The government is to put in place systems and processes to address the challenges and problems being experienced in the healthcare sector in South Africa, both private and public. An Inspectorate of Health Establishments and Office of Standards Compliance will be established and inspections carried out by the Office of Standards Compliance. In addition, the cost of health services will be determined by a legislative framework relating to the reference price list.
This is according to the Minister of Health, Dr Manto Tshabalala-Msimang, speaking at the 8th Annual Conference of the Board of Healthcare Funders.
"We have to do this so that we can ensure that South Africans get value for money spent. The cost of healthcare in the private healthcare sector in South Africa is high and cannot be accessed by the majority of people. While the quality of healthcare in the private sector may be perceived to be good, it is difficult to evaluate it without robust health Quality Assurance systems in place. This is crucial when this perceived quality is used to justify the high cost," said the Minister.
Whilst there has been an 8.8% decline in the cost of medicines dispensed by pharmacists and providers other than hospitals, compared to 2004, there was an increase in hospital expenditure from R11 billion in 2001 to R16.1 billion in 2004/5. There was also an increase in specialists and total non-healthcare costs. So clearly the private healthcare funding industry paid 12.1% more for services in 2005/6 compared to the previous year (R45.8 billion in 2005/6 compared to R40.8 billion the previous year).
The Council for Medical Schemes reports that almost every year, medical schemes increase the contributions paid by the members as they pay out more for services. In addition, non-healthcare costs viz; administration, managed care and broker fees are increasing, as are hospital and specialists costs. However, there is no direct relationship between the quality of healthcare rendered and these increases. Whilst, there has been a decrease in medicine costs, there has been no decrease in the total cost of healthcare and there has been no increase in the number of participants in medical schemes.
These factors beg the questions: Are there 'inappropriate gaps' in the private healthcare system that are largely exploited by the funders and providers of healthcare in a way that does not benefit the members? Is the current model for providing private healthcare insurance in South Africa appropriate and adequate to meet the requirements of the participants and is it sustainable?
Dr Humphrey Zokufa, Managing Director of BHF stated, "It is clear from the Ministers speech that our focus must be on providing affordable and quality healthcare to all of South Africa's people. And it is the responsibility of the stakeholders in the healthcare sector to reach consensus on how this kind of care for all will be arrived at."
In conclusion the Minister stated, "It is my duty and Constitutional mandate to create an environment and establish systems and processes that must address the challenges and problems that exist in both sectors of healthcare in South Africa. Failure to do so can be regarded as abdicating my responsibility and thereby failing the people of this country."