Business unusual for SA's healthcare system

Friday, July 6, 2012

Johannesburg - Role players in both the private and public sectors need to change the way they conduct their business if the country is to efficiently meet the healthcare needs of all South Africans.

Addressing the South African Medical Association (SAMA) conference on Thursday, Health Minister Dr Aaron Motsoaledi said both the private and public healthcare sectors needed an overhaul in order to effectively respond to the healthcare challenges present in the country.

He conceded that the public sector needed drastic change, which government was trying to do through the implementation of the National Health Insurance (NHI).

For the private sector, Motsoaledi told delegates at the conference of the biggest doctors' organisation, measures had to be put in place to deal with the high costs, which he labelled as "uncontrolled commercialism".

The 2010 medical scheme expenditure showed that the total spent was R84.7 billion, with R31.1 billion being spent on hospitals (R30.8 billion on private and R281 million on public hospitals); R19 billion on specialists; R6.2 billion on general practitioners; R2.5 billion on dentists, R6.7 billion on allied services and R11.6 billion on total non-health care.

Motsoaledi said it was for this reason that his department was planning on introducing a pricing commission that would regulate pricing in the private health sector.

These figures, he said, undermined the basic principles of healthcare. Motsoaledi said the situation in the entire healthcare system had to be rectified in order for NHI to exist successfully.

"We cannot continue to have a healthcare system where only a few have access to proper healthcare... We cannot be controlled by commercialism," Motsoaledi said.

The minister added that the country needed a universal healthcare system if it wanted to address the challenges faced by the country, which he said included infrastructure; human resources; improved life expectancy of South Africans; reduced child/maternal mortality; addressing the scourge of HIV and Aids, while improving efficiency in the healthcare system.

Some basics to address these challenges, he said, were already underway through the piloting of the NHI. They were training personnel with the view of making them inspectors.

Others include the accreditation of hospitals for piloting the NHI, which Motsoaledi was visiting across the country, while there were plans to establish an ombudsman that would act as a "public protector", where people can report misconduct in the health sector.

The minister also mentioned that there were plans to tackle infrastructure underspending in the department by refurbishing several hospitals in the country, and increasing the number of doctors produced to about 2 600 per annum. Already, Motsoaledi said, the department would be sending 1 000 matrics to study medicine in Cuba.

Other plans included a policy where all learners coming to school for the first time will do eye, ear and oral hygiene tests followed by vaccinations through the School Health Programme.

The department was also planning to bring the issue of reproductive health under the spotlight to deal with the problem of teenage pregnancy. The number of pregnant learners in schools jumped to 95 000 last year alone.

"About 750 000 pregnancies were reported in public hospitals back in 2007/08, with some girls having abortions three times within a period of six months. Family planning has disappeared and the only thing left is abortion," Motsoaledi said, stressing that this had to change.

The plan would also deal with alcohol and drug abuse in schools, he said, mentioning that they had already started with piloting these programmes.
Acting chairman of SAMA, Mark Sonderup, admitted that the success of NHI would need commitment from all parties. He said several issues would need to be ironed out first, including attracting back the large number of doctors who left the country; and the lack of equipment and infrastructure, if NHI is to be a success.

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