The Gauteng Health Department, which treats more patients than any other province, is woefully unqualified for the implementation of the proposed National Health Insurance (NHI).
This is clear from the many failures disclosed in the Department’s Annual Report for 2018/19 which was debated in the Gauteng Legislature last week.
It is of great concern that the Annual Report details 22 key strategic risks identified by the Audit Committee including:
- inadequate access to quality health services for mental health patients;
- increase in maternal, new-born, infant and child morbidity/mortality;
- high death rate due to increase in the number of HIV and TB infections;
- financial losses due to litigation;
- fraud and corruption;
- aging infrastructure and health technology;
- shortages in pharmaceutical supplies;
- inadequate Human Capital Management and
- Serious Adverse Events.
I pointed out in the debate that with all the failures revealed in this report it is a mystery why Gauteng Health MEC Bandile Masuku is an energetic proponent of the NHI.
The NHI will trample on Provincial health powers and centralize all health funding. Gauteng is notorious for not paying its bills on time, so imagine the mega-disaster if all health payments were centralized!
It is officially estimated that it will cost at least R6 billion, but probably a whole lot more, to get all Gauteng hospitals compliant with occupational health and safety legislation. But this money for capital spending will not be available in the next five years.
Former Health Minister Aaron Motsoaledi has said that six new hospitals are required for Gauteng, but they are not going to happen in the next five years either.
It’s also very unlikely that Gauteng public hospitals will be accredited for the NHI by the Office for Health Standards Compliance.
This is apart from the huge tax increases that will be required to properly finance the NHI.
The truth is that Gauteng Health is nowhere near prepared for NHI, never mind the even worse health systems in all the other ANC- run provinces.
Only the DA-run Western Cape Health Department gets a clean audit, something which is unlikely for Gauteng in the next five years or longer.
Realistically, the poor state of Gauteng’s public health system is a major stumbling block to the implementation of NHI.