By Lehlohonolo Lehana.
Health Minister Dr Joe Phaahla says the public health system is facing several challenges which include the high burden of diseases, leading to huge service demand while resources are continuously reducing because of poor economic performance.
Phaahla said even with limited resources, many public health facilities could perform better if it were not for inefficiency, poor management, neglect of duty to poor supervision, and even outright corruption.
He added despite severe weakness, the public health system had proven resilient even under the most testing pressure of the Covid-19 pandemic.
The Minister was speaking at the second Presidential Health Summit at the Birchwood Hotel in Boksburg – a platform to review the implementation of the interventions agreed to during the 2018 summit and assess the performance of the health system against the Health Compact.
The summit aims to assess the readiness of the health system to implement National Health Insurance (NHI).
Phaahla told delegates that millions of South Africans still receive “acceptable” service at many public health facilities despite the public sector having to contend with many hurdles.
He highlighted pockets of excellence at many facilities from primary health up to specialised services.
For instance, he said, the Prince Mshiyeni Memorial Hospital in Durban delivers about 1 000 babies a month, while a private hospital in the same area delivers about 60 to 80 babies a month with a 70% caesarean section.
The Chris Hani Baragwanath Hospital in Johannesburg records between 1 500 and 1 800 births monthly.
“This just goes on to show the difference in pressure of service between public and private hospitals.”
He cited the Council for Medical Schemes annual report that shows that expenditure on private health excluding out-of-pocket expenditure is slightly higher than the total expenditure of the public health budget, but only services about 15% of the population.
In addition, he said, as unemployment grows more people are being pushed to depend exclusively on the public health system.
“Even those employed and on medical aids are suffocating under ever-increasing contributions.
“Anybody who denies the fact that the current path of our two-tier health system is not sustainable is a denialist… The need for reform of the current trajectory should not be a matter of debate even where we may differ on details but to those who say leave the private sector alone and just fix the public health, we say this is disingenuous.”
Phaahla said he was looking forward to interrogating progress reports and proposals on how to accelerate the further implementation of all pillars which will contribute positively to the implementation of Universal Health Coverage through the NHI.
The nine pillars include human resources; access to medicine, vaccines and health products; infrastructure; private sector engagement; quality healthcare; public sector financial management improvements; governance and leadership; community engagements; information systems and pandemic preparedness.