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Stark imbalances in delivery and funding

25 August 2022 | Healthcare | General | Myra Knoesen

FAnews joined Momentum Health Solutions for a thought leadership engagement webinar, where insights on the healthcare industry landscape and the potential impact on the provision of innovative, quality, private healthcare were shared.

Minister of Health, Joe Phaahla provided an update on the healthcare industry, with Damian McHugh, Executive Head of Marketing at Momentum Health Solutions sharing some thoughts on the National Health Insurance (NHI) and what funders/schemes should be working towards for the future of NHI. 

A discussion with the Minister

The key aspects of the discussion with the Minister, according to McHugh, was the openness of the Minister and the Department of Health (DoH) to work with the private sector to create an improved health care system for South Africa.

“The second key aspect was the fact that he shared that the National Health Insurance (NHI) could be rolled out over time. Phase one would be the roll out of primary health and once that matures, then the secondary phase focusing on tertiary care will be rolled out,” said McHugh.

“It is a process that will take time and perhaps there has been a misconception that the NHI would be implemented in a single change over. This is not the case,” he added.

An unsustainable matrix 

There are stark imbalances in the health delivery and funding of healthcare in South Africa, according to McHugh. 

“Most healthcare workers in South Africa, for example, deliver healthcare for the people in the private sector. However, the people that require healthcare in the public sector far outweighs patients in the private sector. This matrix is not sustainable,” he said. 

“As a private industry we have built up skills that can contribute towards a healthier healthcare system… whether in health delivery, such as running hospitals, or paying claims, or creating incentives for people to change behaviour. There is significant experience in the private sector that can be used to build a healthcare system in South Africa that works and caters to everyone,” emphasised McHugh. 

McHugh highlighted that “we need to start addressing the imbalances in our healthcare industry together, both in the private and public sector.” 

Strengthening the healthcare system 

“We cannot deny that we need a universal healthcare system in South Africa and to establish this, we must correct some of the imbalances and improve the delivery of healthcare to all South Africans. We are committed to making this work however, we want to avoid implementing a system that costs South African’s more money and negatively impacts on and reverses the gains made to date, in terms of the country’s health outcomes,” stated McHugh. 

He added that it is imperative that this change is managed effectively, making use of the experience of both the public sector and private sector to develop a system that runs as seamlessly as possible. “I don’t believe a strong private sector undermines the public sector and I don’t believe a strong public sector has to undermine the private sector. I believe we can have a system where the private sector can alleviate pressure in the public sector and make the utilisation of the budget that is available more effective. There are many previous and existing examples of such which have worked in the interests of strengthening the healthcare system and the provision of healthcare for all.” 

The future of NHI

“I believe funders should embrace collaboration and acknowledge the need for us to work together for a better healthcare system in South Africa. Our private healthcare system is not perfect. We know the public system is not perfect. Therefore, we should ensure that healthcare standards across both public and private are improved, doing so at a more affordable cost than what we are spending now.

“What we do not want to see is the delivery of less healthcare to less South Africans for more. Any scenario that delivers healthcare in South Africa in a manner where there is wastage is inept for a country which has the challenges we are facing,” he concluded. 

Writer’s thoughts:
In South Africa, private and public health systems exist side by side. The public system serves the vast majority of the population but is underfunded and understaffed. The wealthiest of the population use the private system and are better served than the poor. Achieving effective low-cost healthcare is only possible if a number of challenges affecting the industry are tackled. Do you agree? Please comment below, interact with us on Twitter at @fanews_online or email me your thoughts [email protected].

Comments

Added by Cynical Simon, 25 Aug 2022
The issues that need to be addressed are not health issues but ideological issues and governance issues. The idea of the NHI is communistic to the very core and like everything Marxist is doomed to fail miserably.
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Added by Myra, 25 Aug 2022
Hi Adam and Humphrey,

Thank you for sharing your thoughts. I must say that i do agree, the state needs to be far more proactive if a number of challenges affecting the industry are to be tackled.

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Added by Humphrey, 25 Aug 2022
Hmmmm. In an ideal world yes. The reality is that even in the private healthcare sector one has to wait months to see certain specialists (yes I know the initial stages of NHI are aimed at primary health care). Now spread those thin resources over both private and public sectors and you will not have a hope in hell at getting the required care. Much of this can be attributed to the brain drain and we know the reasons for that. NHI will ultimately put our already overstretched private sector practitioners under so much strain that they too will leave.

Much of the public sector healthcare is in an absolute mess (Carte Blanche has clearly revealed this - not that we needed Carte Blanche to tell us). Everything government touches it screws up. Show us you can run the public healthcare sector properly first and then (and only then) think about NHI.
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Added by Adam Samie, 25 Aug 2022
I fully concur. However we need the State to be far more pro-active in the investment in our people. Training of nursing and other medical staff is far from optimal whilst recruitment of other professional people like administrators, human resources and technical staff is sadly neglected. Not everything has to come from the National Purse, good, well skilled support staff is widely available but as usual politics gets in the way. The State needs to foster a co-operative spirit of engagement with the private sector and the community in general to ensure that resources are appropriately obtained and directed. The discussion is too often about tertiary care when the overwhelming burden is at the level of community services. Time for all stakeholders to get serious about tackling the issues much more holistically.
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