SA doctors must prioritise saving lives over greed before NHI discussions, says Dr Sooliman

Gift of the Givers and seasoned medical practitioner, Dr Imtiaz Sooliman has said government can only initiate discussions regarding the implementation of the National Health Insurance (NHI) after addressing the fundamental issues concerning doctors and management.

The NHI is a fund government introduced so it would be able to buy healthcare services for South Africans from healthcare providers both in the public and private sector.

But, Dr Sooliman says for it to work, the health care system needs to get its house in order first.

The founder of the country’s biggest humanitarian group came down hard on the country’s doctors, relating how, during the Covid-19 pandemic, he watched people die because doctors along with the politicians they worked with were greedy and made selfish decisions.

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SAMA conference

Dr Sooliman was speaking at the SA Medical Association (SAMA) conference in Johannesburg earlier this week, which was held under the theme: “Towards Strengthening Health Systems”.

Dr Sooliman said the implementation of the NHI alone would not strengthen the health system but rather that doctors in the sector themselves needed to stop being greedy, take stock of how they were operating and remember why they became a doctor in the first place.

“Why did you become a doctor? Is it just about the money? Where is your conscience, morals, and integrity?” he asked.

“As doctors, you need to fix your attitude and remember why you became a doctor.

“Surely it can’t be about the money. Yes, you make a lot of money as doctors but you also vowed to save lives. Pardon me I say it like it is.

“Before we can envision transforming the healthcare system, we must first confront the corruption within our respective roles and scrutinise the prioritisation of profit over saving lives for the broader population,” he said.

Issues identified

Dr Sooliman said during his humanitarian work at the various health care facilities in the country he noticed a number of issues that needed immediate attention before any other strategies like the NHI could be implemented.

Greed and corruption

He related how during the Covid pandemic, there was a critical situation where Gift of the Givers stepped in to help by sourcing oxygen machines from other countries for South Africans. Thousands were being admitted for Covid-19 infections and related complications, and the demand for oxygen was overwhelming.

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He said they noticed that instead of investing in newer C-pap type machines, which are more efficient in oxygen usage and could have saved more lives, certain doctors and political figures insisted on using high oxygen-demand machines. Their reluctance to adopt the more efficient machines seemed to stem from financial concerns and left less money at their disposal.

“This decision, driven by greed, resulted in unnecessary deaths because hospitals were unable to meet the oxygen demand. It’s a heartbreaking reality that many lives could have been saved if we had enough of the right equipment,” he said.

Unnecessary big salaries

Sooliman emphasised the need for the health department to eliminate unnecessary high-paying positions while frontline workers like doctors and nurses remain unemployed.

He pointed out that despite the lack of funding for essential roles, the government prioritises funding for ineffective managerial positions.

He criticised the lack of accountability for officials such as district medical directors, who receive large salaries without consequences for failures in facility management.

Sooliman expressed disappointment in seeing doctors signing lucrative contracts with public institutions only to prioritise their private practices when needed in hospitals.

He did though, commend the doctors who sacrifice their time and resources to address surgical backlogs, highlighting their compassion. He also acknowledged the dedication of frontline workers who consistently make themselves available for work in public hospitals.

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But, he said that there were still too many doctors sitting in their fancy private practices while neglecting their duties in the public hospitals.

Flimsy budgets and unmaintained infrastructure

He emphasised that numerous issues plaguing the health system stem from mismanagement.

“Maintenance has ceased in public hospitals. Despite annual budgets, the whereabouts of the funds remain a mystery.

“As doctors, it’s imperative to be accountable and transparent regarding budgetary matters,” he said.

Dr Sooliman pointed out that while some facilities underwent rushed refurbishments during the pandemic, many hospitals are obsolete, requiring extensive renovations, and some even demand complete reconstruction.

Recognising the urgent necessity for a comprehensive overhaul of the nation’s healthcare system, the government has introduced the NHI. However, this initiative has faced significant criticism from numerous medical professionals and institutions nationwide.