DOUGLAS RAMAPHOSA: Working together to make the NHI succeed
THE African National Congress (ANC) has announced plans to take its National Health Insurance (NHI) scheme forward and has given us a hint of what the health industry will look like from 2012.
THE African National Congress (ANC) has announced plans to take its National Health Insurance (NHI) scheme forward and has given us a hint of what the health industry will look like from 2012. Responses to the scheme range from guarded optimism to outright rejection.
In the spirit of Lead SA (pioneered by Radio 702,) and the ANC’s Batho Pele (People First) campaign, we have a responsibility to make the plan work, identify areas of concern and put workable proposals on the table.
Whether we like it or not, there will be an NHI in one form or an other. Now that we know the ANC’s intentions, we need to prepare proposals and engage with each other as businesses serving the healthcare sector and take our joint considered views to the ministerial task team for consideration. The ANC has committed itself to wide-ranging engagement and consultation on the issue.
One of the areas the ANC will focus on is the improvement and expansion of public healthcare infrastructure and services. This area, according to the ANC, is critical to realising the principle of universal access to quality care and reducing inequality of access. The quality of service, efficiencies, information technology (IT) infrastructure, project management and processes in a number of public healthcare facilities leave a lot to be desired.
The private healthcare sector has, over the years, invested a lot of resources and deployed world-class expertise in perfecting their systems and processes in a number of privately run clinics and hospitals. The government would be remiss not to enlist such expertise.
SA’s private health sector has arguably the best developed IT and administration systems, skills and capabilities in the world, and a successful track record. This includes the management of doctors’ debtor systems, electronic switching, price- file updates and the integration of the World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems into doctors’ work routines, and so on. There is no need for the NHI to reinvent the wheel.
If it is true that we may see some medical scheme members opt out and rely on state services (Prof Di McIntyre of the University of Cape Town predicts as many as 40%), then the current patient-management administration systems in public medical facilities will not cope with the volumes.
Apart from just refurbishing or building new clinics and hospitals, the expertise of the private healthcare industry will have to be enlisted by the government to ensure these are world- class public facilities and the IT support infrastructure required to operate these effectively is in place. Not only will the management and administration of the new generation of public hospitals require this infrastructure, but the medical staff will need to use secure and proven technology to transfer patient records within and beyond hospitals, as well as clinical data and images, among other records.
It is in the interests of the private sector that public facilities are improved so that there are minimal adverse effects on productivity in the workplace. A number of employees, who currently belong to medical schemes and will in future also belong to the NHI and will be contributing towards it, will certainly visit public facilities to get their money’s worth. If the systems and processes are not improved in such places, this will elongate the already long queues and result in repeat visits, which will affect the ability to provide universal access to affordable, quality healthcare — the main aim of the NHI.
From a private sector point of view, the government will have to establish workable public-private partnerships.
It will be prudent to establish a few facilities run by public-private partnerships as pilot projects before attempting a huge roll-out.
Pilot facilities will give the government time to refine processes and systems and learn from mistakes. Believe me, there will be mistakes.
We are in this together and once there is better clarity on a number of issues, we should all get down to establishing one of the best public healthcare systems in the world, one that we can be proud of.
- Ramaphosa is CEO of Bytes Healthcare Solutions.
Source - Businessday.co.za
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