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Friday, 28 July 2023

Job creation, load shedding and politics have traditionally taken centre stage in South Africa's list of priorities. Amidst the clamour, the crucial healthcare conversation seemed to have been overshadowed. However, recent developments surrounding the passing of the National Health Insurance (NHI) Bill by Parliament has brought healthcare back into focus.

Numerous organisations, political parties and individuals have stepped forward to voice their opinions and provide valuable insights into the potential implications of the proposed Bill on the country's healthcare system. By shedding light, these discussions aim to ensure that the healthcare agenda remains at the forefront of public discourse and decision-making processes.

Healthcare should always be on the agenda of government, private sector and citizens if we truly aspire to effect the change we want to see in our healthcare system. At the crux of it, people want access to quality and affordable healthcare, but what does access to quality healthcare mean amidst the slew of challenges our country and our people face?

Our main challenge is the systemic duality of our healthcare system. The reality is, out of a population of 60 million, an astounding 52 million are without access to medical aid. This means that 86% must rely solely on public health services for care – a burden that falls squarely onto the shoulders of state resources. Government’s ambition no doubt is to bridge this gap through the introduction of National Health Insurance (NHI), which we should all welcome. But both private and public partnerships will play a crucial role in the successful implementation of the NHI vision. 

To address the healthcare needs of the over 50 million individuals who lack coverage in this country, it is essential to adopt a cooperative strategy that incorporates Private Public Partnerships (PPPs) and a well-planned, gradual implementation of the highly discussed and debated NHI, while leveraging  private sector capabilities which are the various technologies that can be adopted across public sector to derive better insights, efficiency, transparency and accountability.

Now is the time for the entire healthcare sector to play out their various roles in pursuit of the 90% target. If we are to create an integrated environment of collaboration and strategic modelling, shared technology will be imperative both from a development and implementation standpoint.

Demonstrating success of private public partnership

For instance, as a member of the private healthcare sector, AfroCentric is involved in the delivery of medicines through the Department’s Central Chronic Medication Dispensing and Distribution (CCMDD) programme, dubbed Dablapmeds by the Department of Health. This programme ensures that over 2 million registered South Africans have continuous and timely access to their HIV and other chronic medication. What this programme does is ensure that, there is a reduction in patient waiting times and better time management by the public sector, and that there is improved quality of care and service delivery. If we undertake more of these successful initiatives, this effort would be followed by an efficiency-driven health sector brought on by combined interventions from both private and public sectors.

The foundation of a successful healthcare sector in South Africa lies in embracing technology.
In addition to implementing effective programmes, achieving greater efficiency in healthcare necessitates the adoption of modern technologies such as Artificial Intelligence and Machine Learning. These advanced technologies enable deep learning, leading to continuous improvements in patient health administration and adherence throughout the entire care journey.

The capabilities of these technologies extend beyond problem-solving at remarkable speeds; they also have the potential to identify patients at risk of hospital events or readmission. Such solutions are essential to alleviate pressure, facilitate effective planning, and ultimately reduce healthcare costs. Moreover, the valuable insights provided by these technologies empower clinical staff to coordinate patient care and address the issue of waste, which currently amounts to approximately 25% in the private sector alone.

Wastage often stems from ineffective information sharing between healthcare institutions. For example, consider a patient who initially receives medical care through the public healthcare system without insurance but later acquires medical coverage. If the patient continues to experience illness, their medical history should be readily accessible from a central database, rather than commissioning more of the same tests and evaluations by new medical teams. Integration between the public and private sector systems would lead to significant cost and time savings, resulting in quicker access to necessary care, and ultimately saving lives.

South Africa possesses the necessary healthcare technology and expertise; all that is required is a collective effort between the private and public sectors to coordinate, adopt these technologies, and enact policy reforms. By coming together and embracing a unified approach, South Africa can harness the full potential of healthcare technology, leading to improved patient outcomes and a more efficient and sustainable healthcare system.

The achievement of success in South African healthcare hinges on the critical aspects of policy reform and adherence. The accumulation of comprehensive data informing health-related decisions equips us with the capacity to provide technical inputs for policy and regulatory documents and proposals, thereby ensuring the seamless delivery of access to care.

We are acutely aware of the challenges that public healthcare is facing, including infrastructure deterioration, capacity constraints, and an increasing skills gap. However, we remain of the view that the NHI Bill in its current form requires a review. A number of comments and inputs were simply ignored with a raft of practical questions remaining unanswered. We are therefore optimistic that the NCOP will take this into account in its deliberations. For now, the Bill in its current form will result in a mass exodus of the already strained healthcare resources.

It is crucial to avoid creating a dichotomy between the public and private sectors, as such disintegration would only exacerbate complexities that adversely affect the well-being of our citizens.

In the pursuit of affordable, high-quality healthcare, it is imperative for the nation to collaborate in achieving the objectives outlined in the National Development Plan for 2030 and the UN Sustainable Development Goals. This concerted effort will elevate our position in the Global Healthcare Index ranking, ultimately leading to a healthcare sector that attracts and retains skilled healthcare professionals while improving the quality of life for all South Africans. The successful implementation of the NHI requires the incorporation of proposals from the private sector and other key stakeholders in healthcare, ensuring transparency and accountability from all parties involved.

By Ahmed Banderker, AfroCentric Group CEO

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