Minister announces NHI plan
Health minister Dr Aaron Motsoaledi is determined to revolutionise South Africa’s health system and his short-term sights are set on the quality of healthcare delivery in the public sector and pricing in the private sector.
Speaking to Health-e after the post-Cabinet media conference yesterday (THURSDAY) where he shared details on the Green Paper released today (FRIDAY), the minister said the National Health Insurance (NHI) system would be implemented over 14 years with the first five years used to put critical building blocks in place.
‘Today I have put up things which must happen,’ said Motsoaledi.
He explained that NHI would be divided into three stages over the 14-year period, the first stage being ‘intense preparation’.
Priorities include the establishment of the NHI Fund and the drastic improvement of infrastructure, patient treatment at hospitals, human resources, management systems at hospitals, information systems and quality control.
The improvement of the health system will be piloted in 10 sites from next year. ‘We have not yet decided which sites we will target, but it has to be a mix between richer and poorer districts so we can ensure we get it right,’ said Motsoaledi.
He explained that they had already completed the audit of 29% of public health facilities and aimed to have 94% done by the end of March.
Motsoaledi said in selecting the pilot sites they would consider among others the health status of the district, the management of institutions and transport systems in the area.
He added that he was also intent on urgently addressing the issue of public hospitals and human resources challenges in the public health system.
‘To address public hospitals, we need to change the health care delivery system, re-engineer the primary healthcare system, change the management of healthcare institutions and improve and overhaul the infrastructure,’ Motsoaledi, racing from the Pretoria briefing to catch a flight to Cape Town.
The minister was cautious to not reveal how he intended to tackle the human resources challenges, but said it was a problem not unique to South Africa. The Green Paper lists a medium term increase in the supply of doctors and specialists and an increase in the production of nurses, pharmacists and allied health professionals.
‘It is one of the biggest challenges worldwide with a shortage of more than four million healthcare workers all over the world.’
Motsoaledi said it was up to Treasury to decide how it would be financed, but he as unequivocal that South Africa was already spending a lot on healthcare, but not seeing the results.
He said that if implemented properly, NHI could allow the country to spend less on healthcare.
Speaking at the post-Cabinet briefing, Motsoaledi described the first steps as ‘’¦truly historic: we are building a health system that will offer decent healthcare for all our people’.
He said he was not declaring war on the private sector, but believed that the challenge and intent of NHI was to draw on the strengths of both healthcare sectors to better serve the public.
‘This involves new ways of doing things. Whether we like it or not, the bulk of South Africa’s healthcare infrastructure resides in the public sector and our task is to overhaul it so that people will choose to go to public facilities once they have options,’ said Motsoaledi.
The Green Paper specifies the building of six flagship hospitals and medical faculties through public-private partnerships in the next five years.
These include the King Edward VIII in KwaZulu-Natal, Dr George Mukhari and Chris Hani Baragwanath Academic in Gauteng, Nelson Mandela Academic in the Eastern Cape, Polokwane Academic in Limpopo and Nelspruit Tertiary in Mpumalanga.
The Green Paper, released today, will undergo three months of public consultation with the next step the release of a White Paper.