Dr Cleeve Robertson, previous director of Emergency Medical Services (EMS).

I came to Hout Bay in 1988 and spent the next 25 years chasing emergencies in Hout Bay.

In 1988, there was no Imizamo Yethu, and Hangberg was a small fishing village.

The rest of Hout Bay was very rural with many small holdings and low-density housing.

That all changed, and Hout Bay has been massively transformed.

We all know that there are many upstream factors that influence health, and that if they are not dealt with health structures have to deal with the consequences. This is the case in Hout Bay where massive informal development and housing creates health-related issues, crime, violence, rape, HIV, TB, the list goes on.

That's not saying that proper housing and infrastructure should not be built; it must be built, and in 30 years, our government has not made good progress.

There is no substantial health structure in Hout Bay, not even a 24/7 ambulance service, meaning that residents have to self-refer or wait hours for services.

A priority-one ambulance response-time performance of 20% within 15-minutes for the provincial ambulance service underlines the problem.

The solution is a district hospital in Hout Bay.

The history to community health centres is that Dr Alan Mac Mahon, recognising the immediate lack of health facilities on the Cape Flats created CHCs as a “temporary” measure before hospitals could be built.

They became permanent, overcrowded facilities with long queues and poor service.

They were never supposed to perform these functions.

This coupled with the removal of district surgeon contracts post 1995 (ANC health policy), which effectively removed GPs from the public health system, created massive strain on the system.

It's time to fix the past.

Hout Bay needs a hospital and it could easily be augmented by contracts for health professionals living in the community, using existing private practitioners to staff the facility part-time and ensure 24/7 services.

Here's a National Health Insurance (NHI) opportunity. We could make it a community project.