South Africa’s healthcare system, plagued by overcrowded hospitals, limited resources, and poor governance, can be fixed, believes outgoing Health Ombudsman Malegapuru Makgoba – but to do that, and for the NHI to work, will take time, careful management, investment from all the relevant sectors and, importantly, lessons learnt from abroad.
Makgoba believes Britain’s National Health Service (NHS) is one of the best in the world, reports News24.
Implemented 75 years ago, it provides access to primary, emergency and psychiatric care, is one of the largest public health systems around the globe, and a good model of universal healthcare, he said.
Makgoba lived and worked in the UK for more than 10 years, completing his PhD in human immuno-genetics at Oxford University in 1983. He was a senior registrar at the University of Birmingham, and also worked as an honorary consultant at the Royal Postgraduate Medical School at Hammersmith before returning to SA in 1994.
However, the NHS isn’t perfect, he added, because it also suffers from leadership issues, human resource problems, governance and financial challenges.
“There’s always a debate about the NHS in the UK. But the one thing everyone agrees on is that this is the only way. They cannot abandon the NHS. They’re all debating how to make it better, not how to get rid of it.”
Funding
The NHS is funded through general taxation, boosted by national insurance contributions (NICs) provided by citizens who earn more than a certain amount a year.
UK law dictates that if you’re over 16 and earn more than £242 (R5 808) a week, or self-employed and make a profit of more than £12 570 (R301 680) a year, you need to pay mandatory national insurance.
In 2003, NIC rates were increased to provide additional funding, but most of the money still comes from general income tax.
The amount people pay differs according to income but there are no limitations to the quality of healthcare a person receives on the NHS.
Equal healthcare for all is one way to address entrenched inequality in SA, pointed out Makgoba. “That’s how you nurture the future generation,” he added. “That’s what the UK focused on. They really impressed on society that good health is fundamental to a healthy democracy. When you go to the UK you don’t see a lot of malnutrition. People are healthier and generally live longer than us.”
The NHS is what the SA Government is hoping to achieve with the NHI. “But there’s still a long way to go,” he said. “This is no quick fix.”
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