Running health like a business – Western Cape
Western Cape health MEC Theuns Botha yesterday accused the African National Congress of mismanaging the province while in control, but in the same forum described national health minister Dr Aaron Motsoaledi as ‘the best news to health services this country has seen for a long time’.
Addressing the province’s Public Private Health Forum Botha said the funds allocated for health services in the Western Cape were inadequate to meet the needs and expectations of its users. ‘The ANC has left us with a legacy of mismanagement. It has required an increase of available funding for maintenance to address the major backlog estimated at around R800-million set against infrastructure with an estimated replacement value of R13,5-billion,’ Botha revealed.
Botha said the morale was low among doctors and nurses, there was a lack of capacity at various levels – specifically trauma units, infrastructure was inadequate and there was a breakdown in the relationship with the private sector.
He said the solution for the Western Cape was no longer to ask for more money. ‘We need to make plans. We need to let the government spend the money elsewhere while we make our own plans’ said Botha who described himself as ‘a bit of a cowboy who comes up with ideas while others make it work’.
The MEC revealed that his province would end this financial year with a R150-million overspend, down from R500-million earlier in the year. He added that the overspend of the other eight provinces amounted to R7-billion ‘ R1,75-billion in Gauteng, R2,3-billion in Kwazulu-Natal and R1,6-billion in the Eastern Cape.
He said that while he had some of the best health officials on the continent at his disposal the national health department had a problem. ‘Minister Motsoaledi is excellent and I hope the organisation he belongs to allows him the space to do what he needs to do. It is extremely exciting, he is open to ideas and he is not jealous of the Western Cape,’ said Botha.
Priority areas identified by Botha included alcohol and substance abuse, HIV/AIDS, infrastructure and strategic partnerships with business and relevant non-governmental organizations.
Botha said substance abuse was killing society. ‘We have spoken to headmasters at schools where 40 percent of learners are tik addicts. There are school we fund and run for the purpose of drug lords and addicts,’ said Botha. He said unless the provincial government tackled the problem at a high level society was in serious trouble, not only through the loss of a generation, but being unable to afford the consequences.
Amanda Brinkmann, head of Western Cape Premier Helen Zille’s Department for Strategic Partners said the province would be launching a comprehensive response to substance and alcohol abuse by the end of next month.
Director-General of Health Professor Craig Househam confirmed that the tik epidemic was ‘wreaking havoc’ in the emergency and mental health services in the province.
‘We now need special wards to put addicts in an effort to not disrupt the emergency wards. It’s the devil’s drug,’ said Househam.
Brinkmann said the province was committed to ‘doing it properly. We want to prevent and treat, but we need to use evidence based responses and are working closely with the universities,’ Brinkmann said.
Botha said the province would be rolling out a new HIV/AIDS programme with patients being put on antiretrovirals once their CD4 count (measure of immunity in their blood) dips below 400. Pregnant mothers will be placed on triple therapy while patients will be actively encouraged to test for HIV.
The Health MEC said it was time to run the province like a business and to set up innovative structures which pumped money into the province’s coffers. He admitted that there had been a breakdown in the past, but encouraged private sector representatives at the meeting to ‘call, sms, e-mail’ me.
Commenting on the proposed National Health Insurance system Botha said it was ‘not a bad concept’ and that he was in trouble with own party for saying so. ‘The actual implementation of this system is impossible and we are very far from being able to do so. The challenge for us is to see what we can do, accept the challenges of what this system aims to achieve and do it in different ways.’
Brinkmann said the province was happy to ‘experiment, pilot, bump our heads and be controversial’.
‘We want to break new ground and try new things and are committed to share with the rest of the country those things that work,’ she said.