ANC RESPONSE TO THE BUSINESS DAY REPORT ON NHI'S HUMAN RESOURCE FIGURES

The ANC has noted report by Business Day today, 06 October 2010,  claiming that our figures in the NHI policy document are ‘distorted'. According to the report, Econex, whose research on NHI is sponsored by private hospital groups, claimed to have found new figures based on "reliable" data sources. The ANC has also noted the report published by Econex on this matter (see here - PDF).

HPCSA data has been used by many researchers in the health sector, including the Health Systems Trust, for many years to assess the number of health workers in the country.

It is generally acknowledged that HPSCA does not provide 100% accurate data on the number of doctors practising in South Africa.  HPSCA data is an over-estimate of the number of practising doctors and as such no one as accurate data on these numbers. This size of over-estimate is not known.

Unfortunately the note by Econex does not tell us what the sources of the ‘industry data' are. If given, we will obviously check the reliability of the source. We will not be surprised if there are flaws in their data.

In the model used in our policy document we provided a total of 28,636 doctors of whom 56% work in the public sector. This is remarkably similar to the numbers used in the Econex note, viz. 27,434 and 55.5%

Our policy document also acknowledges that a number of doctors are either not in practice or have moved overseas. So the figures were not simplistically arrived at.

While accurate numbers are desirable, it is important to stress that at national level, according to some noted experts, inaccuracies in excess of 15% (some say 20%) can be tolerated. This is why planning is over long periods of time. This allows for flexibility in addressing issues of inaccurate data.

The issue of medical specialists is clearly 'misunderstood'. The functions of the specialist should determine the number. Many specialists do GP work, especially in urban areas. Conversely, many GPs do specialist work, especially in rural areas. The divide between GPs and specialists is therefore not so clearcut. The Econex note is rather naive in this regard. The very reason why we do not distinguish between the two in initial national level planning is because the number of specialists are function of the number of doctors that we produce. If, therefore, the ratio of specialist-to-GP remains constant, an increase in the production of doctors will be accompanied by an increase in the number of specialists. Of course, it will be necessary for specialist planning to be done, but it should be done on the basis of need.

We also wish to state that these "new figures" of Econex do not alter the long established fact that ours is a two-tier health care in which there is a significant mal-distribution of health care resources (including human resources) primarily between the public sector and private sector. Unfortunately, Econex fails to acknowledge this reality and treats the system as ‘more of the same'. In particular, their note makes no comment on how we should work towards changing the system.

Statement issued by Jackson Mthembu, ANC National Spokesperson, October 6 2010

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