Motsoaledi: Health system needs overhaul

2011-01-26 20:32

Cape Town - South Africa must overhaul its entire health care system and move towards primary health care, Minister Aaron Motsoaledi said in Parliament on Wednesday.

Motsoaledi said in a briefing to the portfolio committee on women, children and people with disabilities that people were going straight to hospitals for treatment.

"We need to overhaul the whole health care service and move it towards primary health care because some need to be treated at clinics," he said.

"People in South Africa are not utilising clinics. They are utilising tertiary hospitals. This not how health care must be conducted. You don't wake up and go to the highest hospital. You start at clinics."

Most people who went to the Chris Hani Baragwanath Hospital were not supposed to be there, he said.

"This is one of the biggest hospitals in the southern hemisphere. You don't just wake up and go there. This causes overcrowding, it causes congestion, it causes nurses to have nerves fraying and doctors to be angry."

Motsoaledi said he felt "disturbed" when he recently addressed a gathering of traditional leaders.

"One of them stood up and said: minister you are forcing us to go to clinics. We don't want to go to clinics, we want to go to hospitals.

"I got very scared. That type of health care doesn't survive anywhere. In fact one of the reasons health care is so expensive in South Africa is because of that."

The health care system was unsustainable, "extremely expensive", curative and was "hospicentric".

"We need to launch a massive primary health care campaign in South Africa. In Britain in terms of the National Health Service, no one goes to hospital unless they are referred by a general practitioner at primary health care level. Otherwise they will turn you back home. In South Africa if you turn anyone away it will be headlines."

In the next six months Motsoaledi would appoint four key people in each district to deal with primary health care, maternal mortality and infant mortality.

"One of the ways is to take the doctors out of the hospitals and put them in clinics," he said.

'Sugar daddyism'

He also told the committee that vulnerable young women were engaging "sugar daddyism" and as a result were becoming infected with HIV.

Surveys showed that early on in life there were more HIV positive males than females, but when sexual activity started, females with HIV started "jumping up".

Later on in life however, the infection rate of the males increased, meaning that young women suffer the brunt more than young men.

"There is only one explanation - sugar daddyism," Motsoaledi said.

"It shows that older men are having sex with young girls, from that belief that if you sleep with a virgin, etcetera."

He referred to a school in Limpopo where 57 girls between the ages of 13 and 15 had become pregnant.

"It means that they slept with each other without condoms. It is not only pregnancy but also HIV," he said.

Most of the girls who became pregnant were orphans whose parents had died of HIV.

"They are easy prey for men who come with money," he said. "Because they are poor. They sleep with them they fall pregnant. It becomes a vicious cycle.

"If your parent dies of HIV/Aids, you are likely to die of HIV/Aids."

Abortions were another problem with women using it as a form of contraception. Since the Termination of Pregnancy Act in 1997, 702,354 young people had committed abortions.

"It is now going a little bit down. We suspect quite a number of institutions are overwhelmed. They are no longer doing it.

"What is making these young kids commit abortions? It means no family planning or they are not practising it or they have forgotten about it, despite the fact we are distributing condoms,." said Motsoaledi.

  • SEMATSATSA - 2011-01-26 20:49

    I am afraid Dr,the problem is to do with lack of community involvement in the care that the community need, no or inadequate patient awareness of what to do,were to go when they need to use the services.Recruit the relevant people to do the expected responsibilities.Ignore your political role in making this decision and things will improve.

  • Francois - 2011-01-26 21:32

    Minister, thank you for being honest. Can you please ask Bheki Cele to arrest those sugerdaddies for statutory rape?

  • Tlaks - 2011-01-26 22:07

    Ag, shame Doc! In order to sound politically correct, continue blaming the men on high HIV figures. Maybe that will work for you. I can tell you one thing though, this blaming game is not doing anybody any good! With due respect doc, you crunch figures and hastily arrives at conclusions. Here's a little advice: Increase capacity at Primary Health Care and continue to encourage people to test and know their status. Secondly, roll out the ARV treatment Pro gramme and ensure that everyone tested positive and eligible can be accommodated. Thirdly, ensure that drug theft at Healthcare Facilities is dealt with once and for all. Not to mention, pay healthcare workers a descent salary so that there will be no need for them to neglect their duties by engaging in protracted strikes. Encourage male circumcision and continue preaching "condomising" and abstaining as the best form of prevention. Please speak like a Minister and stop feeling your way like a blind person!

  • Skuinskoek - 2011-01-26 22:11

    Dr Motsoaledi, you are my hero - if we can address reproductive health (and responsible parenting = family planning) we will win the fight against poverty. I am proud to work under your reign.

      Colourblind - 2011-01-27 08:53

      Yep - finally a capable minister in charge of Health. This oke really has his head screwed on right. I hope he doesn't get moved anytime soon. We need him to finish what he started.

  • komkyk - 2011-01-27 00:47

    education,education, grass root level,shool nurses,motivational speakers not just for academic qualifications,groom the youth.more television and flyers advertisements about the stuff that builds the society.pls God help us

  • NickDM - 2011-01-27 02:00

    I think the minister has identified a weakness in the healthcare system quite accurately but there is no mention of steps towards a viable solution to this problem. It is a little confusing for me when a short time ago I am sure that the minister announced plans to build several more hospitals (with some SWC budget figure used). Surely from what Dr Motsoaledi has observed, we need many more better equipped local clinics to be built where 75% of the nation's health care needs can be met competently and only then, the remaining citizens requiring further treatment are passed on to larger facilities like Regional Hospitals. I would really appreciate it if the minister could put forward a 2-5-10-20 year plan for turning the current problem that exists around into a beacon for hope and a monument for what can be done. I am more than willing to do what I can and I am sure other frustrated practitioners are too!

  • - 2011-01-27 07:09

    Is this a joke? Most people could have told him that the system is not working. Why do people go to hospitals instead of clinics, is it because the clinics are not properly equipped and or adequately manned with trained staff. If our hospitals are in such a state and inadequate what of the clinics. Private sector patients do not go to hospitals but to their health care centres and seen to by the doctors and if necessary referred to the hospital. The difference being the care centres are properly manned.

  • HAggardGnome - 2011-01-27 07:49

    The wheels have fallen off the Health Care Sector. Once again the deployment of incompetant cadres has proved to be the wrong decision! All the expertise of the previous "regime" was booted out and now we have a skills (and work ethic) vaccuum. People do not want to go to clinics, because the people employed there are useless!

      Colourblind - 2011-01-27 09:05

      That is going to be the biggest challenge. Getting qualified and motivated staff to go and work at the clinics that are typically under funded, under stocked, under staffed and sometimes not even safe. It is a massive challenge facing the minister, but I hope he can do it. It's the only way to stop the bleeding (pun intended)

  • emzozo.. - 2011-01-27 09:08

    Thank you minister but having to come from Limpopo I guessed u might understand how stressing it is to go to a clinic 15km away n being told that WE DO NOT HAVE MEDICATION!!! or better yet the clinic has one sister who does not even have gyno training n she is stresssed and angry her behavior is misinterpreted as bad ppl skills. If u want ppl to go to clinics THEN equip clinic DOn't tell us abt Britain we are not in Britain!!! Clinic in Polokwane is far equiped than a clinic in Moletjie which are 30 KM apart. U will swear u a on a different they are planet if u visit both in the same week for a mere headeche..

  • croix - 2011-01-31 18:32

    "We need to overhaul the health care system...."-no shit,(Dr)Sherlock!? In fact, why don't you guys OVERHAUL the entire way you mismanage the country? If you cannot even pay drs on time, where are you going to find thousands more healthcare staff????? Let's face facts - the ANC SUCKS at running the country.

  • Kent - 2011-07-01 22:14

    Public Clinics? This is a joke! In our local clinic nobody even knows it exists because of the chaos. I ended up going to one, nobody told me what to do. I sat in line for 4 hours only to be told I came on the wrong day. Information centers would be useful. If only the people working at them could speak a word of English and actually knew what to do. Instead we get people in public hospitals and clinics who sit behind counters chatting to friends and going on lunch breaks.

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