Dr Chris Archer

Dr Archer comments:

The recent Presidential Health Summit on the 19th and 20th October assembled more than 500 delegates from all sectors of the healthcare system giving them an unprecedented opportunity to express their anger and frustrations with the disempowering state of the public health services.

Many delegates at the commission on Governance and Leadership were highly vocal regarding the corruption, incompetence, nepotism and political interference that was rife within the public system. So the Summit allowed delegates an opportunity to vent their frustrations but as a method for arriving at coherent and inclusive strategies to effectively deal with the problems it was woefully inadequate, and left one feeling disempowered and largely irrelevant.

Many solutions were suggested but these were in the main very superficially handled and as such the conference amounted to little more than a huge talk shop.

The need to involve all resources including both the private and public systems was generally accepted as was the need to develop a unitary system of healthcare. Towards this end it was proposed that a public/private health charter to guide collaboration be established and all stakeholders are expected to agree a social compact on the 10th December.

What was missing from this initiative however was a clear vision on how a consensus reaching process, that takes into consideration all strategic and technical options, is to be established. A major elephant at the summit that no one seemed willing to discuss, was the role of medical schemes in a comprehensive collaborative and unified new system.

Clearly the solution will not be found in one system taking over another as implied by the NHI. What is needed rather is a new system that allows for the harmonisation and integration of NHI with the medical scheme multi-payer system. If UHC is to be successful it will require the full participation and utilisation of all of South Africa’s healthcare resources, both public and private. Incorporation of the private sector into a unitary health system under a single payer NHI is currently not feasible or affordable. The solution therefore is to find an equitable mechanism to allow participation of medical schemes in funding health services for those willing and able to fund their own healthcare needs privately, but under the umbrella of an overarching unitary system that allows seamless patient movement between the two sectors.

Dr Chris Archer