12 August 2011
As South Africa gears up to start rolling out its National Health Insurance, the government is going all out to ensure that the country’s public hospitals and clinics comply with the exacting standards of the new health care system.
The National Health Insurance (NHI) is due to start rolling in April 2012 as a pilot for the first five years.
Health Minister Aaron Motsoaledi, briefing journalists in Pretoria on Thursday, said the NHI was seen as a 14-year project, with the first five years involving building and preparation.
The Cabinet has approved the NHI Green Paper, which was released on Friday for public comment.
“The cornerstone of the proposed system of NHI is universal coverage,” Motsoaledi said. “It is a financing system that will ensure the provision of essential healthcare to all citizens of South Africa, regardless of their employment status and ability to make a direct monetary contribution to the NHI fund.”
Motsoaledi said the NHI was important for the total restructuring and overhauling of South Africa’s health system. For the NHI to function and become affordable for everyone, drastic changes were needed.
Department of Health was currently conducting an audit of all 4 200 public health facilities in the country, with 800 facilities having been audited by July. The audit was expected to be completed by May 2012.
In order to qualify for NHI, facilities will have to meet exacting standards on availability of medicine, cleanliness, patient safety, infection control, attitudes of staff, and patient waiting times.
Motsoaledi said that if all the toilets in a facility were found to be clean except for one, that facility would fail the test, as cleanliness was one of the vital areas for compliance.
According to the preliminary results, some facilities were doing well, even though they had not yet reached 100 percent compliance.
Audited facilities so far include the Free State University Hospital, which achieved 93 percent for availability of medicines and 71 percent for cleanliness. Dr George Mukhari Hospital in Pretoria scored 54 percent for cleanliness, 76 percent for availability of medicines, and 89 percent for patient waiting times.
Motsoaledi said that teams would be sent to each facility to help it reach full compliance.
He said the first five years of NHI would include pilot studies and strengthening of the health system in areas including management, quality improvement, infrastructure development, equipment, human resources and information management.
He said the NHI would not mean the end of private medical schemes or private health care providers. Rather, the government would work in cooperation with them, for example in cases where hospitals were too far from people.
If there was a private doctor operating in the area, the department would sign a contract with the practitioner to administer NHI so that primary health care could be provided to those in need.