NHI hearings expose health system rot

7 November 2019

If the past week’s public hearings in the Northern Cape, on the National Health Insurance (NHI) bill, have highlighted one thing, it is not that the country is in need of the NHI, but rather that our people are in desperate need of quality universal health care because the government has managed public health resources into the ground.

The near collapse of the state health system in the Northern Cape, as was outlined by residents over the past week, should therefore set off warning bells for all who even dare to consider the suitability of the unaffordable, NHI pipedream.

The lack of available and accessible health care in the province, despite the establishment of many clinics, Community Health Centres and even hospitals, is shocking.

The majority of health facilities, including our two provincial hospitals by way of the state of the art Dr Harry Surtie Hospital in Upington and the De Aar Hospital, are miles away from operating in their mandated capacity because of the ongoing challenges of shortages of health staff from doctors and nurses to clerks and cleaners, lack of equipment, and out of stocks of medication, to name but a few. The situation is replicated across our clinics and CHC’s.

The Tshwaragano Hospital is literally a death trap and even the province’s only tertiary hospital in Kimberley, Robert Mangaliso Sobukwe Hospital, is buckling under the pressure caused by long term mismanagement. Cancer patients are suffering because of unsustainable treatment options. Mentally ill patients continue to suffer because of a lack of accessible services.

Emergency Medical Services as well as patient transport services are dismal. Impoverished patients are expected to pay R200 or more to get to health facilities. More often than not, private transport is roped in to take patients to hospitals when no ambulances are available.

While services are pitiful to say the least, the disease burden is also increasing day by day. This too is directly due to government’s inability to successfully combat the spread of disease through preventative measures.

There is an increased incidence of new drug susceptible and drug resistant TB patients in the Northern Cape because of out-of-stock of medication, losing people in the system and non-functioning TB-tracer teams. There has been an increase in HIV incidences and a decrease in patients remaining on Anti-Retroviral Treatment, as well as increase in Sexually Transmitted Illnesses. This can be attributed to a number of failures including non-availability of ARV’s, lack of condoms due to basic transport issues, and ineffective health services. There has also been an increase in sever acute malnutrition due to poor implementation of the World Health Organisations 20 steps.

The list can go on and on.

It is not an over exaggeration to say that people are getting sicker and dying because the current health system is failing the people. In other words, the government cannot honestly, effectively and innovatively invest the billions that have already been allocated to the public health sector.

If the health department can’t manage the funds it has, how will it cope with additional billions? It won’t, it will just create another massive, failed State Owned Entity that practises patient-shedding because it will have pulled the plug on life support.

NHI will also chase even more health professional overseas. It will open the health sector up to even more corruption. And, instead of raising levels of healthcare across the public and private sectors, it will bring them down.

The DA supports quality universal healthcare for all South Africans but we are increasingly certain that this will not be achieved by the NHI.

Instead, the first thing that must be done is to invest in the public health system, to bring it to the same level as our private health facilities. Then universal health care could be rolled out through a collaboration with the private sector, still giving users a choice of where they receive care. This will enhance competition within the private health industry to guard against the rising cost of healthcare, and it will spare the economy of even more damage. It will see a health system that strives for excellence and not mediocrity in health care. Mediocrity, after all, will not save lives.

We can only hope that the government swallows its pride and does what is right for the people of South Africa and not what it thinks is good for its image.

Issued by Delmaine Christians, DA Member of National Council of Provinces, 7 November 2019