CPC Qualicare / DocWeb | Doctor's Online resource for South African Doctors

December 2018 Newsletter

Its Christmas……. Don’t kill the Golden Goose!!!

…………So it’s back to the drawing board for the NHI Bill after Cabinet failed to approve the latest hatchet job that was presented to them, which, it has been reported, effectively removed Medical Aids from the NHI offering, finished and klaar!

During the next 60 days, the NHI team will hopefully be reworking the bill to once again include the private sector and permit access to medical aids for those who can afford it, whilst dramatically ramping up the level of service, state of repair and outcomes of the State Health Institutions.

The revisited NHI Bill  attempt, at the 11th hour, to allegedly and stealthily change the ethos of the bill by limiting medical aid benefits and services  to those  which are only complementary that offered by the State through NHI has been stopped , for now. The concept however has come up so frequently, that it must have significant support in the minds of certain lawmakers. It’s nothing new as the idea has been around since the original 1994 green paper on healthcare reform. It has been serially written out, and then slipped back into NHI thinking, like a magician’s rabbit.

No South African, here or abroad, can rightfully be satisfied with the current status quo of health in RSA.

The Private sector is excellent in outcomes but very costly to run and is profit centric via providers, administrators, pharmacy and hospital chains.

The Public sector healthcare has islands of excellence, but overall falls short of the mark as a recent visit to the township healthcare outlets surrounding Cape Town revealed. Underutilised State clinics, with understaffed pharmacies and long waiting times, versus oversubscribed private doctors waiting rooms, preferred by the patients as the doctors spoke their language and understood their cultural needs.

The message is clear….. fix the State sector so that it becomes the  default choice of the average South African when seeking healthcare. But do not deny access to the Private sector via draconian legislation, when the State has so little to offer at present.

Harmonise with the Private sector, hybridise their ideas, remove the excessive profit motives whilst retaining the best of breed.

Use the HMI finalised report when it is available to root out anticompetitive behaviour, but embrace their opinions on the good sections of private healthcare and incorporate them.

Medical aids currently cover 9 million lives; employ huge numbers of staff to run them, as do the hospitals and clinics which the private sector has set up, in areas where the state offerings have failed. Implosion of this sector will spell its own form of economic disaster for RSA.

The misgivings as a result of unclear costings related to NHI and raised by Treasury, as well as concerns around probity over the enormous potential NHI fund are all able to be addressed in a rational manner without querying anyone’s national pride, loyalty, or party affiliation.

Lessons from the Western Cape NHI Pilot projects are few and far between, the majority of private doctors not ever having been asked to take part or having been aware that the pilots were running.

For the sake of avoidance of any doubt, CPC/Qualicare wholeheartedly supports a fusion between private and public family practitioners working on risk adjusted capitation to see State patients from their rooms, and continuing to see medical aid and private patients from their surgeries as well.

Public Private Partnerships are the way forward.

Let’s now wait for 30 January 2019 (which is only 3 to 4 months away from the General Election!!!), to see the new reworked version of the NHI bill, hopefully with Private Public Partnerships as a cornerstone to a system we can all support in our love for this wonderful country and the health of its citizens.

In the meanwhile, use the holidays to peruse this edition of Qualicare News which contains a selection of interesting articles which we have published throughout 2018. Each one is worth a read as well as a discussion with your colleagues around the Christmas dinner or braai.

CPC/Qualicare wishes its members and shareholders a well-earned rest over the festive season, a Blessed Christmas, a Happy Chanukah and a prosperous 2019.

Kind regards

QC Team

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