Report on healthcare calls for urgent reform

Researchers have warned that SA’s health system is in need of an urgent overhaul, citing the slow progress in the past decade.

This is according to a new report released yesterday by civil rights groups Section 27 and Concentric Alliance.

The report, titled Health Reform: Perspectives and Proposals, says while there is slow progress in achieving change many citizens continue struggling to access quality health services while medical professionals suffer from burnout. 

The researchers also cite mistrust and disagreements among key stakeholders as part of the reason behind delayed change.

However, the findings also show there is hope if key players in the health sector act urgently.

The report is expected to be officially launched on Monday during a webinar involving representatives from national government, unions, the private health sector and civic organisations.

Section 2 spokesperson Sasha Stevenson said although debates about health reform in the country had been characterised by mistrust and disagreements, the surprising thing was that there were a lot of areas of consensus. 

Stevenson said reform in the SA context meant changing the system to provide quality healthcare to more people across the country.

All of the participants interviewed, which included health regulators, government, medical aid schemes, civil society, the pharmaceutical industry and hospital groups, agreed that that there was an urgent need for change, according to the report.

“There has been paralysis in health reform and we have not seen enough successes but the findings show that there is a way forward. This is very important because it means we can actually start making some changes from tomorrow,” Stevenson said.

The report recommends that stakeholders in healthcare to look past their differences and start pushing for implementation, focusing on areas where they already share consensus.

Stevenson said debates had gone on for too long while implementation suffered.

“We have been talking about NHI (national health insurance) for so many years. The system is buckling but we are still talking about legislation. You need more than legislation to change things,” she said.

Participants were selected based on their level of seniority and influence in the health system. Their identities were kept anonymous to allow them the freedom to share their opinions without fear of reprisal.

Participants also expressed views on NHI. 

“Rather, they think that NHI is an easy way to distract the population and create the perception of reform happening. This sentiment was echoed by a respondent from government who stated that NHI has made such little progress over a long period of time that perhaps it is 'just simply big talk',” the report states.

The report found that although there were profound disagreements, the different parties agreed that access to health care should form the foundation of the system and urgent reform was needed.

Respondents agreed that improving training and increasing the number of healthcare professionals in the country while nine participants said the most severe outcomes of poor accountability in public health was corruption and escalating costs, resulting in significant misallocation of resources out of the public sector.

SA Medical Association chairperson Dr Mvuyisi Mzukwa said the report was spot on.

Mzukwa said there was a lack of consensus and continued mistrusts meant that people could not work towards a common goal.

“We don’t get better health outcomes but we are a country that spends so much on healthcare,” he said.

Mzukwa said current conditions created a lot of frustrations on the ground, with many doctors opting to leave SA to go and work in countries like New Zealand and Canada. 

“At the moment we are seeing issues that were raised such as those raised by Dr Tim de Maayer in his open letter of gross shortages and lack of human capital,” he said.

Spokesperson for the national health department Foster Mohale said there were challenges in the system but this did not mean there was a complete stagnation.

“A lot has been achieved and we believe the NHI will go a long way in addressing most of the challenges to level the playing field as far as access to quality and affordable health service is concerned,” Mohale said.

He said the department was tackling some of the issues by decentralising some specialised services like cancer services to reduce waiting time and travelling costs by establishing service centres in provinces and districts.

Mohale said they were also focused on creating solutions like the medical oncology unit at Chris Hani Baragwanath Academic Hospital through private partners like the Bristol Myer Squibb Foundation.

He said processes to develop specialist units in Mpumalanga, Limpopo, Eastern Cape and Northern Cape were underway.