Working smarter
Western Cape MEC for health Theunis Botha, frustrated by a health budget that is failing to keep up with population growth, has devised a novel solution: partner with the private sector to create a not-for-profit foundation to raise resources purely for public health care.
The resultant Health Foundation is administered by an independent board of business people (most with backgrounds in academia and medicine) chaired by Elgin wine maker and former neurosurgeon Paul Cluver. Its newly appointed CEO is Josh Fisher, who conceptualised the Wits Donald Gordon Medical Centre (the first university-owned private training hospital in SA).
Fisher says the foundation has two main priorities. First, facilitating wellness interventions to try to prevent the complications of lifestyle diseases such as diabetes and hypertension, which place a huge burden on the health budget.
This could mean sponsoring an activity as prosaic as a fun run, but Fisher tends to think big. He’s working on a deal with a cellphone operator that would allow the provincial health authorities to SMS atrisk patients’ wellness information. This is nothing new in the private sector but would represent a first in public health.
Secondly, the foundation wants to generate resources to refurbish and upgrade provincial health facilities.
One pillar of Fisher’s strategy is to capacitate the facility boards of each hospital in areas like financial management so that they can better fulfil their fund-raising function. Across the province only a few of these boards function really well.
The other pillar is to form commercial partnerships with major companies. For instance, Fisher hopes to generate rental income and fees from allowing retail stores and ATMs to be located in hospital lobbies. He also intends to broker the selling of advertising space on public hospital buildings and ambulances.
“It’s early days but the response from the major corporates has been positive,” he says. “Many want to make a difference but feel frustrated because they don’t know how. We give them the comfort of [donating to or partnering with an entity run by] good leaders within the oversight mechanism of the foundation.”
Fisher hopes the foundation will be able to facilitate the generation of R2bn/year within five years — 15% of the current provincial health budget. “Anything less wouldn’t be meaningful,” he feels.
Whether this model could be replicated in other provinces depends on corporates’ confidence in their provincial health departments. The Western Cape is the only health department to have obtained several successive clean audit reports from the auditor-general.