In the patient’s interest

A real leader takes the assets of the nation, whether public or private, and builds on them to serve its people. But Health Minister Aaron Motsoaledi alienates the private sector when his public sector is riddled with gross inefficiencies and could do with some commercial discipline.

About R16.8bn is spent on procuring pharmaceutical products and medicines for 44-million uninsured South Africans each year. Between 2013-14 and 2015-16, there has been a reduction of stock-outs after some interventions in the bad old days of 2010. In particular, the stock-out of vaccines, ARVs and TB medicines has dropped between 6%-52% across provinces. But, according to the auditor-general:

● With no market mechanism at play, there is a mismatch between our changing burden of disease (demand) and the provisioning of what people actually require (supply);

● An arcane budgeting system, where historical rather than burden-of-disease information is used for procurement, results in provinces running out of money, paying for the wrong things;

● At the depots, standard operating procedures are not being adhered to, they are not visited often enough and there are no penalties for mismanagement;

● There is no human resource pipeline to fill a 26% vacancy rate for dispensing pharmacists. The Free State and Mpumalanga have 58% and 44% vacancy rates, respectively;

● The medicines and pills dispensed to patients were not recorded at 63% of all health facilities nationally. This is an extraordinary failure in informational gathering; and

● Supplier payments from provinces — with the exception of the Western Cape — are badly managed, resulting in delayed disbursement of R394.6m, ruinous to small businesses without deep pockets.

In Our Health Plan, the DA argues that the depots should be run like businesses because it will instill a culture of efficiency in the interests of the patient.

Dr Wilmot James, MP

DA national health spokesman