Do your own work, Minister Motsoaledi

2014-08-26 15:06

It’s amazing how the government always finds a way to make others do the hard work when it knows the end result will work in its favour.

On Sunday, Health Minister Aaron Motsoaledi told delegates at the Board of Healthcare Funders conference taking place in Durban that private hospitals need to stop doctors employed in the public sector from moonlighting in their hospitals during working hours.

These doctors, he said, were abandoning medical students to make a quick buck on the side – and this would come back to bite the private sector in the future, he warned.

“The illiterate medical student will work in your [private] hospital some day,” Motsoaledi said.

But why should private hospitals be the ones putting a stop to this practice? Minister, the doctors you’re criticising are employed full-time by the state – it’s up to you to rein them in.

The same goes for Dr Anban Pillay, the deputy director-general for health regulatory and compliance management at the national department of health.

This morning, Pillay asked medical schemes gathered at the conference to draw up rules that would stop their members from bypassing GPs and going straight to specialists to seek treatment for minor ailments.

This sort of thing has been happening for a long time, and medical schemes have complained – repeatedly and loudly.

Now that it may soon affect government, Pillay’s asking schemes to develop restrictions. That’s a bit rich!

The ethics code of the Health Professions Council of South Africa clearly states that a patient can consult any practitioner he or she wants to, Mr Pillay.

As much as the HPCSA is an independent statutory body established in terms of the Health Professions Act there are synergies between it and the department of health.

This means when the council’s code was drawn up the government must have known about – or even contributed to – it.

I guess at the time it didn’t concern the government too much because it’s tough for a public patient to go straight to a specialist without being referred by a nurse at a clinic or a GP in a hospital’s outpatient department.

Now the wheels are turning as the government forges ahead with the National Health Insurance system, which will allow patients who have never had the luxury of private treatment to open entirely new doors. And the government will foot the bill. So if people run straight to pricy specialists, the public purse may not be able to sustain the NHI.

With the coming of the NHI, there needs to be aggressive education about GPs and clinics remaining the first port of call for patients.

This may not work, because public patients are already voting with their feet – they would rather pay more for mostly better quality service. Imagine what it will be like when the government’s paying for that private care?

Specialists cost a lot and take a huge chunk of schemes’ budgets, so I agree with Pillay that medical aids must tighten their rules on specialist referrals.

But the government must also amend the HPCSA’s ethical rules, improve the public sector and then teach people that our public hospitals and clinics are absolutely good enough.

The work needed to improve health systems in South Africa needs to be shared equally between the private and public sector – rather than making one sector do all the hard work so the other reaps the rewards.

– Mapumulo is City Press’ health writer

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