Caldwell R I, Aldous C
School of Clinical Medicine, Department of Internal Medicine, College of Health Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
S Afr Med J. 2016 Dec 21;107(1):39-40. doi: 10.7196/SAMJ.2016.v107.i1.12008.
According to the Constitution of South Africa (SA), citizens living in remote areas are entitled to the same level of healthcare as those with access to tertiary hospitals. Specialist outreach has been shown to achieve this. When SA's National Health Services Commission convened (1942 - 1944), Gluckman summarised: 'Where the need is greatest the supply of hospitals is least.' Primary healthcare (PHC) characterised the Kark's Pholela Health Centre and was highly regarded. Although PHC underpins National Health Insurance (NHI) planning, both preventive and curative healthcare are needed. The KwaZulu-Natal (KZN) provincial Department of Health and the University of KZN College of Health Sciences' 5-year plan for a decentralised clinical teaching platform (DCTP) is ambitious, requiring optimum co-operation between health department and university. Reservations can be addressed through sustained specialist outreach. Above all, the patient mustbe the chief beneficiary. The NHI and DCTP overlap with specialist outreach, but cannot do without it.
根据南非宪法，生活在偏远地区的公民有权享有与那些能够前往三级医院就医的公民同等水平的医疗保健服务。专科医生外展服务已被证明能够实现这一点。1942年至1944年南非国家卫生服务委员会召开会议时，格鲁克曼总结道：“需求最大的地方，医院供应最少。” 卡尔克的福莱拉健康中心以初级卫生保健为特色，备受赞誉。虽然初级卫生保健是国家医疗保险规划的基础，但预防性和治疗性医疗保健都不可或缺。夸祖鲁-纳塔尔省卫生部和夸祖鲁-纳塔尔大学健康科学学院关于建立一个去中心化临床教学平台（DCTP）的五年计划雄心勃勃，这需要卫生部门和大学之间的最佳合作。可以通过持续的专科医生外展服务来解决相关问题。最重要的是，患者必须是主要受益者。国家医疗保险和去中心化临床教学平台与专科医生外展服务相互重叠，但离不开它。
