Dr Nicholas Crisp

The COVID corruption experience will “be looked at” as the country prepares to implement the proposed national health insurance (NHI) system, Department of Health NHI Consultant, Dr Nicholas Crisp, assured in his BHF Dialogue Session presentation yesterday.

“Corruption is the single biggest worry going forward into NHI,” he acknowledged.

“We spend a lot of time working in forums with the Special Investigating Unit and all other law enforcement agencies, deliberately planning systems to design out as much corruption, hacking and other nefarious activities as possible. We will be looking at what went wrong in parts during the COVID time and make sure we learn from those.”

Another concern arising specifically out of the COVID response, Crisp noted, was governance in the transition towards the implementation of NHI. In beginning of the pandemic, he explained, each province, for example, was under so much pressure to respond and to get their plans in order: “This was not the co-ordination we wanted to see, not in the private sector in the beginning either. It took a lot of time but the Minister and Deputy Minister of Health played a huge role in bringing public sector players together,” he said, adding that credit must also go to the provincial MECs and the others in the political space “who came on board to work”.

“Lesson going forward now is how to get interprovincial co-operation and to understand we need to be one country with one system. The same lesson,” Crisp said, “goes for the private sector. We began to learn during COVID that we need to build a system with a national policy. That does not mean a national government policy for the provinces or the national department, but a policy for our 60 million citizens and everybody who is a role player needs to part of it.”

The big lesson learnt from COVID, he stressed, has been that the South African health system was not ready for this type of crisis.

“We did remarkably well under the circumstances and not always because we knew what we were doing. We are actually fortunate being in the position we are. COVID has not gone away but just got less. We can argue numbers, but numbers are a distraction. Trends are important, how we respond and what we do to protect 60 million people.

“I think we owe it to one another to find forums to create and implement a far better system, all integrated to ensure that our healthcare is well prepared and we are not exposed again to the ravages seen during COVID.”