Lawyers is­sue warn­ings about NHI scheme

CityPress - - Business - RIANA DE LANGE busi­ness@city­press.co.za

Pri­vate med­i­cal aids and hos­pi­tal groups should be cau­tious when of­fer­ing ser­vices to gov­ern­ment as part of the pro­posed na­tional health in­sur­ance (NHI) scheme be­cause there are still too many un­cer­tain­ties sur­round­ing the sys­tem, a lawyer has warned.

Neil Kirby, a di­rec­tor at Werks­mans At­tor­neys, said that, while it was ap­pre­ci­ated that the pri­vate sec­tor was freely of­fer­ing ser­vices and re­sources, this needed to be done with cau­tion from a le­gal per­spec­tive.

“We are in un­known ter­ri­tory,” he said dur­ing a meet­ing at the Hos­pi­tal As­so­ci­a­tion of SA’s an­nual con­fer­ence in Cape Town late last month.

The con­fer­ence fo­cused on the fu­ture of health­care in the coun­try and the role of the pri­vate sec­tor at a time when gov­ern­ment is pre­par­ing for the full im­ple­men­ta­tion of the NHI scheme, which is sup­posed to en­sure qual­ity health­care for all South Africans by 2026.

Kirby’s warn­ing fol­lowed var­i­ous sug­ges­tions by lead­ers in the pri­vate health­care in­dus­try about pos­si­ble co­op­er­a­tion be­tween the pub­lic and pri­vate sec­tors re­gard­ing preg­nan­cies, school health­care pro­grammes and cataract and hip re­place­ment pro­ce­dures, as pri­ori­tised in the white pa­per on the NHI.

Ko­ert Pre­to­rius, CEO of Medi­clinic in south­ern Africa, said pri­vate hos­pi­tals could help with, for ex­am­ple, re­duc­ing the back­log of hip and knee re­place­ments by do­ing a per­cent­age of these pro­ce­dures at lower tar­iffs, by ac­quir­ing phar­ma­ceu­ti­cal items and pros­the­ses at state ten­der prices, and by us­ing avail­able ca­pac­ity in pri­vate hos­pi­tals.

Pri­vate hos­pi­tals could help man­age pri­mary health­care clin­ics near them, he added.

Ac­cord­ing to Richard Fried­land, Net­care group CEO, South Africa can’t build a com­mu­nity and econ­omy with­out proper ac­cess to qual­ity health­care for ev­ery­one.

The pri­vate sec­tor is ready to work with the depart­ment of health to cre­ate a sus­tain­able fu­ture, he said.

Net­care has been work­ing with the UK’s Na­tional Health Ser­vice for the past 15 years to pro­vide bet­ter health­care for all cit­i­zens of that coun­try.

One of the projects that demon­strate this suc­cess­ful part­ner­ship is the six mo­bile clin­ics that visit 30 dif­fer­ent hos­pi­tal park­ing lots in Bri­tain over a five-year pe­riod to help tackle the back­log in cataract op­er­a­tions.

Bri­tain’s state hos­pi­tals pro­vide the park­ing lots for these units and ac­cess to elec­tric­ity, said Fried­land.

Pri­vate ser­vice providers have done more than 40 000 cataract op­er­a­tions.

What was ini­tially an overnight pro­ce­dure has now been re­fined to one that takes less than 15 min­utes, and a sin­gle doc­tor can treat 24 pa­tients a day. The ser­vice is of­fered six days a week for 50 weeks of the year.

Jonathan Broomberg, CEO of med­i­cal aid ad­min­is­tra­tor Dis­cov­ery Health, said a break­down in trust be­tween the pri­vate and pub­lic sec­tors in South Africa was ham­per­ing the es­tab­lish­ment of uni­ver­sal health­care.

He said lead­ers from both sides of the spec­trum had to help re­pair this di­vide in trust so that a few “quick goals” that will ben­e­fit ev­ery­one in the coun­try could be scored.

Broomberg said that, world­wide, there are var­i­ous mod­els – all of them unique to the coun­try’s his­tory and de­vel­op­ment – that will enable set­ting up uni­ver­sal health­care.

“The les­son is that we have to de­sign the re­form path ac­cord­ing our coun­try’s needs. The time for talk­ing is past. Im­ple­men­ta­tion is now im­per­a­tive.”

Kirby said there were at least 11 pieces of leg­is­la­tion and their ac­com­pa­ny­ing reg­u­la­tions that would have to be changed be­fore the NHI could be rolled out.

In ad­di­tion, new leg­is­la­tion on the NHI fund (to de­ter­mine, for ex­am­ple, who pays and what the money will be used for) and the NHI scheme (to deal with ser­vice de­liv­ery) is be­ing con­tem­plated.

Other un­cer­tain­ties Kirby re­ferred to in­cluded the fu­ture role of the statu­tory coun­cils, the of­fice of health stan­dards com­pli­ance, the Na­tional Pub­lic Health In­sti­tute of SA, and the de­sign of avail­able ben­e­fits and in­terim struc­tures that have to be fi­nalised be­fore NHI leg­is­la­tion can be con­sid­ered.

A break­down in trust be­tween the pri­vate and pub­lic health­care sec­tors in South Africa is ham­per­ing the de­vel­op­ment of uni­ver­sal health­care

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