVNURS (HONS)
MDENT SCIENCE
M DENT
(PERIODONTICS
AND ORAL
MEDICINE)
M DENT
(COMMUNITY
DENTISTRY)
M DENT
(MAXILLOFACIAL
AND ORAL
SURGERY)
M DENT (ORAL
PATHOLOGY)
M DENT
(ORTHODONTICS)
M DENT
(PROSTHODONTI
CS)
MSC
(DENTISTRY)
MNSC (NURSING
EDUCATION)
M NURS SC
(COMMUNITY
HEALTH
NURSING SCI)
M NURS SC (ADV
MIDWIFERY
NEONATEAL SCI)
M NURS SC (ADV
PSYCHIATRIC
NURSING SCI)
06
1
07
1
1
-
5
5
10
10
2
1
1
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
5
2
0
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
4
2
0
5
0.80
29
10
0.80
58
07
1
1
9
5
5
10
10
07
1
1
0
5
5
10
10
07
1
1
0
5
5
10
10
07
1
1
0
5
5
10
10
127
M NURS SC
(HEALTH
SERVICE
ADMINISTRATION
)
M NURS SC
(PAEDIATRIC SCI)
M NURS SC
07
1
1
07
1
1
07
1
1
0
MOCCTHER
07
1
1
0
MOPTOM
07
1
1
MPHARM
07
1
1
MPH
07
1
MSC (DIETETICS)
07
MSC (NUTRITION)
MASTER OF SCIENCE
IN PHYSIOTHERAPY
MASTER OF SCIENCE
IN HEALTH
PROMOTION
058
147
056
MASTER OF
OCCUPATIONAL
THERAPY
MASTER OF
OPTOMETRY
MASTER OF
PHARMACY
MASTER OF PUBLIC
HEALTH
MASTER OF SCIENCE
IN DIETETICS
MASTER OF SCIENCE
IN NUTRITION
MASTER OF HEALTH
AND MEDICAL
ADMINISTRATION
MASTER OF SCIENCE
IN ENVIRONMENTAL
HEALTH
ENGINEERING
MASTER OF SOCIAL
SCIENCE IN
GEROPSYCHOLOGY
MASTER OF SOCIAL
SCIENCE IN SOCIAL
PSYCHOLOGY
5
5
10
10
5
5
10
10
5
5
10
10
5
5
10
10
5
5
10
10
32
40
40
50
50
1
31
40
40
50
50
1
1
0
5
5
15
15
07
1
1
5
5
15
15
MSC
(PHYSIOTHERAP
Y)
07
1
1
5
5
15
15
MSCHP
08
1
1
10
10
10
10
07
1
1
10
10
10
10
07
1
1
10
10
10
10
07
1
1
10
10
15
15
07
1
1
10
10
20
20
MSC (HEALTH
AND MEDICAL
ADMINISTRATION
)
MSC
(ENVIRONMENTA
L HEALTH
ENGINEERING)
MSOCSCI
(GEROPSYCHOL
OGY)
MSOCSCI
(SOCIAL
PSYCHOLOGY)
0
-
1
-
-
-
-
-
128
MASTER OF SCIENCE
081?
025
039
040
042
033
031?
027
036
047
094
096
MASTER OF
MEDICINE
MSC (SCIENCE)
MMED
(ANATOMICAL
PATHOLOGY)
MMED
(ANAESTHESIOLO
GY AND CRIT/INT
CARE)
MMED
(OBSTETRICS
AND
GYNAECOLOGY )
MMED
(OPHTHALMOLOG
Y)
MMED
(OTORHINOLARY
NGOLOGY)
MMED (PUBLIC
HEALTH
MEDICINE)
MMED
(HAEMATOLOGIC
AL PATHOLOGY )
MMED (CLINICAL
PATHOLOGY)
MMED
(FORENSIC
PATHOLOGY)
MMED
(CHEMICAL
PATHOLOGY)
MMED
(MICROBIOLOGY)
MMED
(DIAGNOSTIC
RADIOLOGY)
MMED (NUCLEAR
MEDICINE)
MMED
(VIROLOGICAL
07
1
1
42
50
50
80
80
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
2
5
0.80
15
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
11
15
0.80
44
20
0.80
59
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
129
043
030
034
046
207
038
051
045
041
049
050
037
052
MASTER OF SCIENCE
PATHOLOGY )
MMED
(PAEDIATRICS
AND CHILD
HEALTH)
MMED
(DERMATOLOGY)
MMED (INTERNAL
MEDICINE)
MMED
(PSYCHIATRY)
MMED
(OCCUPATIONAL
MEDICINE)
MMED
(NEUROSURGER
Y)
MMED
(UROLOGY)
MMED (PLASTIC
AND
RECONSTRUCTIV
E SURG)
MMED
(ORTHOPAEDICS)
MMED
(SURGERY)
MMED (CARDIOTHORACIC
SURGERY)
MMED
(NEUROLOGY)
MMED (FAMILY
MEDICINE)
MMED (HEALTH
COMMUNICATION
)
MMED
(EMERGENCY
MEDICINE)
MSC (MEDICAL
07
4
2
9
15
0.80
44
20
0.80
59
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
5
10
0.80
30
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
4
2
0
5
0.80
15
10
0.80
30
07
5
2
1
5
0.80
15
10
0.80
30
07
4
2
1
5
0.80
15
10
0.80
30
07
5
2
1
5
0.80
15
10
0.80
30
07
5
2
2
5
0.80
15
10
0.80
30
07
5
2
0
5
0.80
15
10
0.80
30
07
5
2
1
5
0.80
15
10
0.80
30
07
4
2
2
5
0.80
15
10
0.80
30
07
4
2
3
5
0.80
15
20
0.80
59
07
4
2
5
0.80
15
10
0.80
30
07
4
2
5
0.80
15
10
0.80
30
5
1.00
5
10
1.00
10
07
1
1
-
-
130
054
093
IN MEDICAL
SCIENCES
MASTER OF SCIENCE
IN MEDICINE
MASTER OF SCIENCE
IN CLINICAL
PSYCHOLOGY
MASTER OF SCIENCE
IN CLINICAL
PSYCHOLOGY
MASTER OF
VETERINARY HEALTH
171
150
250
DOCTORAL DEGREE
DOCTOR OF
PHILOSOPHY IN
DENTISTRY
DOCTOR OF
OPTOMETRY
DOCTOR OF
PHARMACY
DOCTOR OF
PHILOSOPHY
DOCTOR OF PUBLIC
HEALTH
DOCTOR OF
PHILOSOPHY
DOCTOR OF
MEDICAL SCIENCE
DOCTOR OF
MEDICINE
DOCTOR OF
PHILOSOPHY
SCIENCES)
-
MSC (MEDICINE)
07
2
1
0
5
1.00
10
10
1.00
20
MSC (CLINICAL
PSYCHOLOGY)
07
1
1
1
2
5
0.80
9
20
0.80
36
07
1
1
1
0
5
0.80
9
20
0.80
36
07
1
1
0
1.00
0
15
1.00
15
08
2
2
3
0.70
5
5
0.70
9
D OPTOM
08
2
2
3
0.70
5
5
0.70
9
D PHARM
08
2
2
3
0.70
5
5
0.70
9
PHD (HEALTH
SCIENCE)
08
2
2
6
0.70
10
10
0.70
17
DPH
08
2
2
3
0.70
5
5
0.70
9
PHD (SCIENCE)
08
2
2
2
4
0.70
7
10
0.70
17
D MED SC
08
2
2
0
3
0.70
5
5
0.70
9
D MED
08
2
2
0
3
0.70
5
5
0.70
9
PHD (MEDICINE)
08
2
2
0
3
0.70
5
5
0.70
9
MSC
(COUNSELING
PSYCHOLOGY)
MSC
(VETERINARY
HEALTH)
-
PHD (DENTISTRY)
-
131
Appendix Y: Consolidated summary of issues arising from public consultations
with respect to the incorporation of the Medunsa campus into the new health
and allied sciences university
In carrying out its mandate from the Ministers of Higher Education and Training and
Health, the Joint Technical Team (JTT) engaged in a number of meetings and
discussions with internal and external stakeholders and also invited and received
several written comments and proposals both from these stakeholders (including
government departments, higher education institutions, statutory and other regulatory
bodies in the health and higher education sectors, trade unions, youth organisations
and academics) and from interested members of the public. The meetings, which took
place from November 2012 to August 2013, also provided the JTT with an
opportunity to inform and update stakeholders as to progress towards the new
university, expected timeframes and envisaged future activities.
The main issues arising from these consultative processes are outlined below,
organised into the following themes: the expected comprehensiveness of the new
health and allied sciences university; envisaged academic programmes; enrolments;
research; clinical training platforms; veterinary sciences; infrastructure, equipment
and technology; staffing; labour unions; students; transitional arrangements; and the
naming of the new institution.
At all meetings, the JTT consistently stressed the importance of ensuring that the
greatest care is taken in planning for and establishing the new university and its
incorporation of the Medunsa campus of the University of Limpopo (UL).
Stakeholders agreed that this is a huge and unique opportunity, and that it will require
focus and patience.
Given the shortage of almost all categories of health professionals in the country, the
new university needs to consider offering, in the Minister of Higher Education's
words, 'the whole hog' in terms of health science programmes, taking into account the
wide array of health and allied health professionals required for a vibrant health sector.
This suggests that it must include both technically focused certificate and diploma
programmes normally offered by universities of technology (for example, radiography)
and formative degree programmes normally offered by traditional universities (for
example, the MBChB). The comprehensiveness of the new university was therefore
understood to encompass both horizontal and vertical dimensions, ranging from
diplomas to postgraduate qualifications, from technical to professional and academic
programmes, and from health and allied health to health-related programmes such as
medical social work and hospital management.
Moreover, as the Minister of Health emphasised, the establishment of the new health
and allied sciences university is only a part of an even bigger process of building and
rebuilding higher education and health facilities across the country. This process
includes the development of two new universities, in Mpumalanga and the Northern
Cape; the establishment of a new medical school in Polokwane, under the auspices of
the University of Limpopo; the rebuilding or refurbishment of existing hospitals such
as the Dr George Mukhari and Chris Hani Baragwanath hospitals; and the building of
new hospitals, including one in Soshanguve.
132
It is extremely important for South Africa to develop its capacity to train its own
health professionals, and the same time consideration must be given to developing and
recruiting sufficient quality human resources to staff both the new university and the
hospitals, clinics and other health facilities with which the university will cooperate
and which will provide clinical training platforms for its students.
Several presentations from stakeholders on both the Medunsa and Turfloop campuses
focused on both expanding and extending existing academic programmes and
introducing new programmes, using various modalities (including residential, online
and distance).
Among the various new programmes (both undergraduate and postgraduate)
suggested or being contemplated, particularly for the new flagship health and allied
sciences university, are programmes in medical law, health education, health
economics, medical engineering and biotechnology, information technology,
veterinary sciences, alternative or traditional medicine, sport science and possibly
agricultural science and electrical engineering, as well as an increased number of
certificate and diploma programmes.
It was felt that it would be possible for the new university to increase its student
enrolment from the approximately 4000 students currently on the Medunsa campus
to approximately 7 000 students over the course of the next five years, funding
permitting.
However, expansions in programmes and increases in enrolments could not be done
all at once; and it was important for any new qualifications and programmes to be
well-tailored (and also for these and any substantially revised programmes to go
through the full accreditation process), and for student enrolments to be appropriately
planned, so as to optimize funding, ensure the academic and financial viability and
sustainability of both UL and the new university, and address national needs and
priorities. Efforts needed to be made to mitigate any possible negative impact of the
incorporation on current service delivery; expanded and new programmes would also
require improved or reconfigured clinical training platforms; while increases in
enrolments will need concomitant increases in staffing, so as to maintain current
student-staff ratios. Caution needed to be exercised to ensure that health-related
programmes in particular (but also core health and allied science programmes) were
adequately supported and staffed. Synergies and cooperative arrangements are also
possible between the new university and other universities (not only regionally but
perhaps with neighbouring countries as well), such as with the University of Pretoria
in the case of veterinary sciences, or with Tshwane University of Technology and
North West University in the case of dental technology and pharmacy (the B.Pharm is
currently offered in conjunction with TUT).
Planning around the academic model and Programme Qualification Mix of the new
institution also needed to take into account the broader context of national priorities
and government policy directions, regional and international developments, the
evolution of the job market and the specific location of the Medunsa campus with its
agricultural, mining, automotive and tourism economic hinterland.
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It was noted that the Medunsa and Turfloop campuses currently fell equally under the
auspices of the overall University of Limpopo; and that, consequent upon the
unbundling of the Medunsa campus, health science faculty structures on the two
campuses would need to be revised, with consideration also being given to the issue
of any academic departments currently training students across faculties or campuses.
Planning was proceeding for the establishment, in Polokwane, of the ninth medical
school in the country; and a revised MBChB programme and business plan was
almost ready to be submitted to the HPCSA and CHE for accreditation purposes, with
an eye towards a first intake of students in 2015.
Issues around research were also raised, with regard to the need to increase the
Medunsa campus' level of research productivity once incorporated into the new
university. More research funding will be required, and the Medical Research Council
has indicated its willingness to enhance and strengthen research at the new university
(including institutional basic and clinical research capacity and administrative
infrastructure capacity) by supporting the establishment of a fully functional Research
Office and through various funding mechanisms, with particular emphasis on joint
research projects among academic departments that are in close proximity to each
other. There is a need to build mid-level (i.e. sub-senior) staff research capacity (for
instance at the existing Clinical Research Unit, MeCRU), and for additional resources
which can attract the quality human capital to sustain research momentum. Spinal
research was suggested as a particularly pressing need; and should the new university
be expected to contribute to the clinical drug testing of pharmaceuticals, additional
research laboratories and staff would be required. Developments in any of these areas
could possibly lead to the establishment of research chairs.
Discussions around the expanded and improved clinical training platforms, which
almost all the health and allied science disciplines at the new university will require,
emphasised the need for close and continuous involvement and detailed planning and
funding by the Departments of Health at both national and provincial levels, as well as
with staff at the various hospitals. Account also needed to be taken of the Tertiary
Service Grant and the Training and Development Fund. The clinical training
platforms for the new university are being envisaged as extending approximately to
Hammanskraal in the north and across the Bojanala district to Swartruggens in the
west, and based on a network of new, existing and refurbished level 1, 2 and 3
hospitals, provided with student and staff accommodation where needed.
While there may be certain synergies or benefits in terms of interaction, for the most
part students from different universities should not be in training at the same hospitals.
Hence, given the number of other medical and health science faculties in the region,
consideration will need to be given to formal agreements to ensure equal sharing and
adequate management of access to facilities. It was also suggested that, for
sustainability purposes, academic hospitals should be moved from the provincial to
the national domain, so that the burden of financing does not fall disproportionately
on some provinces. Clinical training was envisaged as being community-based, in line
with the latest international thinking. It was also suggested that any new academic
training hospital for the new university ought ideally to be directly linked (in fact,
physically attached) to the university, and equipped with the latest technology.
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With regard to the proposed establishment of a second veterinary sciences faculty in
close proximity to the country's only other such faculty (at Onderstepoort), careful
planning would be needed to avoid competition and promote complementarity with
the University of Pretoria (to which National Skills Fund money has already been
allocated, for the expansion of Onderstepoort), but in full awareness of the country's
need for more veterinarians and other veterinary professionals, including veterinary
nurses, technicians and academics. Consideration will need to be given to ensuring the
availability of academic staff for the new faculty (taking into account, too, potential
competition from veterinary faculties currently in the planning stages in SADC
countries), and adequate clinical caseloads for students from both the new and the
existing faculty; the latter could be addressed by using alternative clinical training
models involving public and private veterinary practices and satellite facilities, with
strong oversight and quality assurance mechanisms.
Suggested initial veterinary foci for the new university included: a greater focus on
undergraduate rather than postgraduate veterinary and allied veterinary training; an
emphasis on food production (livestock, poultry, game meat and aquaculture); and
more concentration on stock and wild animals and the national herd than on
companion animals. Furthermore, a focus on primary animal health and on diseases at
the human-animal interface would complement the national focus on (human) primary
health care. However, it was also suggested that locating the new university's
veterinary faculty in a different location (or, alternatively, establishing the country's
second veterinary faculty at another institution), with a different climate, agriculture,
animals and disease patterns, might diversify training opportunities and promote
employment.
A clinical training model combining on- and off-campus veterinary sites was
envisaged, taking into account whether or not a new state-of-the-art animal hospital
would be built on the Medunsa campus, and for students to receive quality
supervision during off-campus practicals from university-employed or -approved vets
in public or private practice. Satellite training platforms, in partnership with other
universities, in negotiation with private vets and/or with the Department of
Agriculture, Forestry and Fisheries, could also be considered, with the proviso that
students needed exposure not only to small-scale practices but also to large-scale
veterinary hospitals.
The establishment of the new health and allied sciences university and its
incorporation of the Medunsa campus will clearly require additional or improved
infrastructure, equipment and technology if it is to be able to expand its
programmes and increase its enrolments. At the same time it is understood that there
are possibilities of better utilising existing infrastructure and space.
Among the various infrastructural and equipment elements envisaged or suggested
during discussions with stakeholders were:
•
•
an administration block, which would release space in other buildings and give
a higher profile to management;
additional student residences, with the aim of placing up to 100% of the
Medunsa campus' approximately 4 650 current students in on-campus
residences;
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•
•
•
•
•
•
•
•
•
•
•
•
a student centre, comprising a cafeteria, a meeting place, post office, bookshop,
banks, SRC offices, registration facilities, etc.;
one or more oral health Service Learning Centres (complete with a number of
dental chairs, ancillary equipment and staff), to be built in the surrounding
areas;
a multipurpose 'academic centre' (comprising large lecture halls, conference
and seminar rooms, and laboratories);
a Centre for Health Sciences Education, offering certificate and diploma
programmes in health education, and helping to raise the profile of scholarship
around teaching and learning;
an IT or computer centre;
a refurbished and extended library, more digitally oriented and providing
gathering, study, teaching and computer spaces;
a new academic hospital with a range of off-site teaching platforms, including
accommodation for students;
a campus health clinic, which could also provide psychology, counselling and
career guidance services;
an animal research centre;
an improved vehicle fleet, for transport to off-site platforms;
IT connectivity between the new university and its training platforms,
hospitals, veterinary facilities and student residences; and
computerised security systems.
Discussion also took place around a proposed centralised academic administration (to
promote uniform communication, rules and reporting), and the establishment of a
university International Office to facilitate the processing of increasing numbers of
international students and 5th year elective students, as well as returning students from
Cuba (the integration of whom might be facilitated by the offering of language
courses, such as Spanish).
Apart from the need to increase the staff complement in order to service the
envisaged expansion in student enrolments, stakeholders suggested that a thorough
human resources needs assessment should be undertaken to determine optimal
academic, clinical and support staff numbers and areas for staff capacity development.
There is also a need for long-term human resources planning (to retain staff, fill
longstanding vacant positions and/or counter any negative perceptions of current
changes), amid concerns about the pending retirements or expiring contracts of certain
senior staff or staff in key positions, as well as the contract status of certain clinical
staff posts connected to the MBChB programme.
Furthermore, efforts to train more mid-level workers in all health professional fields
need to be aligned with the ongoing development of staffing and post provisioning
norms for both the public and private health sectors, so as to ensure that sufficient
new posts are available to absorb increasing numbers of graduates. Another, future
challenge was to increase the capacity of existing institutions (particularly with regard
to the availability of clinical training spaces) to absorb students returning from
training in Cuba.
136
At the same time, neighbouring universities have expressed concern that their own
difficulties in attracting suitable and qualified staff might be exacerbated by the
establishment of the new institution, with one proposed solution being to provide
relevant employees with an Occupational Specific allowance, as in the public service,
to enhance attraction and retention strategies.
Staff and labour unions were assured that the incorporation of the Medunsa campus
into the new university will not interfere with staff functions or activities or
disadvantage staff in any way. On the date of the incorporation of the Medunsa
campus into the new university, all rights and obligations of the University of
Limpopo for the Medunsa campus will devolve upon the new university. This means
that on the date of incorporation all UL Medunsa campus staff are assured of
employment as per their existing contracts and will retain their existing conditions of
service and benefits, including their salaries. If, subsequent to the incorporation of the
Medunsa campus into the new university, the Council of the new university considers
it necessary for operational reasons to realign its staff complement, all processes in
relation to personnel restructuring must be within the parameters of the Labour
Relations Act.
Student concerns about the impact of the incorporation process on the academic
programmes in which they are currently enrolled were allayed by the assurance that
the transition to the new university will not disrupt their studies nor negatively affect
them in any way. In keeping with the requirements of the Standard Institutional
Statute (Government Gazette No. 23065, 27 March 2002), the Medunsa subdivision
of the University of Limpopo will continue to offer all existing programmes under
their existing rules until such time as the subdivision has been incorporated into the
new health and allied sciences university and the Council of that university decides to
amend or restructure these programmes or rules. The same applies to existing training
platforms currently utilised by Medunsa campus students (such as the Dr George
Mukhari Hospital and others), which will continue to function and be available to
current students until such time as new arrangements are made by the new health and
allied sciences university. Students who are currently registered at UL (Medunsa
campus) but who complete their studies after the Medunsa campus has been
incorporated into the new health and allied sciences university will be awarded their
degree, diploma or certificate in the name of the new university, with that degree,
diploma or certificate also reflecting that the student was first registered at the
University of Limpopo.
Union concerns about issues such as salary scales, retirement age and pension funds,
and student concerns about issues such as fees and NSFAS financial aid, should
continue to be addressed by existing UL university mechanisms or structures such as
the Joint Bargaining Forum, until such time as the incorporation is complete.
In order to facilitate the incorporation of the Medunsa campus into the new university,
a number of transitional arrangements have been suggested, including the
preparation of a protocol for engagement or memorandum of agreement between, on
the one hand, the Council of the University of Limpopo and, on the other hand, the
Interim Council of the new health and allied sciences university which will oversee
the incorporation process.
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The actual details of the delinking and incorporation process, including determining
which academic programmes (both undergraduate and postgraduate) and which staff
are associated with which campus, are to be worked out by Joint Specialised Teams
(JSTs) with clear Terms of Reference and comprising members of both the Turfloop
and Medunsa campuses. Six JSTs are currently envisaged, to be responsible for the
academic project (including programmes, administration, libraries and research), ICT
(including ITS), finances, human resources, students and support structures. The JSTs
will conduct due diligence studies wherever needed, including but not only in relation
to financial systems, budgeting, trusts, foreign donor funding, research grant monies,
the DHET Clinical Training Grant, clinical training platforms, ICT and ITS, subsidies,
human resources, pensions, library systems, student records, licences, Oracle, fixed
asset registers, outstanding debts, defined benefits funds, property, land and mining
rights.
With specific reference to these last two items, according to information supplied to
the JTT by the Departments of Rural Development and Land Reform, and Mineral
Resources, respectively, there are land claims lodged on some of the property or
properties currently occupied by the Medunsa campus, which have not yet been
researched; and an application, by Platinum Group Metals (RSA) Pty Ltd, for renewal
of prospecting rights on the same or other properties currently occupied by the
Medunsa campus, is still in process.
Further discussion revolved around the need for the JSTs to focus not only on
delinking but also on operational issues such as registration and marketing, as well as
on overlapping issues to be addressed by other teams; and in some cases (eg. ICT/ITS)
additional costs would be entailed, such as for consultants and travel, or new staff
appointments, and such costs needed to be clarified. In some instances there may be a
need to train staff involved in the JSTs or who are otherwise involved in delinking and
taking over systems. Continuous oversight and good institutional governance more
generally are essential both during and after the incorporation process.
It is generally agreed that the branding and marketing of the new university is an
urgent priority, with student applications for admission in 2015 needing to be invited
and processed early in 2014. This in turn requires the finalisation of the name of the
new institution. Some current students and staff have proposed giving the new
university the same name as the site where it will be located, namely 'Medunsa', while
other stakeholders have suggested that the name of the new institution should both
build on the rich history of this campus and go beyond it, so as to reflect a new, 21st
century institution which is no longer only a medical university but a comprehensive,
integrated and more encompassing health and allied sciences university which
includes a range of human and veterinary health-related companion programmes.
Some stakeholders have called for a moratorium on new staff appointments (such as
senior management positions, or external non-academic positions) until the
incorporation is complete; a contrary view expressed, however, is that certain key
additional support, academic and management staff (for example, a Director of ICT),
particularly such as may be needed to facilitate the delinking and incorporation
process, ought to be appointed, if deemed necessary, by the Interim Council.
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Appendix Z: Draft Protocol for Engagement
Draft Protocol for Engagement with respect to the Incorporation of the Medunsa
subdivision of the University of Limpopo into the New Health and Allied
Sciences University
1. Preamble
The Minister of Higher Education and Training announced in May 2013 (Government
Gazette No. 36492) his intention to establish a new health and allied sciences
university, and to incorporate the Medunsa subdivision of the University of Limpopo
into this new institution.
The establishment of a new health and allied sciences university incorporating the
Medunsa campus falls within the ambit of the following legislation: the Higher
Education Act (Act No. 101 of 1997), the Promotion of Administrative Justice Act
(Act No. 3 of 2000), the National Health Act (Act No. 61 of 2003) and the Standard
Institutional Statute (Government Gazette No. 23065, 27 March 2002).
The Protocol of Engagement aims to provide a framework that will facilitate the
university, with the Department of Higher Education and Training acting as facilitator
and overseer.
2. Declaration of Intent
The parties to this Protocol declare their unequivocal intent to fully cooperate in an
open, transparent and collegial manner to give effect to the joint decision of the
Minister of Higher Education and Training and the Minister of Health to incorporate
the Medunsa subdivision of the University of Limpopo into the new health and allied
sciences university.
3. Parties to the Protocol
The parties to this Protocol consist of the Council of the University of Limpopo,
represented by its Chairperson, and the Interim Council of the new health and allied
sciences university, represented by its Chairperson.
The Department of Higher Education and Training, which is overseeing and
facilitating the process of incorporating the Medunsa campus into the new health and
allied sciences university, is represented by its Deputy Director General, responsible
for universities, duly authorised to do so.
4. Purpose and Scope of Engagement
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The purpose of the Protocol is to facilitate cooperation between the current parent
institution, namely the University of Limpopo, its subdivision, namely the Medunsa
campus, and the future parent institution, namely the new health and allied sciences
university, in the period leading up to the date of the incorporation of the Medunsa
campus into the new health and allied sciences university.
The Protocol seeks to provide a framework for effective communication, interaction,
planning, preparation, implementation and mutual support between the parties during
the transitional period in which the Medunsa campus is being separated, de-linked and
unbundled from the University of Limpopo and being joined, linked and incorporated
into the new health and allied sciences university, leading up to the date of
incorporation; and to ensure that operational decisions by any of the parties in this
period do not adversely impact on the operational and organisational integrity of
either the parent institution, the subdivision or the new health and allied sciences
university.
The scope of engagement is aimed at facilitating the incorporation of the Medunsa
campus into the new health and allied sciences university. More specifically, the
scope of engagement includes:
•
•
•
•
•
•
•
•
facilitating the formation of Joint Specialised Teams to carry out defined
planning tasks necessary for the separation and incorporation process;
undertaking an audit or due diligence of all physical, academic, financial,
human resources, ICT, library and support structures and activities on or
pertaining to the Medunsa campus;
facilitating the land transfer process;
ensuring the availability of adequate administrative, academic, staff and
residential space;
identifying and separating academic resources in such a way as to ensure
that all parties and related institutions are able to begin and/or continue to
function effectively;
sharing academic resources between the current parent institution and its
Medunsa subdivision until such time as the formal incorporation of that
subdivision into the new university;
honouring all existing commitments and agreements with partners; and
supporting the institutional establishment of the new university.
5. Guiding Principles
The parties to this Protocol affirm their commitment to the spirit of the Constitution of
the Republic of South Africa.
The parties to this Protocol commit themselves to the following principles to guide,
facilitate and enable the process by and through which the Medunsa campus is
separated from the University of Limpopo and incorporated into the new health and
allied sciences university:
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a) Full disclosure of information: All material information relevant to facilitate
the process of separation and incorporation will be fully, transparently,
proactively and timeously disclosed.
b) Full participation: The full participation of all institutional constituencies and
stakeholders will inform and underpin the separation and incorporation
process.
c) Mutual benefit: The parties will act in accordance with good faith and trust in
order to ensure that decisions and actions taken result in the advancement of
the mandates and goals of all the parties.
d) Coordinated action: The parties will ensure that their plans and actions are
synchronised and integrated with a view to achieving their shared objectives.
6. Areas of Cooperation and Joint Decision-Making
The parties agree that, at a minimum, cooperation and joint decision-making should
cover the following matters:
6.1 Asset Transfer
The parties will undertake all the required steps to ensure the expeditious transfer of
all physical and other assets (including but not necessarily limited to all land, property,
plant, buildings, equipment, endowments and trusts as well as intellectual property
such as royalties and patents) pertaining to the current Medunsa subdivision to the
new health and allied sciences university.
6.2 Staff
6.2.1 The parties will undertake an audit of all human resources currently at or
available to the current Medunsa subdivision, including the distribution of such staff,
their levels of appointment, qualifications, age, gender and race, and their terms of
employment, conditions of service and benefit structures.
6.2.2 The parties agree to a moratorium on all staff appointments pertaining to the
current Medunsa subdivision prior to the date of the incorporation, except
appointments to management positions essential to the operation of the campus or
appointments to essential but vacant existing posts, in both of which cases the parties
must agree on the need for such appointments and the interim management of the new
university must participate in all processes and decision-making pertaining to such
appointments so as to ensure continuity of academic activities and services to students.
6.2.3 The parties agree to a moratorium on all staff promotions pertaining to the
current Medunsa subdivision prior to the date of the incorporation, unless there is
prior agreement as approved by the Council of the University of Limpopo and that
such promotions are necessary for operational purposes, in which case the promotions
must be determined jointly.
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6.2.4 The parties agree to a moratorium on all out-of-cycle staff remuneration
adjustments and/or increases pertaining to the current Medunsa subdivision, and agree
that all normal annual remuneration adjustments and/or increases will be subject to
prior agreement between the parties.
6.3 Renewal of Contracts
The parties agree that in relation to the current Medunsa subdivision there will be no
renewal of any existing purchase or service contracts and no new purchase or service
contracts must be entered into, without prior agreement between the parties. In cases
where there is agreement that a new or renewed purchase or service contract is
necessary for operational purposes, the period of the contract will be determined
jointly by the parties. In all cases the parties shall ensure that the everyday functioning
and operations of the current Medunsa subdivision are sustained and not negatively
affected.
6.4 Capital Expenditure
All existing capital projects and expenditure affecting the Medunsa subdivision and
the establishment of the new health and allied sciences university must be jointly
monitored and approved by the parties and, where applicable, approved by the
Minister of Higher Education and Training.
All new capital projects and expenditure affecting the Medunsa subdivision and the
establishment of the new health and allied sciences university must be decided upon
and approved by the Interim Council and interim management of the new health and
allied sciences university and, where applicable, approved by the Minister of Higher
Education and Training.
6.5 Communication
The parties agree to establish transparent processes for effective communication to
ensure that all institutional constituencies and stakeholders are fully and regularly
appraised of all progress, processes and investigations related to the incorporation.
6.6 Operational Functionality
The parties agree, in the interests of ensuring that the new health and allied sciences
university is operationally functional on the proclaimed date of its incorporation of the
Medunsa campus, to permit and assist preparatory work to be overseen by the Interim
Council of the new health and allied sciences university, and intended to facilitate the
incorporation process, including:
a) an audit of all existing Medunsa campus and joint Medunsa/Turfloop
campuses academic programmes, structures, staff, students and facilities, as
well as of quality assurance systems;
b) an audit of all Medunsa campus student support systems and services,
including student governance structures, financial aid, student academic
administration, international office, accommodation, catering, discipline,
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health, special needs, recreation, support and counselling, admissions and
registration, calendar and fees;
c) an audit of all Medunsa campus human resources, including staff distribution,
levels of appointment, qualifications, age, gender, race, terms of employment,
conditions of service and benefit structures;
d) an audit of the current financial situation of the Medunsa campus, including its
financial obligations, assets and risk profiles (i.e., a due diligence study), and
all current financial management and administrative systems, policies and
procedures;
e) the development of an institutional operating plan, and the introduction of a
uniform resource allocation and budget process;
f) an audit of the existing Medunsa campus ICT landscape, from infrastructure,
systems, hardware, software, data migration and administrative systems,
through teaching support and desktop and laptop equipment, to services and
licensing and procurement contracts; and at the same time making provision
for reporting on historical information (i.e., for providing academic transcripts
of students of the former institution); and
g) an audit of all Medunsa campus library and information services, including
management, human resources, policies and procedures, client services,
technical services, collections, space, model (centralised or decentralised),
information technology, and budgets, costs and cost implications.
6.7 Transitional Academic Arrangements
The parties acknowledge that, in keeping with the requirements of the Standard
Institutional Statute (Government Gazette No. 23065, 27 March 2002), the
subdivision being incorporated, namely the Medunsa campus, must continue to offer
all existing programmes under their existing rules until the programmes and rules are
amended or restructured by the Council of the new health and allied sciences
university.
Moreover, the University of Limpopo, as the entity currently legally responsible for
the Medunsa campus, must continue to provide all resources and support necessary to
the academic enterprise on that campus to the same degree and in the same manner up
until the date of incorporation.
In similar vein, the parties agree that existing training platforms utilised by Medunsa
campus students (such as the Dr George Mukhari Hospital and others) must continue
to function and be available to pipeline students until such time as these platforms are
no longer needed or new arrangements are made by the new health and allied sciences
university.
6.8 Facilitation of the Incorporation Process
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The parties agree that a steering committee will be established by the parties to this
Protocol to give effect to this Protocol. The steering committee will consist of an
equal number of representatives from the parties to this Protocol, as well as
representatives from the Department of Higher Education and Training.
The parties agree that the steering committee, which by giving effect to this Protocol
is intended to facilitate the incorporation of the Medunsa campus into the new health
and allied sciences university, will at all times assist and support the Interim Council
which will be appointed by the Minister to be responsible for and oversee the
incorporation process. As prescribed by the Higher Education Act (Act No. 101 of
1997) and the Standard Institutional Statute (Government Gazette No. 23065, 27
March 2002), the Interim Council will, among other things, establish an incorporation
office, develop an overall incorporation plan, and take forward (and, where possible,
conclude) any preparatory work intended to facilitate the incorporation process and
already begun by the steering committee established in terms of this Protocol.
Suitable office space on the Medunsa campus shall be made available to the Interim
Council.
The Department of Higher Education and Training will continue to provide support
and oversight until such time as the incorporation is effective.
6.9 Conflict Resolution
In the event of any conflict between the steering committee giving effect to this
Protocol, and the Interim Council of the new health and allied sciences university
overseeing the incorporation process, the optimisation of the functions and operations
of the new health and allied sciences university and its incorporation of the Medunsa
campus shall take priority, in the interests of maintaining continuity of academic
activities and services to students.
The Department of Higher Education and Training will be available to act as a
facilitator at all times.
Any conflict arising which cannot be resolved amicably between the steering
committee and the Interim Council shall be referred to the Minister of Higher
Education and Training, or a facilitator nominated by him, for full and final resolution.
7. Duration of the Protocol
This Protocol for Engagement will come into effect on the date of last signature of the
parties and will remain in effect until the date on which the incorporation of the
Medunsa subdivision into the new health and allied sciences university is effective.
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Appendix AA: Joint Specialised Teams: Terms of Reference
JOINT SPECIALISED TEAMS: TERMS OF REFERENCE
Introduction
In keeping with its mandate from the Minister of Higher Education and Training to
determine transitional arrangements with regard to facilitating the establishment of a
new health and allied sciences university and its incorporation of the Medunsa
subdivision of the University of Limpopo, and on the basis of its consultations with
and submissions from all internal and external stakeholders, the Joint Technical Team
(JTT) has identified the need for the establishment of six (6) Joint Specialised Teams
(JSTs) to, among other things, conduct audits of all academic programmes, human
resources, finances, ICT and student and support structures, undertake SWOT
analyses, determine priorities and develop action plans, so as to facilitate the
separation and incorporation process.
The 6 Joint Specialised Teams are as follows:
A. JST: Academic Project (including academic programmes, clinical training
platforms, accreditation, quality assurance, academic administration, admissions,
registration, examinations, student records, libraries, research and academic
support/development).
B. JST: ICT (including ITS).
C. JST: Finances (including financial systems, budgeting, trusts, donor funding,
research grant monies, grants, subsidies, pensions and licences).
D. JST: Human Resources (including marketing, communication and branding).
E. JST: Students (including student governance, financial aid, orientation, catering,
sport, health and residences).
F. JST: Support Structures (including security, grounds, facilities, transport and
cleaning).
Each JST will consist of an equal number of representatives from the UL Turfloop
and UL Medunsa campuses. These representatives will be appointed by the campus
management of each campus. The 6 campus-specific representatives of each JST must
include 1 union member and 1 student representative from that campus. Where
appropriate, UL Turfloop campus management may appoint representatives from the
UL Polokwane campus in the place of representatives from the UL Turfloop campus.
The JSTs will report to the Steering Committee established in terms of the Protocol
for Engagement entered into by the Council of the University of Limpopo,
represented by its Chairperson, and the Interim Council of the new health and allied
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sciences university, represented by its Chairperson, and intended to provide a
framework to facilitate the incorporation of the Medunsa campus into the new health
and allied sciences university.
Once established, the JSTs will continue to meet and work as outlined below until
such time as the Steering Committee, in consultation with the JST Team Leaders,
determines that their work is complete.
A fund shall be set aside under the auspices of the Department of Higher Education
and Training to cover all reasonable expenses incurred by JSTs or their members with
regard to secretarial support, travel to JST meetings and/or technical or professional
support.
1. Rationale for the separation and incorporation process
The rationale for the separation of the Medunsa campus from the University of
Limpopo and its incorporation into the new health and allied sciences university
should always inform and steer the discussions and work of the JSTs.
The rationale is to establish a new stand-alone, comprehensive, academically and
financially viable health and allied sciences university incorporating the Medunsa
campus. This new university is expected to offer an extensive and diversified range of
health professional programmes and qualifications, taking into account both the wide
array of health professionals required for a vibrant national health sector and the need
to increase the availability of health care and health care training especially for the
country's underserved, under-resourced and rural communities.
The JSTs should also conduct their discussions and work in awareness of the need for
both the new university and the University of Limpopo to begin and/or continue to:
•
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•
•
•
•
•
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Establish themselves as unique and leading brands in South African higher
education;
Produce quality graduates with skills and competencies relevant to the socioeconomic development of the country;
Maintain high standards of teaching, learning, research and development;
Serve their local communities as well as the nation through active involvement
in the upliftment and empowerment of the population;
Ensure increased and equitable access to higher education;
Strive for an enhanced throughput of students, without sacrificing quality;
Ensure the stability of the academic project and the quality of delivery on all
campuses without interruption during the separation and incorporation process;
and
Honour all existing commitments and agreements with partners.
2. Appointment of the JSTs
For each of the 6 JSTs, UL Turfloop campus management and UL Medunsa campus
management will each identify 6 specialist members of staff from their campuses,
making a total of 36 JST members (including the union and student members)
appointed from each campus.
146
Each campus management will identify one of each of their 6 appointees as a Team
Leader, whose name will be forwarded, for recording purposes, to the Steering
Committee referred to in the Introduction to this document. It is of the utmost
importance that those members appointed as Team Leaders have both the relevant
expertise and can make dedicated time available for their team leader duties.
The two JST Team Leaders (one each having been appointed by each campus
management) will jointly call the first JST meeting within one week of their
appointment as Team Leaders, utilizing secretarial support provided by the Medunsa
campus. The first JST meeting will take place on the Medunsa campus and be chaired
by the Medunsa-appointed Team Leader, the second meeting will take place on the
Turfloop campus and be chaired by the Turfloop-appointed Team Leader, and so on
in rotation.
This document, 'Joint Specialised Teams: Terms of Reference', as approved by the
JTT, will serve as the general guide for all JSTs.
3. Composition of the JSTs
Membership of the respective JST’s will be restricted to staff members and students
with relevant expertise in the identified areas.
Each JST will consist of 12 members (6 each being appointed by each campus
management), including union and student representatives.
Each JST may, subject to the prior approval of the Steering Committee, coopt
additional members with skills and expertise requisite to specific tasks, depending on
the volume and complexity of the work.
The new health and allied sciences university will provide secretarial support for all
JSTs.
4. Purpose and tasks of the JSTs
Each JST should develop an action plan for all matters that fall within its identified
area, in accordance with the overall aim of facilitating the separation of the Medunsa
campus from the University of Limpopo and incorporating it into the new health and
allied sciences university.
In the process of developing an action plan, each JST should seek to identify and
separate academic resources in such a way as to ensure that both the University of
Limpopo, the Medunsa campus and the new university are able to begin and/or
continue to function effectively, wherever possible ensuring that operational decisions
by any party do not adversely impact on the operational and organisational integrity of
either the University of Limpopo, the Medunsa campus or the new university.
The following will be the tasks of each JST:
147
1. conduct an audit or due diligence of all matters and activities within its
identified area and which pertain in particular to the Medunsa campus, as
outlined in the Department of Education (now Department of Higher
Education) document, Higher Education Restructuring and Transformation:
Guidelines for Mergers and Incorporations (April 2003);
2. conduct a SWOT analysis;
3. identify any areas of overlap or interrelatedness with other JSTs;
4. determine the point of departure in each area;
5. identify priority issues in each area;
6. determine areas where sub-teams need to be established, determine the terms
of reference for such teams, and set them to work;
7. determine cost implications in each area;
8. investigate possible organizational structures and human resource implications
applicable to each area;
9. identify possible legal implications;
10. develop an action plan for actions identified;
11. determine the separation and incorporation processes in the relevant area and
link them to the necessary benchmarks; and
12. submit its action plan and final recommendations in writing to the Steering
Committee within the timeframe agreed.
5. Reports and reporting lines for the JSTs
The JSTs, via their two Team Leaders, will report once a month in writing to the
Steering Committee, briefly indicating progress, difficulties, overlaps and targets.
Each JST must submit a first report in the form of an action plan to the Steering
Committee by the end of February 2014.
Thereafter, each JST must submit a monthly progress report on activities and
achievements to the Steering Committee.
Each JST must submit its final recommendations to the Steering Committee by the
end of August 2014, for consideration during the latter's September meeting.
Ideally, team consensus should be reached on a JSTs action plan and final
recommendations before it is submitted to the Steering Committee. If there are
disagreements, these should be attached as a sub-report. The Steering Committee will
be the final arbiter in all disputes.
The two JST Team Leaders will jointly present their Team's final recommendations to
the Steering Committee.
6. JST work procedures
JSTs are to meet regularly once a month for the duration of their existence, chaired in
rotation by the Team Leaders. At its first meeting, each JST will determine its plan of
action.
148
All meetings must be structured in terms of a written agenda determined and
disseminated in advance by the two Team Leaders, and minutes must be taken at each
meeting. Agendas and minutes must be forwarded to the Steering Committee within
one week following each meeting, for record keeping and monitoring of progress.
Members of the Steering Committee may attend any meeting of a JST.
149

A New Health Sciences University incorporating Medunsa

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