Lives are being lost, and more placed at risk as legal bickering and challenges continue around the NHI Act, but, says Netcare Group CEO Dr Richard Friedland, “we don’t have the luxury of time”.
“Let the legal battles continue, but let’s begin to collaborate across all sectors meaningfully,” he urged delegates at the inaugural Health Ombudsman Conference in Johannesburg last week, where a focus of the gathering of experts was universal health coverage.
Friedland said the healthcare sector needed a fundamental shift towards preventative care to reduce the burden of chronic illness, non-communicable disease and mental illness, and that this included rolling out patient-centred solutions giving patients “a sense of autonomy in their care”, reports News24.
The private sector could contribute to universal health coverage through training, public-private partnerships, digitisation and electronic health record rollout, and sharing of policies and procedures, among other things, he said, adding that there was space for collaboration while litigation continued.
Social justice advocate Mark Heywood said the gaping health inequalities in South Africa are ongoing and commonplace, with many of the disparities in the system still mirroring those during apartheid.
“If you are a poor black woman with cancer, you are likely to be diagnosed at stage 4 and won’t get the care you need,” he said in his speech.
Section 27 importance
“When Section 27 of our Bill of Rights was put in in the first place, Health was a marker of discrimination under apartheid. It was one of the worst markers,” said Heywood, adding that although progress had been made, the primary determinants of access to healthcare were still “what they were under apartheid”: race, gender, class and geography.
Political conflict over the rollout of the NHI Act was exacerbating the system’s challenges, he observed, and progress in increasing access to healthcare services has all but stalled over the fight over the Act.
“At the moment, where we need collaboration on healthcare access, there is conflict. The fight has hindered reform in area after area and goes against the spirit of universal healthcare. Our egos become determinants of access to healthcare services. Litigations …are not going to put any medications in any clinics.”
Professor Susan Cleary, Head of Health Economics at the University of Cape Town, said South Africa’s total healthcare spend, in both the public and private sectors, was around R492bn.
More than half of that (R249bn) is spent in the private sector – 15% of the population – while the remaining R243bn supports the 85% of the population using public healthcare.
Cleary said funding levels have dropped dramatically post-Covid-19, with funding on par with 2010 levels.
One area in which South Africa had excelled was reducing the risks of financial catastrophe due to out-of-pocket medical payments, she added.
“Our current system does deliver excellent final protection. It is one of the best globally – but our economic context is sobering. Difficult choices need to be made on the breadth of benefits so that access to quality healthcare can be maximised.”
The congress coincided with the observance of World Patient Safety Day, underscoring the Ombudsman’s commitment to ensuring the quality and safety of healthcare services for all users.
Health Ombud Taole Mokoena described the conference as “a vital platform to reflect on our progress, challenges, and opportunities in ensuring that healthcare is recognised not as a privilege, but as a fundamental human right”.
See more from MedicalBrief archives:
Motsoaledi urges ‘renewed action’ towards universal healthcare
How SA can transform NHI into universal healthcare, successfully
Eight steps to get SA's health sector right