Private patients swell public hospitals’€™ coffers

Although Mrs Roshnie Maharaj doesn’€™t have a medical aid, she didn’€™t want to go to a public hospital when she needed a hysterectomy.

But when she called a private clinic, they told her the procedure would cost R20 000. Then she heard about Folateng, and there she was charged R11 000 for the hysterectomy.

“As you can see, I’€™m back for more medical attention,” said Mrs Maharaj this week, after being admitted for another health problem. “I came back because the service is great. It is very clean, and a lot cheaper than the private clinics.”

Folateng ‘€“ or “place of healing” in seSotho ‘€“ is a private facility within Johannesburg General Hospital.

Modelled on the success of Cape Town’€™s Tygerberg Hospital ‘€“ whose private wards bring in some R10-million each year for the hospital ‘€“ Folateng has been going for little over three months.

Based on the seventh floor of the hospital, Folateng has all the comforts of a private institution. Everything ‘€“ from the stone coloured bathrooms to the nurses’€™ stations constructed of honey-coloured wood ‘€“ is brand new and inviting.

Wards range from single beds to five-bed units. The doctors and specialists are the same people who treat state patients, but food is supplied by Fedics and the nurses are specifically allocated to Folateng.

There are 100 beds available at present, but this will expand to 250 within then next few months. Occupancy is around 67-70%.

Dr Abdul Rahman, Chief of Operations in the Gauteng Department of Health, says that there have always been private patients in government hospitals, but that they would be scattered throughout the institutions.

“This is a way of consolidating the patients so that they can be looked after,” says Rahman. “Our public health facilities have always enjoyed a reputation for providing good medical care, but over the years this has been eroded, mainly because the ‘€˜hotel’€™ facilities have not been that good. We want to regain our good reputation.”

The department also hopes to take advantage of a recent change in medical aid rules. In a bid to stamp out inflated claims, medical aid schemes are now allowed to designate specific healthcare providers and institutions as “preferred providers”, tie them to contracts and ensure that their members use only these people and facilities.

Rahman says a number of medical schemes are already considering Folateng as a “preferred provider” as it offers good value for money.

Sister Rachel Ramphora, head of Folateng’€™s nursing services, says that Transmed patients are compelled to use state facilities and they are flocking to Folateng.

Rahman believes there are many other groups of patients that can be attracted to Folateng, such as people employed in the public service, foreigners and those who do not have medical aids but can afford to pay a little bit more.

He also hopes that if National Health Insurance is introduced (a compulsory medical aid for all working people who do not have private cover which is based on them using state facilities), its members will also come to Folateng.

It’€™s too early to assess Folateng’€™s financial success, but there is no doubt that it will be profitable. Eighty percent of that profit will be ploughed back into the hospital to improve infrastructure and equipment, thus directly benefiting state patients who cannot afford private care.

Twenty percent will go to the province and can be used to improve hospitals that are unable to offer private wards.

Private healthcare expert Nigel Sinclair Thompson, who is a consultant to Gauteng on the private amenities project, says that initially there was a misconception that the hospital was being privatised.

“On the contrary, we are using money that would usually have gone into the private healthcare to invest in public health. And we are creating jobs.”

He stresses that while the private patients use the same facilities as state patients, they are not given preferential treatment.

“In the past, the private patients simply used to skip the queue. Now there are specific time slots for private patients to use the equipment for non-emergencies. All emergency cases are treated the same.”

By the end of the month, private wards will open at Helen Joseph Hospital, while private wards in Sebokeng and Pretoria West will become operational early next year. Another six sites are planned in the next few years.

“There is so much duplication of resources between private and public healthcare,” says Sinclair Thomson. “This is a way of using existing facilities more efficiently.”

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