The 8 issues that will define SA healthcare in 2020

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2020 will be a critically important year for healthcare in South Africa, writes Spotlight. It has formulated eight questions to set out what is at stake.

How, if at all, will the design of National Health Insurance (NHI) change in 2020?
One critical question for 2020 then is how much, if at all, the design of NHI will change during the parliamentary process. Will Members of Parliament seriously and meaningfully engage with questions regarding the details of how NHI will function and be governed and then change the Bill as needed?

Will government finally fix the regulation of private healthcare?
One obvious thing for the Department of Health to do is to revise the Medical Schemes Amendment Bill based on the findings of the HMI and then to submit this Bill to Parliament. 

Will there be any high-profile prosecutions for corruption in the public healthcare sector?
A few high-profile prosecutions in the healthcare sector will not only help restore some much-needed confidence in the state, it will also be a shot in the arm for NHI.

Will our understanding of SA’s TB epidemic change significantly in 2020?
In order to get more reliable information on the country’s TB epidemic South Africa started a National Tuberculosis Prevalence Survey in 2017. The survey was set to be completed in 2018 and reported in 2019, but there were delays.

Will the Department of Health finally fix and integrate its medical records and unique patient identifier systems?
The Department of Health had by early 2019 enrolled over 26 million people on its new Health Patient Registration System (HPRS) – a number that is no doubt much higher today. Yet, healthcare workers report that in many places medical records in the public sector remain a mess.

Will a serious and realistic plan emerge to train and retain healthcare workers?
In November 2019 the National Department of Health reported to parliament that a “new HRH Strategy is being developed” and that “it will provide guidance on the number of health workers required for effective service delivery in the public and private sectors, as well as strategies for dealing with key HRH challenges.” Whether we will see this plan in 2020 and whether it will be ambitious and implementable enough to meet the huge need in our healthcare system remains to be seen.

Will South Africa get legal certainty and political direction on medico-legal cases?
The debate on how best to tackle the department’s medico-legal dilemma is set to rage on this year in the courts as well as in government.

Who will be the new director general in the Department of Health and how will this appointment impact the department?
It is now almost two years since Cyril Ramaphosa became president of South Africa. For all the promising dust that has been kicked up, there is still very little to show for the new dawn when it comes to healthcare. Many questions about NHI and about accountability for corruption in the public healthcare sector remain unanswered. Maybe 2020 will be the year when the dust settles, and we see just how much has or has not changed.

Full Spotlight report

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