Phaahla highlights progress and challenges in improving healthcare system

The exorbitant cost of living has resulted in a significant number of employed individuals who have medical aid coverage struggling to cope with the ever-increasing contributions required to maintain their healthcare plans.

As a result, many of them are choosing to supplement the medical care they received with visits to already strained public health facilities.

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This has seen a shift in the dynamic of private versus public healthcare in the country.

According to Minister of Health Dr Joe Phaahla, the dawn of democracy also saw the rise of the medical aid industry.

Segregations of healthcare

During his address at the Presidential Health Summit held in Gauteng on Thursday, Phaahla highlighted that this expansion of the medical aid industry had resulted in a shift from the segregation of healthcare services based on race to segregation based on income and socioeconomic status.

The quality of healthcare that an individual has access to is now determined by their place in society rather than their racial background.

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But this too, he said, was changing. He reiterated that it was therefore fitting that the Presidential Health Summit did not only focus on improving the public health system but also on “how to close the gap between the two with an acknowledgement that ultimately it is only the implementation of Universal Health Coverage which can create long lasting equity.”

This was exactly the intention of the 2018 summit, he said, that outlined several areas (or pillars) within the country’s health system that needed to be addressed and solved.

These ‘pillars’ made up a document called the Presidential Health Compact:

He explained that the 2023 summit will now look at the ways in which these areas were addressed, what progress has been made and what still needs to be done.

In terms of feedback, Phaahla said that the sudden impact of the Covid Pandemic upon the health system helped to accelerate addressing a number of the issues that were highlighted in 2018.

Human resources

With regard to Human Resources for Health, Phaala said that the Presidential Stimulus package implemented in 2018/19 and a further cash injection at the height of Covid-19 saw a lot more healthcare workers being absorbed into the system. But, he added, the sustainability of this has been undermined by continuous budget cuts.

Access to essential medicine

Covid-19 interventions also helped improve access to essential medicines with the roll-out of the vaccine.

“We haven’t had any major shortages of necessary medications over the past five years, although this could change depending on how we manage our finances and procure supplies,” he said.

He added that the health department could do better with implementing a better Stock Visibility System.

Infrastructure

Phaahla said that the The estimated cost of all Infrastructure needs done in 2019 was around R70 billion for hospitals and R12.6 billionn for Primary Health Care facilities.

“Under COVID-19, funds were directed to put up a number of temporary structures, some of which are being converted for regular long-term use. While there is ongoing rollout ofreplacement , upgrades and maintenance projects, it’s not enough,” he said.

He said that they needed to be in talks with National Treasury around the financing model.

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Quality, safety and quantity of services

In terms of improving quality, safety and quantity of services, which seems to be the main pillar regarding the most attention in the Compact, Phaahla explained that there were plans for Primary Health Care facility upgrading through the Ideal Clinic Realisation programme, but added that this suffered a bit of setback during Covid-19.

“There is much pressure on the quality of hospital care and this is due to high volumes of patients and poor management of staff. Medical litigation remains a high risk, but we are working with all provinces to have a coordinated response,” he said.

Financial management

With the PPE corruption exposing the weakness and rot in the sector’s financial management, Phaahla said that urgent attention was given to supply chain management.

“A number of cases were investigated by the Special Investigating Unit leading to disciplinary processes.

“Incidents of poor financial management are still occurring, leading to non-delivery of essential goods and services,” he said.

He mentioned that an anti-corruption forum in the sector was launched in 2019 but its impact was still to be felt.

Information systems

With regard to developing a proper information system, Phaahla said that some progress has been made with regard to the development of an integrated Health Information System resulting in the registration of more than 60 million individuals on the Health Patient Registration System.

“There is progress in making sure systems used by provinces are interoperable. But there is still a lot that needs to be done to make sure that the private sector also has interoperable systems with the public sector for smoothness of services across,” he said.

Phaahla did not touch on how the public sector was engaging with the private sector on how to improve access to and quality of health care.