Prior to the election of a democratic government, hospital planning in South Africa was managed using the SA Hospital Norms (SAHNORM) under a rigid system strictly controlled by the Treasury Committee Area Norms and Cost limits. The system had inherent shortcomings, coarsely aggregating area irrespective of function or application and pooled the project funding to secure a simplistic single bottom line.
The Publication of the Public Finance Management Act repealed the Exchequer Act and consequently, the SAHNORM and its management structure. Without a similar subsequent system or structure to manage health infrastructure planning, a haphazard methodology of managing health facility norms and standards came about. The cost of building health facilities increased dramatically and inequity of applied standards stifled the efforts of health planners to provide equitable access to health care.
This paper proposes a methodology to provide a new system of area standards, driven by clinical needs, in order to give guidance to health planners, give a baseline for cost comparisons and a method of judging value for money in a given health facility design. The proposed area standards framework provides a benchmark for sizing clinical areas according to their function and level of care, and to provide allowances for their essential support services. This will provide a new basis against which any new facility can be measured. Managing area is a proven manner of positively influencing capital cost, be thereby reducing capital requirements while retaining maximum clinical service output.
“More clarity for less costly confusion”.
