SA's public health system not in crisis - dept

Monday, May 25, 2009

Pretoria - South Africa's public health system is not collapsing or in crisis despite the challenges faced, says the Department of Health.

This follows a newspaper article on Sunday which allegedly stated that the country's public health system was at "risk of collapse if hundreds of underpaid and overworked doctors left".

Health spokesperson Fidel Hadebe on Sunday assured South Africans that the country's public health system continues to function despite the many challenges it is faced with.

"Contrary to what the story seeks to project, the public health system in South Africa continues to function and provide health care to millions who need such services," Mr Hadebe said.

He said the department has on numerous occasions acknowledged the many challenges facing the country's public health system and its plans to address them.

"Apart from the issues of remuneration, ageing infrastructure and general management challenges including financial management are among the challenges that continue to hamper the public health system in South Africa," Mr Hadebe said.

However, Mr Hadebe said it was important to note the amount of work that is being done to address these challenges.

Among the measures taken by the department to address these challenges include the implementation of the Occupation Specific Dispensation (OSD) for nurses in 2007 as part of a plan to attract more nurses into the sector and retain.

Mr Hadebe said that despite the implementation and teething challenges that were encountered, the tide was beginning to turn with more nurses re-joining the public sector.

"A decision was made to start with this sector of health care workers given the extent to which they were being lost to the private health sector and over-seas countries," he said.

Negotiations are currently underway at the Bargaining Council to agree on a similar OSD regime to cater for doctors, dentists, pharmacists and emergency medical personnel.

Mr Hadebe explained that apart from remuneration, the OSD for this category of professionals will also address issues of career progression and performance management among others so that good performers are recognised and rewarded accordingly.

The department has also allocated about R3 billion for 2009/2010 financial year to be spent on the current hospital revitalisation programme that is geared at building new infrastructure and rehabilitating existing facilities.

The budget will be increased to R4.1 billion in the 2011/2012 financial year.

The department has also seen progress on the quality improvement initiatives that address among others patient experience of care, clinical care, waste management and patient and staff safety.

"All of these measures are in a basket of interventions required to improve the performance of the public health system in our country, contrary to a one-dimensional view that suggests otherwise," Mr Hadebe said.

He noted that the country has about 386 hospitals and 3 500 clinics that perform at varying levels of satisfaction, adding that the new Health Minister Aaron Motsoaledi has expressed his commitment to addressing many of these problems which largely have to do with financial and human resources management among others.

To suggest that the public health system is collapsing or in a crisis is alarmist at this stage, Mr Hadebe said.

Outlining the key priorities his department will give special attention to last week, Dr Motsoaledi said financial management, information technology, infrastructure services and human resource management and development have been identified as the main points of focus.

"Whether it is a municipality, provincial government or national government throughout any government department, these are the main challenges that led to problems, protests and various forms of discontent pointing to several weaknesses in government.

"From the briefing I have received, I have come to the conclusion that these four areas should be the main points of focus with the department, but in addition and as different from all other departments, I would like to add quality of care," Dr Motsoaledi said.

On the issue around remuneration of doctors in the public health sector, Dr Motsoaledi said he would consult with his counterparts within the inter-ministerial committee to try and resolve the issue.

He also acknowledged that doctors and other health care professionals were underpaid.

"The issue of whether doctors and other health professionals are underpaid or not, were not to be debated as their remuneration does not satisfy the department as well.

"The issue under debate is when and how do we solve this problem, however, as a doctor myself, I wish to assure my colleagues out there that I understand what they are going through because I personally have gone through it," he said at the time.