Department of Health to spend R17 billion upgrading South Africa’s clinics
Dr Aaron Motsoaledi
Minister of Health
The Department of Health will invest R17 billion over the next three years into upgrading the country’s public clinics to ‘workable’ levels in line with a broader preparation for introducing the National Health Insurance (NHI) system. Health Minister Dr Aaron Motsoaledi announced the department’s plan during the official opening of the 2nd National Pharmacy Conference on Friday 21 October 2016.
Motsoledi, in opening the much anticipated 2nd National Pharmacy Conference, reported that government had concluded an investigation into the amount required to upgrade the clinics into facilities capable of delivering services to their communities. The figure unveiled was insufficient for high level services, but would hopefully provide key medications and the infrastructure medical staff demanded.
In a wide-ranging, hard-hitting delivery, Motsoaledi called the NHI and the #FeesMustFall campaigns the same side of the coin rather than diametrically opposed initiatives. While the world economic systems are divided into communism or socialism and capitalism, education and healthcare are the two indisputable issues where the state has to provide the resources.
Many people currently criticising the NHI are the same people wholeheartedly supporting the #FeesMustFall campaign without recognising the link between the two. Education ministries provide bursaries for the poor who cannot afford the fees to further their studies, but the healthcare system only helps the rich.
“If there is to be equity, specifically free education for the poor at tertiary level, there must be free medical assistance for the poor as well. Medical aids are nothing more than pre-payments for future medical demands, because nothing in life is free – someone always has to pay for it,” Motsoaledi said.
An article published in the British medical journal The Lancet indicated the world was on the brink of the third medical transition, essentially a change that affects populations rather than individuals. The first had been the 18th century introduction of clean water and sanitation, the second the 20th century widespread vaccination policies, and now the shift focusing on universal healthcare financing that would ensure every citizen has access to equitable healthcare based on their health requirement and not their socio-economic status.
While South Africa called the policy NHI, universal health coverage was an issue incorporated in the United Nations (UN) Sustainable Development Goals. Motsoaledi said the myths purported about the NHI ignored it was a system that pools capital to allow every citizen access to good quality healthcare – a concept medical aids already employ.
“South Africa does not have a debate about the quality of healthcare, since the reality is the depth of the pocket determines the level of care. We need to serve citizens in line with international conventions,” he said.
Globally, issues like Brexit and the US presidential race have highlighted the extent to which the world’s poor are ‘demanding their time under the sun and the rich are resisting the change’.
Motsoaledi said the NHI was not calling for private healthcare to be closed down to introduce a ‘poor public healthcare system that is corrupt, inefficient and unable to deliver’, but South Africa must recognise the current private healthcare system was expensive in global terms. Currently, while 16% of the population belong to medical aid schemes, Motsoaledi said a Competition Commission enquiry into the private healthcare system had identified only 10% of citizens can afford to use it.
Last year was the first time the World Economic Forum (WEF) in Davos invited health ministers to the annual discussions, recognising the link between economic growth and health.
“We now know you cannot have sound economic growth without a good healthcare system. That means you cannot end poverty, unemployment and inequality with poor healthcare systems – and the recent Ebola scare demonstrated how if one country has poor healthcare, the whole world can be affected and die,” he said.
He added government has invested R4.5 billion on developing a health information system that ensures patient records are universally accessible. Essentially, changing clinics or hospitals does not require reconfiguring the patient’s medical records.
While the system was not yet functional, he said the state has been working with the Council for Scientific and Industrial Research (CSIR) for the past five years and was confident of an outcome in the near future.