By Dr Dumisani Bomela, 27 October 2017, businesslive.co.za.
South Africa has only half the global average number of doctors, a number that has remained static for decades.
In their presentations, the CEs offered practical support to the several interventions identified by the Department of Health as it begins its first steps towards quality healthcare for all — specifically maternal and women’s health, school health, the screening and treatment of paediatric cancer, the elderly and disabled, and mental health screening.
Among other suggestions, Netcare Group CEO Dr Richard Friedland pointed to his group’s success in developing high-volume and low-cost cataract treatments in the UK, offering to make his group’s expertise available here. Koert Pretorius, CEO of Mediclinic Southern Africa, suggested that in addition to the private sector making private hospital capacity available to the public sector, it could help erase backlogs in maternity care and various procedures by “undertaking a percentage of these cases at lower cost”.
Discovery Health’s CEO, Dr Jonathan Broomberg, pointed out that while it was important for ongoing engagements and debate on the form of a future healthcare system, including through the committees recently announced by the Department of Health to interrogate various aspects of National Health Insurance, it was at least equally important to retain a strong focus on delivering immediately on the everyday healthcare needs of what Friedland earlier called an “unsustainably unequal” society.
In other words, while we continue to shape and form through ongoing engagements the future of the healthcare system, let us get on with making sure we do the best we can for South Africans today.
It is highly likely that as collaborations deepen on everyday healthcare delivery, collaboration on larger issues — such as National Health Insurance — will become easier, more pragmatic and less adversarial.
The situation South African healthcare finds itself in is not unique. At the conference, Denise Soares dos Santos, who runs one of the largest private-sector healthcare hubs in Brazil, and her compatriot Luiz Augusto Carneiro described how the two sectors had found ways to exist side by side, sustainably, against a backdrop of slow economic growth, the need to reform their healthcare system and the pressing need for social stability in an unequal society.
Their journey to this point may not have been untroubled — for one, healthcare inflation ran for years in the double digits — but Brazil has shown that workable solutions can indeed be found.
Similarly, Dr Vinod Bhat, vice-chancellor of Manipal University, described how India had fashioned success out of collaboration between the public and private sector in expanding training facilities for doctors to meet a debilitating shortage in the profession in that country. So did Brazil, which responded similarly to India.
SA faces the same challenge in that this country has only half the global average number of doctors, a number that has remained static for decades even as the population has doubled.
There are no such partnerships in this country to increase the numbers of medical students; there are no public-private collaborations in SA to increase the numbers of doctors in training.
In like manner, another speaker at the conference, Marine Erasmus, director at Econex, made the point that the cost of universal healthcare debate is a distraction from the need to collaborate to improve on the performance of the healthcare system and its outcomes.
The critical point is that whether we are concerned about the daily healthcare needs of South Africans or the long-term future of the healthcare system, the potential for success is exponentially higher when partnerships exist.
We now have the stated intention of moving towards universal healthcare through the gazetted National Health Insurance, but to move from a stated intention to a realised ambition is another thing altogether. To paraphrase one conference speaker: having a policy is important, but it is not enough; without collaboration, we cannot expect to wake up on April 1 2026 (or at some future date) and hope that by some miracle, universal healthcare will be in place.
Nor, he may have added, will we solve the immediate healthcare challenges South Africans face without joining hands today.
• Dr Bomela is Hospital Association of SA CEO.
