Motsoaledi: Be patient on NHI

Cape Town - Health Minister Aaron Motsoaledi on Tuesday appealed to the public to be patient regarding the envisaged National Health Insurance (NHI) system, while at the same time providing further detail.

Speaking in the National Assembly during debate on his budget vote, he said there were two different groups of people in this regard.

Those who correctly and legitimately hoped that NHI would bring relief in their everyday hardships as far as their health care was concerned.

"And they are of course very right. However, the other group eagerly waiting are those consumed by self interest and greed that will shame even the devil," he said.

They were waiting for any development and vowed to do anything in their power to stop NHI dead in its tracks.

"To both groups, the legitimate expectation group and the greedy lot, I am appealing for their patience.

"We are working around the clock everyday around this issue of NHI. The problem is that many believe that NHI is just the release of a document.

"For us in health, we know that it also involves an extensive preparation of the health care system while at the same time preparing a policy document."

In this case the re-engineering of the health care system was very vital.

Under the present system whether public or private, no national health insurance could ever survive.

"I know that at face value problems in the health system are said to be existing only in the public sector and the private sector must be left alone to some wayward phenomena called market forces, even though these market forces dismally failed to stop or more appropriately caused the most recent global economic collapse," Motsoaledi said.

"Logically it means not doing anything we are preparing for the collapse of the health care system."

Poor management

While it was very true that the public health care system was bedevilled by very poor management leading to poor quality of care adding to the very low resources available in the public health sector, the present overall health care system both public and private would be completely re-engineered.

The current system was unsustainable, destructive, extremely costly, and very hospicentric or curative in nature.

"For any intervention dealing with the cost of health care like the NHI to make any sense, a complete re-engineering is essential and it is an obligation placed upon our shoulders," he said.

The re-engineering would be according to three main streams, including a district based model, in which a team of five specialist or clinicians would be deployed in each district.

These teams would specifically focus on maternal and child mortality.

"It is my intention that by the end of this calendar year, we should be far ahead in implementing this initiative," he said.

The second stream of re-engineering was a school health programme which would be launched with the ministers of basic education and social development.

A task team had been established about eight weeks ago and was working around the clock to deal with these issues.

This stream would deal with basic health issue like eye care problems, dental problems, hearing problems, as well as immunisation programmes in schools.

When the team had completed its work, implementation would start in the poorest schools in quintile one and two, which were also far from the nearest health centres.

The last stream would be a ward based model which would deploy at least 10 well trained PHC workers per ward.

This method was being put to good use in Brazil where 30 000 of such people called Community Health Care Agents had been deployed to various communities, Motsoaledi said.

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