Systemic change a must to save health system – Mabuza

Poor leadership and governance are among areas of weakness identified by the Presidency at every level of South Africa’s public healthcare system, Deputy President David Mabuza said yesterday.

Mabuza was speaking during the two-day Presidential Health Summit in Boksburg on the East Rand, that ends today.

The summit is expected to come up with a road map on how best to address the country’s healthcare crisis by adopting a set of resolutions.

Due to President Cyril Ramaphosa’s ill-health – which this week led to him cancelling an official visit to the Democratic Republic of Congo – Mabuza, who led the government delegation at the Birchwood Conference Centre, became a late replacement at the watershed gathering.

In his address at the summit, also attended by ministers Nkosazana Dlamini-Zuma (national planning commission for policy and evaluation) and Aaron Motsoaledi (health), deputy ministers, World Health Organisation healthcare financing director Joe Kutzin, health MECs, directors-general, labour and civil society leaders, Mabuza was frank about the state of public health in South Africa.

“Our hospital boards and clinic committees are not functioning optimally, with communities not engaged to ensure quality healthcare for the population in the catchment areas,” he said.

“The management of hospitals needs to be improved through delegation of managerial authority to the hospital CEOs to allow them to take full accountability for the performance of their facilities.

“To remedy some of these challenges will require a change in the management culture of hospitals that is underpinned by consultation between staff, managers and labour over decisions that affect the work environment.”

Mabuza said a consultative style of management between managers and labour “will go a long way to reducing conflict and resultant labour unrest”.

Turning to staff shortages affecting delivery of services, he said there had been “a serious outcry from all corners of our country about the shortage of the workforce in the public sector”.

“Whereas the president has agreed to inject a certain number of the health workforce as part of his stimulus package, this is just but a temporary measure for immediate relief.

“This summit has to come up with an everlasting solution on this issue.

“In transforming the healthcare system for the better, we need to ensure that we have committed and appropriately skilled healthcare professionals,” he added.

“We need to ensure that proper governance systems are in place to improve accountability for performance across all levels of healthcare delivery in our system.”

Citing successes in voluntary HIV testing and the rollout of free antiretroviral drugs, Mabuza said life expectancy had “dramatically improved and many lives have been saved”.

He said the public health system contributed to the reduction of HIV, child and TB-related deaths.

Mabuza said: “By 2004, a total of 70 000 babies were born HIV-positive on an annual basis. But through our very successful prevention of mother-to-child transmission programme, the figure has dramatically dropped to less than 4 500 babies by 2017.

“Eighty percent of infants under one year old are vaccinated to protect them against preventable diseases like measles and 300 000 people receive treatment for tuberculosis.

“We must express our thanks and appreciation to the doctors, nurses, pharmacists and other health workers in the public and private health system, who make these successes possible”.

Despite the progress, the country still faced rising levels in diabetes, cancer, hypertension and mental illness.

He said: “For us to improve the health system, we need to understand the causes of the crisis.

“We need a systemic change that will outlive us and become a gift to the new generation.”

– brians@citizen.co.za

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