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SAPPF HEALTHVIEW: November 2018 Special issue: 2018 in a nutshell Part 1 A summary of highlights regarding National Health Insurance and Governmental News (July - December 2018) Food for thought Joan van Dyk Min. Aaron Motsoaledi 'Estranged bedfellows: Why the private sector remains wary of universal healthcare' “Globally, one in four private healthcare groups surveyed, won’t work with governments. Whether the National Health Insurance (NHI) succeeds or fails, will depend on public-private partnerships. But the scheme will have to overcome more than just money woes to get the two sectors to settle old quarrels if new research is any Indication,” wrote Joan van Dyk: Mail & Guardian, 21 November 2018 Under the NHI, a centralised fund will procure a package of services from both the public and private sectors on behalf of South Africans, wrote Van Dyk. However, a recent survey of 20 of the world’s biggest private healthcare providers showed many remain wary of working with governments. Collectively, these companies own 500 hospitals and 7 000 clinics across 40 low- and middle-income countries. A quarter reported no intention of changing their business models to allow public sector purchasing, according to the research presented in November at the World Innovation Summit for Health (Wish) in Doha. The Wish research document can be found at: http://www.wish.org.qa/wp-content/uploads/2018/11/IMPJ6078-WISH-2018- Private-Sector- 181026.pdf Read a summary of the article by Joan van Dyk in the attached document: estranged bedfellows National Health Insurance in 2018 Controversial NHI Draft Bill NHI: a political plaything? On 23 November Business Day reported that health director-general, Precious Matsoso, said she had been completely side lined by President Cyril Ramaphosa’s adviser, Olive Shisana, and Health Minister Aaron Motsoaledi in revising the controversial draft National Health Insurance (NHI) Bill. The fiercely contested bill will be tabled before the Cabinet in the first week of December. Precious Matsoso Olive Shisana On 27 November, Business Day wrote an Editorial Comment: NHI a political plaything? From the editorial comment: “Health director-general Precious Matsoso broke ranks in truly remarkable fashion last week when she accused Shisana of sidelining her in the development of the NHI bill. “For the director-general to be left out in the cold in this manner, is truly astonishing. And for her to lay bare the dysfunction in the government by further claiming Shisana has ridden roughshod over the public consultation process, makes it even more so. Business Day reported on 29 November that Motsoaledi has issued a seperate statement defending the government’s handling of the NHI Bill. Motsoaledi said he rejected “with contempt” reports of alleged irregularities in the manner in which the legislation was being processed. Read the editorial comment in the attachment: NHI Comment ‘NHI funding figures vital for assessing health fund viability’ "In SA’s dire economic environment it is truly shocking that the most important aspect of the NHI Bill, namely the money available for it, was brushed aside by Health Minister Aaron Motsoaledi as not being his problem,” wrote Dr Johann Serfontein (senior health consultant, HealthMan) in Business Day, 2 July. The underlying assumption that the 4.4% of GDP, currently spent on private healthcare should be available to all citizens, is an inaccuracy the Minister fails to comprehend. Some R45-bn of private expenditure might be funded by the government in the form of an employer subsidy or tax credits, but this still leaves R140-bn spent by medical scheme members on their private healthcare, forsaking other personal comforts in the process. "Should this private health expenditure stop tomorrow, the public system will gain an additional 8.8-m people to treat, without the state budget increasing by a single cent. This private money would leave the health system. It does not magically transfer into the public sector for utilisation. "Unions will not allow their members to lose out on R31-bn in employment benefits - they will demand it in cash, leaving only the medical tax credit to possibly be added to the health budget," wrote Serfontein. The question remains whether NHI tariffs will be based on the state costs of rendering a service. Doctors on the NHI provider network will be kicked off if they charge above NHI rates. If NHI rates do not consider private practice costs, providers will simply cease to render services in SA altogether, adding to the shortfall of medical personnel, said Serfontein. On 1 November Fin 24 quoted Minister Motsoaledi, saying that NHI projects will be put on the back-burner as the DoH has to reprioritise its budget. He said that Treasury had essentially cut back allocations to the Department by R9- bn since 2015, while State subsidies and medical tax credits for private healthcare users grew by R11-bn. It was decided the DoH would reprioritise monies intended for NHI to recruit over 2 000 healthcare professionals and purchase beds and linen for hospitals in dire need. He said that he held back on spending the R4.1-bn of NHI money, because he was warned as early as May that reprioritisation would be on the cards. 'NHI will be an unmitigated disaster' “Despite its proven incompetence at managing public service organisations, the government is determined to create a vast centralised healthcare system. "Instead of failing only some South Africans, as it does now, government healthcare will soon fail all South Africans,” wrote Ivo Vegter in Daily Maverick; 27 August “The government keeps proving that it is incapable of running large organisations. South African Airways, Eskom, Transnet, the Post Office, the Passenger Rail Agency of South Africa, Portnet, and a host of other state-owned enterprises are beset with critical problems. “Minister Motsoaledi is sure the government is capable of running universal healthcare, but the primary government website, www.gov.za, on which these bills are supposed to be available, was down and returning ‘502: Bad Gateway’ errors at the time of writing. “Almost no aspect of healthcare will remain outside the centralised control of the NHI Fund. This vast new bureaucracy will have power to contract for and procure virtually all medical products and services in the country. It will inevitably be inefficient, as government bureaucracies always are, and will present significant new opportunities for patronage and corruption,” wrote Vegter. SAMA calls for ‘Codesa’ for NHI issues October: In a submission to the DoH, the South African Medical Association (SAMA) says the NHI Bill and other parallel reform processes do not seem to have the interests of health providers at heart. Evaluation reports of the NHI pilot programme show that many pilot facilities fell short on a range of issues, typifying the severe challenges in the public healthcare system. SAMA called for a re-opening of NHI consultations with doctors (and the wider society), to allow the profession to register its concerns and propound its ideal NHI model. These consultations, which SAMA says must be instituted by Parliament, should resemble the ongoing land appropriation hearings, and must be at provincial level. SAMA said a “Codesa” for NHI should be instituted to allow exhaustive debate. Rocky start tenders In August MedBrief reported that the first tenders for the NHI have been issued, but only three medical scheme administrators pitched for the compulsory information session. According to Rapport, experts are critical of the tender specifications for five priority programmes announced by Minister Motsoaledi when he published the NHI Bill for public comment. NHI underspent by R82-m In his audit report, recently submitted to Parliament, Auditor-General Kimi Makwetu revealed that the DoH has underspent the budget on NHI by R82-m in 2017-18. The DoH allocated R166-m for the NHI information system, but spent only R83.8-m. It blamed delays in infrastructure projects on technical compliance complexity, delays in awarding projects to contractors and contractual issues with some contractors for the problem. Healthcare practitioners sceptical - Solidariteit Health practitioners in South Africa are very sceptical about government’s proposed NHI plan, with many considering migrating to other countries if the ambitious project is implemented - according to a report released in July by trade union Solidarity. Nicolien Welthagen, a senior researcher at the Solidarity Research Institute, said the research found that practitioners feel there has not been sufficient consultation with them on the government’s plans to implement the NHI. 72,6% of practitioners indicated that they have not been consulted during the process, while only 38,8% of general practitioners feel that they have sufficient knowledge of the NHI. More than 80% of healthcare workers believe that health practitioners will leave SA if government steams ahead with the roll-out of the NHI and 81,7% of the respondents indicated that they believe the NHI will destabilise the health sector. Read more about NHI related developments in 2018 in the attached document: NHI2018 CMS suggests single medical scheme for public servants Will NHI affect medical schemes? – CityPress, 1 July Ramaphosa wrests control of NHI - Business Times, 26 August Will NHI be just another state-owned enterprise?- People’s Health Movement South Africa, 21 September NHI : “going nowhere slowly” – Editorial Comment, Business Day, 30 October View on Government AfriForum to lay charges against top health officials In November lobby group AfriForum announced that it will be laying criminal charges against the nine heads of the provincial departments of health in terms of the Public Finance Management Act. According to the statement these nine departments were all guilty of irregular‚ fruitless‚ wasteful and unauthorised expenditure‚ altogether wasting over R10-bn during the 2016/2017 financial year. This information was obtained from the annual reports of the departments. The first charges were submitted against the current Gauteng head of health‚ Mkhululi Lukhele‚ who is alleged to have misappropriated R1.3-bn in the 2017/2018 financial year. Doctors unable to access community service jobs for 2019 In August The Citizen reported that the DoH’s application portal for doctors hoping to apply for community service positions next year, is such a mess that hundreds of doctors were unable to register and verify their details, despite the deadline for applications being only a few days off. These doctors could be rendered unemployed come January. They will only be able to apply for placement again in the June intake of community service doctors. Attempts by The Citizen to get a response from the DoH, proved futile. Life Esidimeni: How many doctors and nurses will lose their licences? In August half of the top officials responsible for the Life Esidimeni tragedy still have not been reported to their professional associations, according to information from the South African Nursing Council (SANC). The Gauteng DoH only reported Barney Selebano, the former head of the department and also a medical doctor, to the HPCSA in December 2017 — more than 10 months after Makgoba’s initial recommendation. He has yet to sit in front of a preliminary committee of inquiry, which investigates cases of alleged misconduct and is still able to practice pending the outcome of his case. Meanwhile the South African Society of Psychiatrists (SASOP) has undertaken a campaign to encourage health professionals to expose abuse. SASOP has partnered with the rural health action project to assist in the training of its members, who include psychiatrists, occupational therapists, nurses and psychologists. In October it was reported that ANC Gauteng leaders Qedani Mahlangu and Brian Hlongwa will remain on the party's provincial executive committee, the ANC said, despite their respective roles in the Life Esidimeni tragedy and R1.2bn corruption scandal. The alarming rise of medical malpractice claims In July Financial Mail reported that soaring pay-outs for medical negligence claims against the state pose such a threat to healthcare provision that government is proposing a “new pay as you go” system to compensate victims. By the end of the 2016-2017 fiscal year government faced contingent liabilities - the cost if all claims were successful - of R56.1-bn. This equates to almost a third of the R170.9-bn consolidated health budget for 2016-2017. Doctors sought for service to NHI In November Business Day reported that the DoH is seeking new ways to entice private sector general practitioners to provide their services under the NHI scheme after a lacklustre response to its attempts to get them to work in state facilities. Only 250 private-sector GPs (far from the 900 they needed) were contracting with the state at the end of March, according to the Foundation for Professional Development MD, Gustaaf Wolvaardt. Part of the problem appears to be the rate offered by the government, which ranges from R470 per hour in urban areas to R573 per hour in a rural setting. A GP in private practice can expect to earn between R1 200 and R1 600 an hour, said Casper Venter, the MD of HealthMan. Another issue is the fact that the GP contracting model restricts doctors to working in state facilities. From April 2019, it will offer GPs the opportunity to see state patients in their own consulting rooms, under a “capitation” model in which they will receive a set fee to take care of a specific number of patients per month, said deputy director-general Anban Pillay. According to a report by the Treatment Action Campaign (TAC) SA has not filled over 37,000 posts in the public health sector. The report was based on monitoring efforts from November 2017 until this year. Limpopo had over 44,000 funded posts. Only 35,450 were filled by February 2017. Other badly-affected provinces include KwaZulu-Natal, with 8,904 vacant posts, Free State with 4,101 and Gauteng at 6,100 posts. Oncology crisis: In August Min. Motsoaledi confirmed that there were at least 15 oncology machines worth R40-m each waiting to be used at public hospitals - but he is still looking for cancer doctors to operate them. KwaZulu-Natal had one oncologist to service 1.3-m cancer patients; Do not miss the December issue of HealthMan Private Pratice Review for Part 2 of our special issue: 2018 in a nutshell Special Notices To place an advertisement or special note in the next issue of SAPPF HealthView, contact Maretha Conradie at [email protected] HealthView and Private Practice Review provide news and opinion articles as a service to our members to enhance their understanding of the health care industry. The information contained in these publications is published without warranties of any kind, either express or implied. HealthView and Private Practice Review are published solely for informational purposes and should not to be construed as advice or recommendations. Individuals should take into account their own unique and specific circumstances in acting on any news or articles published. Often these articles originate from sources outside our organization that are reported in the national press. Consequently, any information, trademarks, service marks, product names or named features are assumed to be the property of their respective owners, and are used solely for informative purposes in our publications. There is furthermore no implied endorsement of any of the products, goods or services mentioned in our publications.

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Page 1: Food for thoughtdocs.mymembership.co.za/docmanager/419ae5a4-f8c7...providers will simply cease to render services in SA altogether, adding to the shortfall of medical personnel, said

SAPPFHEALTHVIEW:November2018

Specialissue:2018inanutshellPart1

AsummaryofhighlightsregardingNationalHealthInsuranceandGovernmentalNews(July-December2018)

Foodforthought

JoanvanDyk Min.AaronMotsoaledi

'Estrangedbedfellows:Whytheprivatesectorremainswaryofuniversalhealthcare'

“Globally,oneinfourprivatehealthcaregroupssurveyed,won’tworkwithgovernments.Whetherthe

NationalHealthInsurance(NHI)succeedsorfails,willdependonpublic-privatepartnerships.Butthe

schemewillhavetoovercomemorethanjustmoneywoestogetthetwosectorstosettleoldquarrels

ifnewresearchisanyIndication,”wroteJoanvanDyk:Mail&Guardian,21November2018

UndertheNHI,acentralisedfundwillprocureapackageofservicesfromboththepublicandprivate

sectorsonbehalfofSouthAfricans,wroteVanDyk.

However,arecentsurveyof20oftheworld’sbiggestprivatehealthcareprovidersshowedmany

remainwaryofworkingwithgovernments.Collectively,thesecompaniesown500hospitalsand7

000clinicsacross40low-andmiddle-incomecountries.Aquarterreportednointentionofchanging

theirbusinessmodelstoallowpublicsectorpurchasing,accordingtotheresearchpresentedin

NovemberattheWorldInnovationSummitforHealth(Wish)inDoha.

TheWishresearchdocumentcanbefoundat:http://www.wish.org.qa/wp-content/uploads/2018/11/IMPJ6078-WISH-2018-Private-Sector-181026.pdf

ReadasummaryofthearticlebyJoanvanDykintheattacheddocument:estrangedbedfellows

NationalHealthInsurancein2018

ControversialNHIDraftBill

NHI:apoliticalplaything?

On23NovemberBusinessDayreportedthathealthdirector-general,PreciousMatsoso,saidshehadbeencompletelysidelinedbyPresidentCyrilRamaphosa’s

adviser,OliveShisana,andHealthMinisterAaronMotsoalediinrevisingthecontroversialdraftNationalHealthInsurance(NHI)Bill.

ThefiercelycontestedbillwillbetabledbeforetheCabinetinthefirstweekofDecember.

PreciousMatsoso OliveShisana

On27November,BusinessDaywroteanEditorialComment:NHIapoliticalplaything?

Fromtheeditorialcomment:“Healthdirector-generalPreciousMatsosobrokeranksintrulyremarkablefashionlastweekwhen

sheaccusedShisanaofsideliningherinthedevelopmentoftheNHIbill.

“Forthedirector-generaltobeleftoutinthecoldinthismanner,istrulyastonishing.Andforhertolay

barethedysfunctioninthegovernmentbyfurtherclaimingShisanahasriddenroughshodoverthe

publicconsultationprocess,makesitevenmoreso.

BusinessDayreportedon29NovemberthatMotsoaledihasissuedaseperatestatementdefending

thegovernment’shandlingoftheNHIBill.Motsoaledisaidherejected“withcontempt”reportsof

allegedirregularitiesinthemannerinwhichthelegislationwasbeingprocessed.

Readtheeditorialcommentintheattachment:NHIComment

‘NHIfundingfiguresvitalforassessinghealthfundviability’

"InSA’sdireeconomicenvironmentitistruly

shockingthatthemostimportantaspectofthe

NHIBill,namelythemoneyavailableforit,was

brushedasidebyHealthMinisterAaron

Motsoalediasnotbeinghisproblem,”wroteDrJohannSerfontein(seniorhealthconsultant,HealthMan)inBusinessDay,2July.

Theunderlyingassumptionthatthe4.4%of

GDP,currentlyspentonprivate

healthcareshouldbeavailabletoallcitizens,is

aninaccuracytheMinisterfailstocomprehend.

SomeR45-bnofprivateexpendituremightbe

fundedbythegovernmentintheformofan

employersubsidyortaxcredits,butthisstill

leavesR140-bnspentbymedicalscheme

membersontheirprivatehealthcare,forsaking

otherpersonalcomfortsintheprocess.

"Shouldthisprivatehealthexpenditurestop

tomorrow,thepublicsystemwillgainan

additional8.8-mpeopletotreat,withoutthestate

budgetincreasingbyasinglecent.Thisprivate

moneywouldleavethehealthsystem.Itdoes

notmagicallytransferintothepublicsectorfor

utilisation.

"Unionswillnotallowtheirmemberstoloseout

onR31-bninemploymentbenefits-theywill

demanditincash,leavingonlythemedicaltax

credittopossiblybeaddedtothehealthbudget,"

wroteSerfontein.

ThequestionremainswhetherNHItariffswillbe

basedonthestatecostsofrenderingaservice.

DoctorsontheNHIprovidernetworkwillbe

kickedoffiftheychargeaboveNHIrates.IfNHI

ratesdonotconsiderprivatepracticecosts,

providerswillsimplyceasetorenderservicesin

SAaltogether,addingtotheshortfallofmedical

personnel,saidSerfontein.

On1NovemberFin24quotedMinister

Motsoaledi,sayingthatNHIprojectswill

beputontheback-burnerastheDoHhas

toreprioritiseitsbudget.

HesaidthatTreasuryhadessentiallycut

backallocationstotheDepartmentbyR9-

bnsince2015,whileStatesubsidiesand

medicaltaxcreditsforprivatehealthcare

usersgrewbyR11-bn.

ItwasdecidedtheDoHwouldreprioritise

moniesintendedforNHItorecruitover2

000healthcareprofessionalsand

purchasebedsandlinenforhospitalsin

direneed.

Hesaidthatheheldbackonspending

theR4.1-bnofNHImoney,becausehe

waswarnedasearlyasMaythat

reprioritisationwouldbeonthecards.

'NHIwillbeanunmitigateddisaster'“Despiteitsprovenincompetenceatmanaging

publicserviceorganisations,thegovernmentis

determinedtocreateavastcentralised

healthcaresystem.

"InsteadoffailingonlysomeSouthAfricans,asitdoesnow,governmenthealthcarewill

soonfailallSouthAfricans,”wroteIvoVegterinDailyMaverick;27August

“Thegovernmentkeepsprovingthatitis

incapableofrunninglargeorganisations.South

AfricanAirways,Eskom,Transnet,thePost

Office,thePassengerRailAgencyofSouth

Africa,Portnet,andahostofotherstate-owned

enterprisesarebesetwithcriticalproblems.

“MinisterMotsoalediissurethegovernmentiscapableofrunninguniversalhealthcare,buttheprimarygovernmentwebsite,www.gov.za,

onwhichthesebillsaresupposedtobeavailable,wasdownandreturning‘502:Bad

Gateway’errorsatthetimeofwriting.

“Almostnoaspectofhealthcarewillremain

outsidethecentralisedcontroloftheNHIFund.

Thisvastnewbureaucracywillhavepowerto

contractforandprocurevirtuallyallmedical

productsandservicesinthecountry.Itwill

inevitablybeinefficient,asgovernment

bureaucraciesalwaysare,andwillpresent

significantnewopportunitiesforpatronageand

corruption,”wroteVegter.

SAMAcallsfor‘Codesa’forNHIissues

October:InasubmissiontotheDoH,theSouth

AfricanMedicalAssociation(SAMA)saysthe

NHIBillandotherparallelreformprocessesdo

notseemtohavetheinterestsofhealth

providersatheart.EvaluationreportsoftheNHI

pilotprogrammeshowthatmanypilotfacilities

fellshortonarangeofissues,typifyingthe

severechallengesinthepublichealthcare

system.

SAMAcalledforare-openingofNHI

consultationswithdoctors(andthewider

society),toallowtheprofessiontoregisterits

concernsandpropounditsidealNHImodel.

Theseconsultations,whichSAMAsaysmustbe

institutedbyParliament,shouldresemblethe

ongoinglandappropriationhearings,andmust

beatprovinciallevel.

SAMAsaida“Codesa”forNHIshouldbe

institutedtoallowexhaustivedebate.

Rockystarttenders

InAugustMedBriefreportedthatthefirsttenders

fortheNHIhavebeenissued,butonlythree

medicalschemeadministratorspitchedforthe

compulsoryinformationsession.According

toRapport,expertsarecriticalofthetender

specificationsforfivepriorityprogrammes

announcedbyMinisterMotsoalediwhenhe

publishedtheNHIBillforpubliccomment.

NHIunderspentbyR82-m

Inhisauditreport,recentlysubmittedto

Parliament,Auditor-GeneralKimiMakwetu

revealedthattheDoHhasunderspentthe

budgetonNHIbyR82-min2017-18.TheDoH

allocatedR166-mfortheNHIinformationsystem,

butspentonly

R83.8-m.Itblameddelaysininfrastructure

projectsontechnicalcompliancecomplexity,

delaysinawardingprojectstocontractorsand

contractualissueswithsomecontractorsforthe

problem.

Healthcarepractitionerssceptical-SolidariteitHealthpractitionersinSouthAfricaareveryscepticalaboutgovernment’sproposedNHIplan,with

manyconsideringmigratingtoothercountriesiftheambitiousprojectisimplemented-accordingtoa

reportreleasedinJulybytradeunionSolidarity.

NicolienWelthagen,aseniorresearcherattheSolidarityResearchInstitute,saidtheresearchfoundthatpractitionersfeeltherehasnotbeensufficientconsultationwiththemonthegovernment’s

planstoimplementtheNHI.72,6%ofpractitionersindicatedthattheyhavenotbeenconsultedduring

theprocess,whileonly38,8%ofgeneralpractitionersfeelthattheyhavesufficientknowledgeofthe

NHI.

Morethan80%ofhealthcareworkersbelievethathealthpractitionerswillleaveSAifgovernmentsteamsaheadwiththeroll-outoftheNHIand

81,7%oftherespondentsindicatedthattheybelievetheNHIwilldestabilisethehealthsector.

ReadmoreaboutNHIrelateddevelopmentsin2018intheattacheddocument:NHI2018

CMSsuggestssinglemedicalschemeforpublicservantsWillNHIaffectmedicalschemes?–CityPress,1JulyRamaphosawrestscontrolofNHI-BusinessTimes,26AugustWillNHIbejustanotherstate-ownedenterprise?-People’sHealthMovementSouthAfrica,21SeptemberNHI:“goingnowhereslowly”–EditorialComment,BusinessDay,30October

ViewonGovernment

AfriForumtolaychargesagainsttophealthofficials

InNovemberlobbygroupAfriForumannounced

thatitwillbelayingcriminalchargesagainstthe

nineheadsoftheprovincialdepartmentsof

healthintermsofthePublicFinance

ManagementAct.

Accordingtothestatementthesenine

departmentswereallguiltyofirregular‚fruitless‚

wastefulandunauthorisedexpenditure‚

altogetherwastingover

R10-bnduringthe2016/2017financialyear.

Thisinformationwasobtainedfromtheannual

reportsofthedepartments.

Thefirstchargesweresubmittedagainstthe

currentGautengheadofhealth‚Mkhululi

Lukhele‚whoisallegedtohavemisappropriated

R1.3-bninthe2017/2018financialyear.

Doctorsunabletoaccesscommunityservicejobsfor2019

InAugustTheCitizenreportedthattheDoH’s

applicationportalfordoctorshopingtoapplyfor

communityservicepositionsnextyear,issucha

messthathundredsofdoctorswereunableto

registerandverifytheirdetails,despitethe

deadlineforapplicationsbeingonlyafewdays

off.

Thesedoctorscouldberenderedunemployed

comeJanuary.

Theywillonlybeabletoapplyforplacement

againintheJuneintakeofcommunityservice

doctors.

AttemptsbyTheCitizentogetaresponsefrom

theDoH,provedfutile.

LifeEsidimeni:Howmanydoctorsandnurseswilllosetheirlicences?InAugusthalfofthetopofficialsresponsiblefor

theLifeEsidimenitragedystillhavenotbeen

reportedtotheirprofessionalassociations,

accordingtoinformationfromtheSouthAfrican

NursingCouncil(SANC).

TheGautengDoHonlyreportedBarney

Selebano,theformerheadofthedepartment

andalsoamedicaldoctor,totheHPCSAin

December2017—morethan10monthsafter

Makgoba’sinitialrecommendation.

Hehasyettositinfrontofapreliminary

committeeofinquiry,whichinvestigatescasesof

allegedmisconductandisstillabletopractice

pendingtheoutcomeofhiscase.

MeanwhiletheSouthAfricanSocietyof

Psychiatrists(SASOP)hasundertakena

campaigntoencouragehealth

professionalstoexposeabuse.SASOP

haspartneredwiththeruralhealthaction

projecttoassistinthetrainingofits

members,whoincludepsychiatrists,

occupationaltherapists,nursesand

psychologists.

InOctoberitwasreportedthatANC

GautengleadersQedaniMahlanguand

BrianHlongwawillremainontheparty's

provincialexecutivecommittee,theANC

said,despitetheirrespectiverolesinthe

LifeEsidimenitragedyandR1.2bn

corruptionscandal.

Thealarmingriseofmedicalmalpracticeclaims

InJulyFinancialMailreportedthatsoaringpay-outsformedicalnegligenceclaimsagainstthestate

posesuchathreattohealthcareprovisionthatgovernmentisproposinga“newpayasyougo”

systemtocompensatevictims.

Bytheendofthe2016-2017fiscalyeargovernmentfacedcontingentliabilities-thecostifallclaims

weresuccessful-ofR56.1-bn.Thisequatestoalmostathirdofthe

R170.9-bnconsolidatedhealthbudgetfor2016-2017.

DoctorssoughtforservicetoNHI

InNovemberBusinessDayreportedthatthe

DoHisseekingnewwaystoenticeprivate

sectorgeneralpractitionerstoprovidetheir

servicesundertheNHIschemeafteralacklustre

responsetoitsattemptstogetthemtoworkin

statefacilities.

Only250private-sectorGPs(farfromthe900theyneeded)werecontractingwiththestate

attheendofMarch,accordingtotheFoundationforProfessionalDevelopmentMD,

GustaafWolvaardt.

Partoftheproblemappearstobetherate

offeredbythegovernment,whichrangesfrom

R470perhourinurbanareastoR573perhour

inaruralsetting.AGPinprivatepracticecan

expecttoearnbetweenR1200andR1600an

hour,saidCasperVenter,theMDofHealthMan.

AnotherissueisthefactthattheGPcontracting

modelrestrictsdoctorstoworkinginstate

facilities.FromApril2019,itwillofferGPsthe

opportunitytoseestatepatientsintheirown

consultingrooms,undera“capitation”modelin

which

theywillreceiveasetfeetotakecareofa

specificnumberofpatientspermonth,said

deputydirector-generalAnbanPillay.

AccordingtoareportbytheTreatment

ActionCampaign(TAC)SAhasnotfilled

over37,000postsinthepublichealth

sector.Thereportwasbasedon

monitoringeffortsfromNovember2017

untilthisyear.

Limpopohadover44,000fundedposts.

Only35,450werefilledbyFebruary2017.

Otherbadly-affectedprovinces

includeKwaZulu-Natal,with8,904vacant

posts,FreeStatewith4,101andGauteng

at6,100posts.

Oncologycrisis:InAugustMin.Motsoalediconfirmedthattherewereat

least15oncologymachinesworthR40-m

eachwaitingtobeusedatpublic

hospitals-butheisstilllookingforcancer

doctorstooperatethem.KwaZulu-Natal

hadoneoncologisttoservice1.3-m

cancerpatients;

DonotmisstheDecemberissueofHealthManPrivatePraticeReviewforPart2ofourspecial

issue:2018inanutshell

SpecialNoticesToplaceanadvertisementorspecialnoteinthenextissueofSAPPF

HealthView,[email protected]

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