While President Cyril
Ramaphosa identifying health as a focus area for his administration is to
be welcomed, focusing on health does not mean passing an NHI Bill.
“It means budgets and plans, and the implementation of
plans, to fix our health system before irreversible damage is done,” civil
rights support organization, SECTION27, stresses in a pre-State of the Nation
(SONA) statement released this morning.
“It means tackling the corruption currently in the
system. It means prioritising the health care system and recognizing it as a
system through which we realise rights, improve teaching and learning outcomes
and revive the economy. This SONA, we call for transparency and urgency in health
system reform,” the statement adds, continuing as follows:
“South Africa has been ‘on the brink’ of major health
system change for almost a decade. National Health Insurance has been discussed
for years and made less tangible with each iteration of the policy. A leaked
revision of the NHI Bill late last year included sweeping changes to the
version published for public comment, albeit not, apparently, in response to
those comments. We remain in the dark about the status of the Bill currently.
Task teams have worked on aspects of health system reform in reports that have
never been made public. The Competition Commission has spent R196 million on a
Market Inquiry into Private Health Care which has made significant preliminary
findings and recommendations but has now been stalled until the new financial
year due to a lack of political will to find the funds for it to finish the job
“The health care users of South Africa (read everyone
in South Africa) are the ones to suffer from the delays and lack of
transparency. Rather than using the years of reports and submissions to drive
health system reform, we have become fixated on the passage of an NHI Bill that
says little about quality and instead focusses on the creation of a Fund and
various structures at national, district and sub-district level.
“These delays and obfuscation are even more
devastating in the context of a health system in crisis. A system in which 5 of
the 696 health facilities assessed by the Office of Health Standards Compliance
according to its minimum standards in fact comply with those standards. A
system in which private health care users are being pushed into state care
through ever increasing costs and unknown quality.
“Health financing is a vital component of health
system improvement but the creation of a Fund does not itself improve the health
system. The Fund needs a system to buy services from. We do not have that
“We are seeing some green shoots, however. The Special
Investigations Unit has identified the health sector as a corruption
susceptible sector and has set up a process to expedite investigation and
prosecution of corruption in the sector. This must be supported. Health workers
are being appointed at facilities around the country as part of the stimulus
package. This will relieve some pressure and will have positive economic and
social impact – health jobs and health services are good for the economy and
good for people.
“We cannot afford to stop at a few interventions and
the passing of a Bill. This SONA we call for real action to fix the health
system. Work in the knowledge that quality health care services improve
learning in schools, revive rural economies and save billions of rands now
spent in treating preventable diseases. Expand the investment in human
resources for health and establish mechanisms to manage and retain the people
in the system. Audit and repair infrastructure. Strengthen governance and
management systems; develop and implement a plan for the regularisation,
appointment (uninfluenced by party political structures and patronage),
capacitation and resourcing of health committees and boards to begin to
exercise governance functions within health facilities. Strengthen the capacity
and resources of the OHSC to ensure that it able to fulfil its mandate
effectively. Mobilise a national campaign to focus on the prevention of
maternal and perinatal deaths and injuries – stop killing babies and their
mothers through health system failures. Finalise the Health Market Inquiry and
implement its recommendations.
“This SONA, we want to hear about how this government will
fix health,” SECTION27 concludes.
SOURCE: Nomatter Ndebele, Communications Officer