Newsmaker – Health where it hurts

2011-08-13 15:55

Dr Aaron Motsaoledi is on a crusade to improve the quality of public healthcare

It’s been a hectic week for Health Minister Aaron Motsoaledi, who on Thursday released government’s Green Paper on the national health insurance plan.

Shortly after the announcement in Pretoria, he hopped on a plane to Cape Town to attend a series of government meetings.

In the evening he was back in Gauteng to attend to other government affairs and prepare for a trip to the Free State early the following morning.

When we speak on the phone ­later that night, there isn’t a hint of exhaustion in his voice.

“What can a nation that is dying achieve?” he says when asked about his unmistakable passion for his work.

“I’ve been a health activist all my life.

“I understand health issues can’t be resolved without political emancipation.”

Motsoaledi (53) holds a bachelor of medicine and surgery from the University of KwaZulu-Natal.

The ANC national executive committee member replaced Barbara Hogan as health MEC after he was appointed by President Jacob Zuma in 2009.

Before that he was education MEC and acting premier in Limpopo, his native province. He comes from rural Phokwane in the province’s Nebo district.

Motsoaledi has taken to his position with a zeal that has seen him volunteering his services at public hospitals.

He once helped perform 10 ­circumcision operations at Chris Hani-Baragwanath hospital in Soweto.

But some of his announcements, including his recent call to circumcise newborn babies to help fight the spread of HIV and other sexually transmitted infections, have raised concerns.

The Medical Rights Advocacy Network wrote to Motsoaledi after he announced government’s plan, starting next year, to circumcise babies born in public hospitals.

It said this could open South ­Africa up to cosmetic industries that might use discarded virgin foreskins to sustain a multimillion-dollar industry in the manufacture of insulin and artificial skin.

He says: “This is very comical. I don’t know if we’re a comic nation or what?

“If we say that, we might as well say women must stop delivering because their placentas are needed in the cosmetic industry (they’re used to make products to rejuvenate skin). Circumcision has been done for religious reasons but foreskins ­haven’t been sold, so what’s different now?”

Earlier this month Motsoaledi announced an 18% aggregate ­reduction in the cost of anti-tuberculosis medication and antibiotics, amounting to a saving of ­R242 million.

This followed a similar announcement last year that the department had awarded last year’s R4.28 billion antiretroviral tender to 10 suppliers, a 53.1% saving on the cost of antiretrovirals.

Motsoaledi has said the national health insurance plan is primarily aimed at reducing the cost of private healthcare and improving the quality of public healthcare.

A pilot phase of the plan will start in April next year, in 10 districts, after the completion of an audit of all the country’s public health ­facilities.

“Even if a miracle happens, that tomorrow every person in this country has medical aid, the reality is that we can’t do without the public health service because the private health sector only caters for 16% of the population,” Motsoaledi says.

“We’re not yet at a stage where we can determine the costs of how much people will be paying.”

For the plan to succeed, he says, the quality of service in public hospitals must be non-negotiable and healthcare costs in the private sector must be tackled equally ­seriously.

“The national health insurance plan is not a war between the public health sector and the private healthcare sector – it’s not even a competition or a beauty contest between these two healthcare delivery systems.

“If we view matters in this light, and if we try to tear each other apart, the people of South Africa will be the real losers.

“The challenge and intent of the national health insurance plan is to draw on the strengths of both healthcare sectors to better serve the public,” he says.

Motsoaledi acknowledges that “the quality of care in public health institutions is often unacceptable”.

“I use a lot of public healthcare myself, and I’m often struck by the lack of quality in some of our institutions,” he says.
The department has appointed task teams to rebuild various hospitals across the country.

“Some of the hospitals are so ­dilapidated that we’re moving everyone out,” he says.

“Some of the urban facilities are even worse than rural hospitals.”

Motsoaledi has been championing the HIV counselling and testing campaign launched by Zuma in April last year.

This has seen the number of ­people on antiretroviral treatment rise to almost one million.

“We’ve not yet won the war against HIV, so we have no choice but to continue (initiating people on ARVs) so long as the virus exists,” says Motsoaledi.

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