Plans by the Minister of Health, Dr Aaron Motsoaledi, to push ahead with the National Health Insurance (NHI), is an act of desperation. It is a decision doomed to failure from the outset.
The minister is completely out of touch with the crisis in the South African public health system, and this was highlighted by his denial of a crisis despite the damning report from the commissioner of the Office of Health Standards Compliance (OHSC).
Recent presentations to the Portfolio Committee on Health by each of the provinces, the OHSC and the Auditor-General, painted a picture of a health system that has collapsed entirely. It is beyond a crisis, it has simply failed.
DA visits to hospitals and clinics around the country have exposed medicine shortages, equipment shortages and a severe shortage of beds. In most hospitals visited, infrastructure is collapsing and lack of maintenance in facilities is painfully obvious.
In Limpopo alone there is a backlog of 26 000 surgeries and cancer patients will have to wait 12 months from time of diagnosis to start of treatment. This is a death sentence for cancer sufferers. Almost every province has declared that they are unable to make effective changes or improve facilities due to severe lack of budgets.
While the Western Cape has 33 specialists per 100 000 residents, Limpopo only has 1.3 specialists per 100 000. The MEC of Health in Limpopo stated that “If people are one day sick and require a specialist, they will wish they were born in the Western Cape”.
Doctors are leaving the public health sector in their droves. They cannot work under the present conditions with lack of resources, very long hours due to lack of effective personnel and maladministration at every level.
The DA will not under any circumstances support the National Health Insurance Bill in its current format. Firstly, it cannot be implemented due to failure in the current health sectors which cannot deliver effective healthcare to the majority of South Africans.
Secondly, the minister himself cannot tell us what the costs will be to implement the bill and advises that it will take up to 15 years to effectively implement. The provinces cannot manage current budgets and have all declared they are under-financed.
Thirdly, the NHI pilot projects have failed abysmally already. If a pilot project is unsuccessful, there is no chance that it will be successful nationally. Lastly, the NHI aims to put a cap on the amount of private health insurance providers and medical aids. This creates a risk of monopoly in the industry, price fixing and collusion.
After extensive consultation with both academia and industry, the DA’s offer, titled Our Health Plan – to uplift the health sector and introduce a practical and sustainable health plan – is far more effective. It can be rolled out and put into effect within 5 to 8 years, takes into account the needs of all South Africans and, where put into practice, has proved itself.
Furthermore, our health plan will provide quality healthcare which is affordable and can be implemented using our current health budget. This would mean that medical aid contributions would no longer be tax deductible. The additional revenue would go to reducing the costs of medical aid.
Where the Our Health Plan is implemented in the Western Cape, the province has showed that it can deliver better healthcare than in any other provinces, a fact recognised by the MEC of health in Limpopo. Mortality rates are lower – half of any other province, it has attracted the highest number of South African doctors and has the highest number of specialists per capita. Hospitals and clinics are better maintained and have far better resources.
The minister aims to rob Peter to pay Paul. The current health system has collapsed and is in severe financial crisis. It can be fixed, but will require proper leadership, less corruption and better management and appropriate use of budgets.
The DA health plan is the only alternative to resuscitate a broken system.
– Lindy Wilson serves as the DA Shadow Minister for Social Development.