Optiklin Eye Hospital
Leading up to a dream that came true:-
I had a yearning, to be able to do eye surgery in South Africa in a dedicated eye ambulatory surgery clinic.
This was in the early 1980’s. South Africa was in many aspects a very different country at that stage ……. hospital and medically.
In those days Ophthalmologists were beginning to do eye surgery in the USA in private free standing ambulatory surgery clinics, unattached and unaffiliated to general hospitals, ….. and under local anaesthetic.
Over here the provincial and government hospitals were the only options available. We had to share the same operating rooms with other disciplines of surgery, which often overran the scheduled times and the operating rooms then still had to be specially cleaned before any eye operations could be done. All operations were done under general anaesthetic. Patients then had to go to a recovery room and stayed in hospital for at least 2 days. Understandably there were long waiting lists as well as surgery backlogs.
It would be so great to have operating rooms that are dedicated for eye surgery, always clean and no operation backlogs or cancellations as a result of other surgeons because of their delays and emergencies. And, just as important to be able to immediately buy any instruments that we needed for surgery, without writing a motivation and waiting many months for approval ….. if the next budget would allow that.
Hurdles in the way:-
Private hospitals were frowned upon by the government. They were just opening up to the idea that day clinics and large general hospitals could be privately owned under certain conditions. Ambulatory surgery under local anesthesia was totally unheard of and the hospital classifications and regulations for such clinics did not exist. To make use of lazy boy chairs in the pre- and post-op areas rather than beds ,was regarded as heresy.
We had to pay for an American hospital consultant group Ann Dean Associates to fly over here with flow diagrams and plans of ambulatory surgery clinics in the USA to help convince the authorities in South Africa to make new rules so that we could get our ambulatory surgical clinic.
Where I did my operations:-
Boksburg Benoni Hospital (now the Tambo Memorial Hospital) was my main surgical hospital of choice. This was a great hospital with a very high standard of patient care and many well known doctors and nurses had their careers forged in this hospital. However the operating time available for eye surgery was very limited. Therefore, I did all my eye surgeries that did not need general anaesthetics in a day clinic which I shared with some dental surgeons and GP’s.
On my own I could not make the building and running of a dedicated eye clinic financially feasible. After Dr Chris du Toit settled in Kempton Park it became an option worth considering. We might just break even.When Dr. Wayne Crewe-Brown started in Springs we decided to give it a go. That was in 1989 and we started building in 1990.
Problems / Hitches:-
As all 3 of us were in solo “opposition” practices in neighbouring towns, we decided not to have consulting rooms in our clinic, only operating rooms and ward beds, because wherever we build the clinic it would be unfair towards the other 2 surgeons in the neighboring towns. The 2 main choices we had was either Benoni or Boksburg, since both bordered on the N12 freeway, was easily accessible and near the airport.
South Africa at that stage had many restrictive racial laws, which was a problem since we insisted that this clinic must be open for all races on an absolute equal basis. Boksburg was prepared to give us such an undertaking in writing, but the Benoni municipality was not. The 2 best most suitable properties we found were in Jetpark, Boksburg and Lakefield, Benoni. Problem with the Boksburg property was that it was in an industrial area with difficult access roads. The Benoni property was classified as agricultural holdings and the best option but we had to convince the municipality to drop the racial issue. In the end we managed to rezone this specific area in Benoni from agricultural to special commercial and then our property was again rezoned to one with hospital rights with no racial restrictions.
There were also many frustrating and laughable situations such as that whites and blacks were not allowed to use the same toilets and change rooms. This would have meant that half of the space our building was going to be, would be taken up by toilets. You do the math …
Endless hours were spent in meetings to convince the department of health to allow the ambulatory surgical clinic since there were no regulations or specifications for such a class of hospital or clinic. The government regulations for hospitals as well as those of the medical insurance companies and nursing were rewritten to accommodate us.
South Africa was also still under international sanctions because of apartheid. This made it extremely difficult to import many of the specialised equipment that we needed. Because of the time difference overseas communications were more difficult and most deals had to be made by telex. It was a great improvement when the telex machines started to print letters out in stead of the tape strips with holes in them. Then came fax machines, wow, that was wonderful … you pushed a letter in on your machine and it miraculously appeared elsewhere in the world. All these modernisations took place while we were building our new hospital.
My wife Esme, who is a Quantity Surveyor and who had her own private practice at that stage was indispensable and crucial to the success of our project. She was the project manager and kept our building expenses under a very tight reign. At this stage she had already visited and had a comprehensive knowledge of the layout, flow and functioning of ambulatory clinics in the USA. After Optiklin she was involved in the planning and construction of quite a number of Ambulatory Eye Hospitals around the country.
So, in 1990 we were ready to go, all regulations, plans were in place and approved, finance was in place and the builder on site. But, just as the digging of our foundations were done, our financing bank decided to withdraw our finance because they suddenly decided that our clinic won’t be financially feasible. We (the architect) now had to make the building much smaller and get the new plans approved all over by the municipalities and health departments while the construction company was on site and penalties were our immediate destiny. But we pulled through.
The very competent head scrub nurse (sister) at the day clinic where I worked at that stage Sr. Nellie Koen became the head of our nursing staff (matron) at the new Optiklin Eye Hospital. Along with her came Sr. Helen Stockton as well as most of the staff of the day clinic and Sr Tersia Minnaar who was the main scrub nurse (sister) for dr. Chris du Toit at the hospital where he worked up until that time in Kempton park.
The day we were all waiting for had arrived! Dr. Rina Venter the minister of health, did the opening ceremony on 5 August 1991. It was a great success and we were on our way !
Centre of excellence:-
Shortly after opening we took delivery of our Nidek Excimer laser. We did groundbreaking work in the field of refractive surgery and our work was well recognised in the UK, USA and Canada. In 1994 our head of nursing Sr. Nellie Koen visited most of the main high volume Ambulatory surgical centres in the USA and Canada. Here she was able to see first hand in real time how the nursing staff handled the daily high surgical volumes. With her help and knowledge we were able to become much more streamlined and time efficient, ….. the best in the country. We were visited by many renowned international surgeons from the USA, UK, Japan and Europe.
A group of doctors in Boksburg built the Sunward Park general hospital in Boksburg. Together with them and eight other hospitals on we formed the Excel Hospital group in the late 1990’s. The largest hospital group in the country that was listed on the stock exchange was Clinical Holdings, which was taken over in 1997 by the much smaller Netcare group, (an interesting story on it’s own, for another day) Netcare was on an acquisition spree and bought our Excel group of 10 hospitals in 1998. Optiklin still belongs to Netcare.