Good leadership will ensure the success of South Africa’s NHI

2014-08-25 13:55

South Africa can learn a thing or two about activism and leadership in healthcare from Australia and the United Kingdom, two countries with a rich history in providing universal coverage.

This is what emerged on the first day of the annual Board of Healthcare Funders’ conference in Durban.

South Africa can learn how these countries found a way to make the public and private healthcare sectors work together with an aim of offering quality and affordable healthcare to all its citizens, irrespective whether they are rich or poor.

The United Kingdom introduced its National Health System in 1948 and Australia introduced its Medicare system in 1975. Both systems are more like the National Health Insurance (NHI) system that the South African government is trying to introduce.

Two speakers at the conference – Lord Nigel Crisp, who was the chief executive of the NHS from 2000 to 2006, and Dr Michael Armitage, chief executive officer of Private Healthcare Australia – spoke at length about the importance of activism and strong leadership in time of healthcare transformation.

Most of the lessons they shared addressed some of the thorny issues around the NHI.

Key points from the speakers:

» There must be a dialogue between the private and public sector about changes to the health system and about how both parties can work with each other to provide quality healthcare to all;

» Leaders must work with clinicians because they deal with patients and know what will work on the ground;

» Leaders have to make patients, clinicians and other stakeholders, such as the private sector, understand how the transition will affect them and where they fit in;

» Appoint the right people to do the job;

» Develop and introduce quality standards;

» Give support and tools to clinicians so that they can provide quality healthcare and maintain the standard;

» Contract private GPs to work with the public healthcare sector. It must be clear what are the expectations from both the public and private healthcare sectors;

» GPs should assume the roles of gatekeepers to avoid patients going straight to specialists or major hospitals; and

» The private sector must actively interact with customers in plain language and promote better informed decisions about their products and services even if the government has a national health insurance in place.

This helps to ensure that the private health sector does not die because some people will want top-up cover (in addition to the NHI) and there are those who prefer to continue with having private medical insurance.

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