Departmental academic review

REFLECTION

The PHCD has been in existence for 10 years and needs to be reviewed in the light of changes in its composition and functions since its inception, as well as the changing context of the Faculty of Health Sciences, the University of Cape Town, the province and the country. The extent to which the original goals of the PHCD have been achieved, needs to be assessed, and the goals themselves reviewed.

Through the leadership of 3 directors and an acting director over the period of 10 years, many changes have taken place. Primary Health Care is not a cognate discipline in itself, but requires a complex interdisciplinary and intersectoral approach, so the PHCD has to work through other departments in order to achieve its goals. As the mission of the PHCD suggests, most of these are achieved through education and social responsiveness, although academic research in the field is now also increasingly being produced.
The structure of the PHCD as a cross-faculty unit under the Dean’s office is both an advantage and a disadvantage. The advantages include the ability of the unit to interact at an equal level but not competitively with the whole range of departments in the faculty, and to take responsibility for cross-cutting issues that are not otherwise taken up and implemented. The disadvantages include the inability of the Directorate to run postgraduate programmes or register PhD students independently, which means that the unit cannot develop its own funding streams but must rely on faculty funds.
The relationship of the PHCD with the Department of Public Health and Family Medicine is a close one, starting from the situation of being part of the Department prior to 2003. The division of responsibility for the MBChB 4^th year block into public health and health promotion course codes, creates a conceptual separation of the discipline of Public Health from the PHC approach that is somewhat contrived. From an undergraduate teaching perspective, this separation can cause confusion. However the insertion of the PHC approach into the teaching of other disciplines such as internal medicine or paediatrics is clearer.