12 July 2005
The government has introduced a draft health charter aimed at improving access to and quality of healthcare in the country, as well as raising black economic empowerment in the sector.
“We must ensure our health system reflects the diversity of our society and meets the various health care needs of the total population of South Africa,” said Health Minister Manto Tshabalala-Msimang at Monday’s presentation of the charter.
The document was compiled by a task team with representatives from both the public and private health sectors.
Currently, the minister said, inequalities in health services meant the health and life expectancy of the poor were far worse than those of high-income groups.
The state spends R33.2-billion on health care for 38-million people, while the country’s private sector spends some R43-billion servicing 7-million people.
Some 15% to 20% of the population have excellent access to health services, while 75% to 80% of South Africans have limited or no access.
“Due to our sad history, access to and distribution of health care and ownership of health establishments remain grossly unequal,” Tshabalala-Msimang said. “We cannot remain silent about this issue.”
The vast majority of South Africans are disadvantaged because of their race, gender and economic status, she said. For this reason, the minister hoped that the charter would be implemented to significantly rectify the wrongs of the past.
“The charter requires us to achieve the most efficient use of resources in the health sector, to adequately address the health needs of South Africans,” Tshabalala-Msimang said.
Medical aid unaffordable
She also highlighted that medical aid schemes had become increasingly unaffordable, resulting in a widening gap in healthcare access between high-income and middle-income groups.
Another area of major increase in expenditure by medical schemes is non-health items such as scheme administration fees (at R4.5-billion in 2003), managed care initiatives (R1.1-billion) and brokers’ fees, which increased by 64% from R354-million in 2002 to R581-million in 2003.
The draft health charter also emphasises another kind of equity – that of service provision, ownership and control.
It requires the development of a human capital programme that plans for and meets the human resource requirements of the country over the next 15 years.
“We have put together programmes for the broader representation of historically disadvantaged groups, including women and people with disabilities, in the workplace,” said the minister.
The proposed targets are that, across the value chain, 60% of the workforce should be black and 50% women by the year 2010. The aim is to increase these figures to 70% black and 60% women by 2014.
The document proposes that there be 26% ownership and or control by black people, a process to start immediately.
By 2010, each business in the healthcare sector should at least be 35%-owned and or controlled by black people, while equity ownership by black people should increase to 51% by 2014.
The terms of the draft charter were well received by health sector stakeholders. However, they have requested that some technical adjustments be made. These and other submissions are to be put to the National Department of Health by 15 August.
Tshabalala-Msimang will present the document to Cabinet by the end of August or beginning of September.