Govt prepares facilities ahead of NHI implementation

Thursday, August 11, 2011
Gabi Khumalo

Pretoria - As the implementation of the National Health Insurance (NHI) gets closer, the Department of Health is pulling out all the stops to ensure that most health facilities reach 100 percent compliance by 2012.

Health Minister, Dr Aaron Motsoaledi, announced this morning that the department was currently conducting an audit of all 4 200 public health facilities in the country, with 800 facilities already having been audited by July.

The Green Paper on the NHI will be released on Friday for public comment.

The NHI is expected to get rolling in April 2012 as a pilot for the next five years.

"The cornerstone of the proposed system of NHI is universal coverage. It is a financing system that will ensure the provision of essential healthcare to all citizens of South Africa, regardless of their employment status and ability to make a direct monetary contribution to the NHI fund," said Motsoaledi.

He reiterated that the NHI meant more than ploughing in a lot of money, but that it was important for the total restructuring and overhauling of the health system. He said for the system to function and become affordable for everyone, drastic changes were needed.

The department has set out standards for facilities to qualify for NHI. These include the availability of medicine and suppliers, cleanliness, improving patient safety, infection control and positive and caring attitudes of staff, as well as time spent by patients queuing when visiting the health facilities.

Motsoaledi explained that the audit, which ought to be completed by May 2012, measures vital and essential areas, where the facilities have to comply 100 percent in order to qualify for NHI.

Motsoaledi made the example that if all the toilets in a facility are found to be clean except for one, that facility would fail the test as cleanliness falls among the vital areas for compliance.

According to the preliminary results, some facilities are doing very well, even though they did not reach 100 percent compliance.

Audited facilities so far include the Free State University Hospital, which achieved 93 percent in availability of medicines and 71 percent in cleanliness. Dr George Mukhari Hospital, in the north of Pretoria, scored 54 percent in cleanliness and 76 percent in availability of medicines, with 89 percent in waiting time.

Motsoaledi said now that they have the results, a team would be sent to the facilities to help to ensure that they comply.

"We are hoping that with our help, some of the institutions will get there," said an optimistic Motsoaledi.

He explained that the first five years of NHI will include pilot studies and strengthening the health system in areas including management of health facilities and health districts; quality improvement; infrastructure development; medical devices, including equipment; human resources planning, development and management; information management and system support, as well as the establishment of a NHI fund.

He further emphasised that the NHI will not abolish private medical health schemes and private health care providers. Instead, government will work in cooperation with them. This will help in instances where hospitals are too far from the people. If there is a private doctor operating around the area, the department will sign a contract with the practitioner to administer NHI so primary health care can be provided to those in need.

Motsoaledi, who also spoke at a post Cabinet briefing today, reiterated that NHI will not happen overnight and is seen as a 14-year project, with the first five years being a process of building and preparation.

Cabinet spokesperson Jimmy Manyi said Cabinet had approved the NHI Green Paper, noting that it is a major step towards improving the access and quality of health care for all citizens of South Africa.

"Cabinet stressed that ... the success of this policy will largely depend on a whole range of other important variables such as clean water, nutrition, general physical exercise, etc," Manyi said.

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