NHI plan needs clarity on the “how”
South Africa’s healthcare reform is being dissected by private hospitals at its annual conference taking place in Cape Town this week under the banner of ‘Reform side by side’.
The relationship between the Hospital Association of SA (HASA) and health minister Dr Aaron Motsoaledi has been slightly strained since his attack on private hospitals earlier this year.
Addressing the Congress of SA Trade Unions’ central committee in June Motsoaledi said that private hospitals charged hefty prices for simple procedures and that this should be changed through regulation.
At the time HASA expressed disappointed over Motsoaledi’s ‘unwarranted’ attack on private hospitals saying it ‘came as a surprise’ as the private sector was involved in discussion with the health department to improve the quality of healthcare.
Addressing the HASA gathering yesterday (subs wed), KPMG Chair of Global Health Dr Mark Britnell said patients didn’t ‘give a hoot’ about anything else but accessing good treatment.
Britnell, who had assisted former UK Prime Minister Tony Blair in developing the country’s National Health System, said England faced similar challenges at the time.
In the late nineties almost half of all UK hospitals had been built prior to the Second World War and the vacancy rate stood at almost 15%, the majority being nurses.
‘The NHS was swamped by medical emergencies, long waiting lists and not enough staff, but there was political will to change it,’ said Britnell.
He said it was critical that South Africa also allowed hospitals to become self-governing and to involve private hospitals and other private providers such as GPs in the delivery of healthcare.
‘South Africa’s Green Paper is strong on the what, but less so on the how,’ he said.
Britnell said that countries such as Mexico and Brazil showed that a country could very quickly provide universal coverage in the primary healthcare sector.
Professor Heather McLeod, a health systems expert and actuarial scientist, said there appeared to be confusion between universal coverage for healthcare and universal coverage for health insurance.
It is estimated that only some 16.4% of South Africans had health insurance cover in 2008, however everyone has access to healthcare through various avenues, said McLeod.
She said dissatisfaction with the current national health system was dissatisfaction with the quality of care in the public sector.
McLeod listed five steps that would improve universal coverage, namely improving those parts of the national health system not on the same standard as the best in the country, closing the access gap for the estimated 7% not reached, addressing the current subsidy policy, contracting with private primary care providers and revising the medical schemes’ prescribed minimum benefits package to include primary care.
The health minister will address the conference today.
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