Mark Steele MPP
DA Member of the KZN Legislature Health portfolio committee
THE SA Medical Association (Sama) has sounded a warning which the national health department would be wise to heed before making any further commitments to the National Health Insurance (NHI) scheme. Private doctors and especially GPs will require reasonable compensation for their services if they are to make a portion of their time available to public sector patients. The vast majority of doctors are committed to health care for all, but they will not give their services away without serious negotiations over the fees to be charged.
This is just one of the reasons why NHI must be critically examined. The way it is currently being promoted sounds more and more like the way OBE was originally sold to parents and teachers – an ideologically driven salvation for all things, complete with its own vocabulary and assumptions about the way society can simply be molded and controlled.
Before NHI can work it must address the real problems of public health, which were brutally exposed this week during a site inspection by the KwaZulu-Natal health portfolio committee to the brand new primary health care facility in KwaMashu. This is not some apartheid era institution, underfunded and dilapidated. This is a spanking new community hospital – but with an outpatients department half the size it should be and with totally inadequate ventilation. Patients sit in the heat breathing in each other’s ailments – no wonder they cried out when we arrived to the MPLs they recognized to help them!
The committee were unanimous in condemning the dreadful lack of planning and poor management evident at the facility – and yet that is precisely the problem NHI is not facing up to – the need to make public health workers and managers accountable for their services to the public. Without accountability nothing will change in public health care for those who do not have the means to exercise a choice of which provider they consult over their personal health problems.