‘They check your purse instead of pulse’

There will be blood on the floor when changes are implemented to the public health care sector, Health Minister Dr Aaron Motsoaledi said.

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There will be blood on the floor when changes are implemented to the public health care sector.

The same blood will be shed in the private sector when the National Health Insurance (NHI) is implemented, and that is the mess which had to be dealt with, Health Minister Dr Aaron Motsoaledi said on Friday.

He counted procurement and supply chain management among the biggest problems in the public health sector,.

This left workers without the basic tools of the trade, he said.

“The poorest get the least in healthcare services while the rich get the most,” he told the Sefako Makgatho University community on Friday.

Motsoaledi told the students, lecturers and other academics from the university and from Dr George Mukhari Hospital that both private and public health had problems which were a let down.

“These will have to change with the introduction of the universal health coverage tool,” he said of the impending introduction of NHI.

There would be resistance, because people had become so used to doing things their own way, he said.

He told his audience that an analysis of the private health system found that it was extremely expensive.

He gave examples of the costs, which he said were exorbitant and which quickly depleted funds.

“Once they run out of funds treatment is immediately stopped and they are kicked out,” Motsoaledi said.

He said healthcare workers in the private health sector no longer practiced the basics of handling a new patient.

“They no longer check the pulse, but check your pocket,” he said.

They looked for a medical aid card, and when they didn’t find it, looked for a credit card.

“If that is not there they look for cash and if there’s no money they turn you away,” the minister said.

This, he said, had changed the face of healthcare delivery.

Motsoaledi said universal healthcare coverage would remove the barriers to healthcare, which included finances, and would reduce the catastrophic health expenses and ultimately contribute to a better quality of life.

“It will alleviate poverty and improve human development,” he said.

The country also needed the NHI to deal with the four burdens of disease, which included communicable diseases and trauma from, among others, vehicle accidents.

Violence between people and on the road was the fourth burden on the health system, and it stemmed from the violent nature of South Africans.

Motsoaledi said it was embarrassing when doctors from overseas were sent to South Africa to learn about treating stab wounds.

“And we are not even at war,” he said.

He blamed private hospitals for pushing costs up in their quest to make it on the stock exchange.

“That is where the money is going,” he said, adding that a hospital on the stock exchange would deal with patients as a business dealt with its clients.

“Being on the stock exchange is a profit-driven process, so they will be ruled by profit.”

And there was nothing wrong with working for profits, he said.

“But taking health provision there is wrong,” he said.

He explained that the NHI would be funded through mandatory pre-payment for health.

“This is the payment of money into a pool before people get sick.”

The predominant payment for medical care was cash and this was a big problem.

“Medical aids do that, but only for the 16% privileged few,” he said.

Too many were left out of that private health care sector.

“When 80% are left to rely on one public sector this led to a collapse of the system.”

The current system, both private and public, did not cover everything.

“The introduction of NHI will cover everything.”

He said it would usher in a massive change in the system in both the private and public sector.

@ntsandvose

ntando.makhubu@inl.co.za

Pretoria News Weekend