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2019/11/292019/11/04 08:40 AM

The government-initiated National Health Insurance (NHI) has been lauded as a great development towards achieving equitable healthcare, particularly for the poor, but traditional healers believe they have been marginalised from the new dispensation.

This emerged from the public hearings undertaken by the portfolio committee on health countrywide to get input on the NHI Bill.
2019/11/152019/11/19 09:02 AM

While the National Health Insurance Scheme is expected to provide universal healthcare for all South Africans, there are concerns that not much will change for the transgender community.

This week, Eyewitness News is focusing on the state of health in the country, covering a wide range of topics, including transgender care.
2019/11/142019/11/19 08:52 AM

Deputy Health Minister Joe Phaahla said that South Africans should not be concerned that once the NHI was implemented that the public health system would collapse due to a shortage of staff.

Deputy Health Minister Joe Phaahla said that reports of shortages of doctors and nurses in South Africa were simply untrue.

Phaahla told Eyewitness News that there would be enough doctors and nurses when the National Health Insurance was implemented as health professionals who worked in the private sector would be integrated with those who worked in the public sector.
2019/11/132019/11/19 08:35 AM

Trade union Solidarity has criticised the recent decision by the government’s biggest medical scheme to guarantee private hospital care to all its members, saying it was an admission of the state’s failure to run an effective public healthcare system. Business Day reports that last week the Government Employees Medical Scheme (GEMS) announced that even its lowest-paid members would from January 2020 have cover for private hospital admissions, as part of its efforts to standardise the benefits across its different options.

Solidarity said: “While Solidarity welcomes the decision itself and believes that all South Africans should have access to private medical care, (it) sheds light on the state’s incoherent behaviour which, on the one hand, regards National Health Insurance (NHI) as a highly necessary intervention, but then negotiates access to private services for their own officials.”
2019/11/19 09:01 AM

Die ANC maak ‘n reusefout as hy dink die beplande Nasionale Gesondheidverseekering (NGV) sal die to werstaf wees wat alle problem in die gesondheidsektor uit die weg ruim.

So het Philip van Staden, die VF Plus se woordvoerder oor gesondheid, gisterminiddag gesê toe die Nasionale Vergadering (NV) die begrotingsverslag van die department van gesondheid oorweeg het.
2019/11/122019/11/19 08:49 AM

Gauteng's health department is the worst in the province when it comes to non-payment of suppliers, with 987 businesses owed a combined R1.9bn dating back to 2014.

This was revealed in the legislature by health MEC Bandile Masuku in reply to questions by DA MPL Jack Bloom.
2019/11/122019/11/19 08:50 AM

Over 200 nurses marched to the KZN Department of Health in Pietermaritzburg

“Patients are dying on hospital benches while hundreds of nurses are unemployed,” says Nonhlanhla Mazibuko. She was one of over 200 unemployed nurses who marched to the Department of Health head office in the Natalia Building, Pietermaritzburg, on Monday.

Marching under the banner of the South African Revolutionary Allied Workers Union (SARAWU) they were demanding that the department fill all the vacant posts at hospitals and clinics in KwaZulu-Natal.

Most of the nurses came from Pietermaritzburg, joined by nurses from from Greytown, Mandeni, Ngwelezane, Estcourt, Port Shepstone and Durban.

Mazibuko, who is chairperson of the unemployed nurses committee, said hospital wards were full yet nurses with qualifications were sitting at home.

“Some of us studied in private colleges and we don’t have experience. They must not ask for experience. Where are we going to get experience from?” asked Mazibuko. “Those nurses who are trained in private colleges are isolated by the department,” she claimed.

Jabu Zulu, an unemployed nurse who joined the march, said, “One nurse is expected to serve over 60 patients in the ward … How is that possible? They should hire nurses the same way they recruit us for votes,” she said.

“All we see is a lot of sod turning. We are not the Department of Agriculture. When are they building hospitals and clinics for us to be employed?” asked Zulu.

Retired nurse Jabu Mtshali said, “I came to support the nurses because I can relate to what they are going through. The sad thing is that nurses pay for their [Annual Practising]

Certificate at the SA Nursing Council. Imagine paying for a certificate while staying at home.”
The director of nursing in the province Nompumelelo Sosibo said the department will look at the issues raised by the nurses.

Sosibo said health MEC Nomagugu Simelane will respond to the memorandum in 14 days.
2019/11/122019/11/19 08:58 AM

‘It was like they wanted to make sure that it looked like the NHI Bill had everyone’s approval, it was just a sham.’

The public hearings into government’s proposed National Health Insurance (NHI) Bill had a rocky start in Mpumalanga recently as civil society organisations and some opposition parties slammed the process. Some raised questions over poor planning and possible hidden agendas. Others raised concerns that the hearings may be a missed opportunity to meaningfully bring the public into the conversation about the bill that is meant to outline the funding of universal healthcare.

A local newspaper, The Bulletin, in the days before the scheduled meetings criticised the Parliamentary Portfolio Committee on Health for failing to communicate the hearing details properly to the public and to media.

Meeting well-attended

Despite a last minute venue change from Secunda to Ermelo (two towns about one and a half hours’ drive from each other) and without prior notice, apologies or explanations, the fourth of the Mpumalanga public hearings in Ermelo was well attended. The hearings were held in the municipal council chambers that were packed with people – reportedly between 800 and 900. The meeting was also live-streamed.

Sfiso Nkala of SECTION27, who’s also the civil society chairperson for the province’s AIDS Council, was one of the people who drove from Ermelo to Secunda on the Monday afternoon to find the shut doors at the Lillian Ngoyi Centre. He had to drive back to Ermelo knowing he would miss the first hour and a half of the meeting.

Nkala said: “It was like an ANC rally, not a public hearing. About 90% of the people were wearing ANC regalia; you can’t help thinking that these people came from the branches and from the ANC alliance partners.”

Asked to endorse NHI

Nkala told Spotlight that when he took up a spot in the line of people waiting their turn at the microphone, there was a person who moved down the line telling the people to have their say but also to state that they endorse the NHI.

“It was like they wanted to make sure that it looked like the NHI Bill had everyone’s approval, it was just a sham.

“My biggest worry is that people have not been given any information so that they can ask informed questions about this bill,” said Nkala.

A ‘managed democracy’

Thami Nkosi, Right2Know campaign manager, said the shambles of the Ermelo public hearings amount to a “watered down version of public participation that is an indictment on the ANC and on opposition parties who are not holding the ruling party to account”. He said the public hearings should not be reduced to political rallies, or manipulated processes of public consultation in decision making.

Nkosi added: “When politicians act with their own political interests rather than for the public and the most marginalised then we are left with a managed democracy, not a true democracy.”

Alleged ANC propaganda

DA MP Siviwe Gwarube, who serves on the Portfolio Committee on Health, also slammed the hearings as “deeply politicised”. Gwarube said in a statement the hearings sought to mislead the public about the legislation in order to sway their inputs.

“Parliament produced a leaflet that was not signed off by the Portfolio Committee, which sought to educate people about the bill but instead advocated for the passing of the bill. This is a complete betrayal to the people of South Africa and undermined the work that Parliament is meant to do.”

The Afrikaner and minorities rights group AfriForum was also critical. Its spokesperson on National Health Insurance, Natasha Venter, said:

“How did they get so many people to the meeting when the general public didn’t know about the changed venue till the day? The pamphlets were also only in isiZulu and it was essentially a script of ANC propaganda about NHI funding. They didn’t tell people about how unsustainable NHI will be; only that people will be able to get referred for private healthcare – of course everyone wants to hear that. It seemed from the start that these hearings are about reaching an outcome that push through the NHI, without really being truthful to the public.”

AfriForum also complained about the venue being changed without prior notification; the fact that on the night there were only pamphlets in isiZulu; a lack of translation services offered for a public meeting that was conducted in isiZulu; and that the hearings were cut short by an hour and half despite the hearings being set down for four hours.

‘Quite a good level of understanding’

The chairperson of the Portfolio Committee on Health, Dr Sibongiseni Dhlomo, said the change of venue from Secunda to Ermelo came from the municipalities and was not in Parliament’s control. He said he knew eight days before about the venue change.

Dhlomo explained that isiZulu is the dominant language in Ermelo, which is why the meeting was conducted in isiZulu. According to him translations were “offered simultaneously” for those who requested it. Dhlomo said pamphlets that were distributed on the night were only one part of public engagements undertaken by the provincial department of health. He didn’t have a direct answer as to why the meeting ended an hour and a half early, despite people being in the queue to speak.

“We found that the people at the hearings had quite a good level of understanding of the bill,” said Dhlomo, who was previously the MEC for Health in KwaZulu-Natal.

Despite the hearings already under way, he said it is too early to comment on the criteria he and his team are using to measure the success of the processes by which the public hearings are being run.

“We are parliamentarians; all we are doing is listening to what people are saying so that we can collate that feedback and take it back to the Speaker of Parliament.”

Skipping steps?

The Gert Sibande district in Mpumalanga was one of 10 districts in the country where the NHI was piloted in 2011/ 2012. In 2016 the organisation Section27 undertook an evaluation of the programme.  At the time the overriding conclusion was:

“The piloting process in Gert Sibande has shown very limited success and provides important lessons for NHI as a whole although the infrastructural, human resources and governance weaknesses in the district are far from resolved. More fundamentally though, NHI requires more than a few ‘tweaks’ to the funding system for health.”

Now, three years later, these concerns remain.

“It is as if steps have just been skipped,” said Nkala. “There hasn’t been logical progression to get to the point of an NHI Bill being under discussion.”

He said key issues surrounding corruption and misappropriation of funds for the public health sector have not been addressed, likewise the training and retention of nurses and doctors. According to Nkala, people have also not been advised about their rights to a better health service.

“Most people don’t know they can fill out an official complaint about a clinic or a hospital and those who do know are unlikely to find a complaint form in any of our hospitals.”

Nkala proposed that the hearings that are scheduled for four-hour sessions should include a short but sound explanation of the bill, to help people better understand its contents.1

It also emerged this week in Parliament that subsequent meetings in the Northern Cape were poorly attended, with only 10 people attending in De Aar and 60 in Upington
2019/11/112019/11/19 07:52 AM
Solidarity today condemned the hypocrisy of the decision by GEMS, the medical aid fund for state officials, to provide access to private hospitals for members belonging to their cheapest option.
While Solidarity welcomes the decision itself and believes that all South Africans should have access to private medical care, they shed light on the state’s incoherent behaviour which, on the one hand, regards National Health Insurance (NHI) as a highly necessary intervention, but then negotiate access to private services for their own officials.
Morné Malan, senior researcher at the Solidarity Research Institute (SRI) argues:
“It is absurd that the private sector whose name is already slandered by the state, is now regarded as a saviour because state hospitals simply cannot step up to the plate. It is a concession on the part of the state that all criticism on the status of healthcare is actually valid.”

Furthermore, Solidarity is calling on the state to act consistently and to admit that they simply do not have the capability or power to manage healthcare within South Africa.

“The failures their mismanagement in state hospitals result in is ubiquitous. This is an admittance they observe themselves. However, it is not acceptable for the state to try and protect its own officials from their poor performance while the rest of the country is subject to it,” said Malan.

Solidarity further confirms their continued opposition to the nationalisation of healthcare by means of the NHI, which will place all services in the hands of the state – whose own officials do not even want to make use of public healthcare.

“It is ridiculous that the state wants to place the lives and health of all South African citizens subject to a system they do not even trust with their own health. The message is clear: It will be public healthcare for you, but private healthcare for those working in the state,” Malan stated.

“The state cannot drive healthcare. It is time for them to stop doing that. Expanding the state’s involvement to a point where they manage everything, will only bring everything to a failure and bring about disastrous consequences,” Malan concluded.

Issued by Morné Malan, Senior researcher: Solidarity Research Institute (SRI), 8 November 2019
2019/11/112019/11/19 08:33 AM

The Government Employees Medical Scheme has reinvested close to R1bn to enhance benefits for members for 2020, it said in a statement on Thursday.

GEMS, the country's largest restricted medical Scheme, has over 720 000 principal members and over 1.8 million beneficiaries, according to its CEO Dr Stan Moloabi
2019/11/19 08:36 AM

Staatsamptenare wat dit voor heen nie kon bekostig nie, gaan volgende jaar toegang tot private hospitale kry.

Gems, die Mediese fonds vir staatamptenare, stel volgende jaar op sy goedkoopste opsie ‘n network van private hospitale beskikbaar waarvan lede gebruik kan maak.
2019/11/19 08:46 AM

Pharmacy retailer Dis-Chem is tapping into “telemedicine” and deals with airports and hospitals as it forges a new growth path.

It is doing so in an industry marked by risking health-care costs, a tough economy and consumer demand for accessible and convenient health care.
2019/11/102019/11/19 07:53 AM

Trade union Solidarity has criticised the recent decision by the government’s biggest medical scheme to guarantee private hospital care to all its members, saying it was an admission of the state’s failure to run an effective public healthcare system.
Last week the Government Employees Medical Scheme (GEMS) announced that even its lowest-paid members would from January 2020 have cover for private hospital admissions, as part of its efforts to standardise the benefits across its different options. Gems members constitute the majority of SA’s 1.1-million public servants, and currently runs to 720, 00 principal members and their dependants.
2019/11/19 08:47 AM

n Mens dal ver moet soek na ‘n beter voorbeeld van presies hoe siek Suid-Afrika se staatsdiens is as die verhaal van die linne en die R150 miljoen waaroor Rapport on langs berig het.

Eerstens is daar die algehele onvermoë om selfs die mees basiese take te verrig. Die bedrag van R150 miljoen wat in die vorrigge boekjaar aan die Nasionale Gesondheidsverseekeringstelsel (NGV) toegewys is om ‘n nypende linnekort in staatshospital te verlig, het ‘n somtotaal van nul lakens opgelewer.
2019/11/19 08:51 AM

The health department has been accused of making silly excuses for its delay in releasing the list of compulsory community service placements, which has left about 2600 young doctors in limbo.

With a little over a month before the start of their community service, the graduate doctors are still in the dark about where in the country they will be placed.
2019/11/11 08:42 AM

The Free State MEC for Health Montseng Tsiu has encouraged local scientists and medical practitioners to continuously conduct researches in the field in order to ensure the country is able to provide quality healthcare for everyone when it introduces the National Health Insurance (NHI).

She said well researched studies in the field of health will make it easier for government to understand the challenges faced by people and be able to come up with the right interventions.
2019/11/11 08:43 AM

Dis-Chem is glad nie bang vir die koms van Nasionale Gesondheidsverseerkering (NGV) nie. Inteendeel, die apteekgroep staan en vryfsy hande omdat hy glo sy network van klinieke gaan voordeel trk uit die NGV se klem op premêre gesondheidsorg.

Ivan Saltzman, uitvoerende hoof van Dis-Chem, sê die NGV se doelwit is bekostigbare toegang tot gesondheidsorg “en ons verwag dit sal ‘n verandering in die verbruik van sorg in die private gesondheidsektor in die toekoms teweegbring”.
2019/11/11 10:19 AM

The DA in the Western Cape has urged members of the public to vigorously interrogate and comment on the National Health Insurance (NHI) Bill.

Opportunities for public comment close on 29 November.
2019/11/082019/11/11 10:24 AM
Business Day Live

Medscheme seeks to standardise core benefits in line with NHI.

SA’s biggest medical scheme for public servants plans to extend private hospital cover to all members from January as it seeks to standardise core benefits in line with government policy on National Health Insurance (NHI).
2019/11/11 10:25 AM

SA’s biggest medical scheme for public servants plans to extend private-hospital cover to all members from January as it seeks to standardise core benefits in line with National Health Insurance policy.

The government Employees Medical Scheme (Gems) move to expand core private hospital cover is in line with the Competition Commission’s health market inquiry, which recommended and industry-wide standard benefit package. It also has the potential to reduce the load on the overstretched public-health system by using spare capacity in the private market.
2019/11/072019/11/11 09:45 AM

Near collapse of province's health system province should set off warning bells

If the past week’s public hearings in the Northern Cape, on the National Health Insurance (NHI) bill, have highlighted one thing, it is not that the country is in need of the NHI, but rather that our people are in desperate need of quality universal health care because the government has managed public health resources into the ground.
2019/11/062019/11/11 08:25 AM

National finance Minister Tito Mboweni delivered his mid-term budget speech on Wednesday of last week which showed that despite slow economic growth, the health sector continues to receive one of the biggest slices of the country’s budget.

Health-e News has rounded up five things that the midterm budget tells the country about the state of healthcare and its future.

More money for the National Health Insurance

The National Health Insurance (NHI) Bill was tabled in Parliament earlier this year. The bill is South Africa’s policy on providing universal healthcare. When introducing the Bill to Parliament, Health Minister Zweli Mkhize said that the NHI will be fully implemented by 2026.

Treasury estimates that rolling out the NHI would require an additional R33bn annually from the beginning of the 2025/26 financial year. It says that the current economic climate rules out previous cost predictions that were in the white and green papers of the Bill.

Treasury also says that provinces will receive a special fund to contract health professionals in pilot NHI districts.

Cancer treatment and mental health to be included in the HIV, tuberculosis, malaria and community outreach grant

In 2021, oncology and mental health will be included in the HIV, TB, malaria and community outreach grant. According to Treasury, the fund will come from the NHI indirect fund and thereafter given to provinces to run the programmes. However, Treasury says that it will work with the Department of Health to review and restructure the grant as a strategy towards the implementation of the NHI.

The country has been marred with a shortage of oncologist and facilities without any cancer treatment equipment. In 2017, KwaZulu Natal was left with no oncologists in the public sector. While Mpumalanga only received its first hospital that provides cancer treatment this year.

South Africa has also faced mental healthcare crisis such as the Life Esidimeni tragedy that led to the deaths of 144 mental health state patients who were transferred from private healthcare facilities to 27 illegal non-government organisations. To date, none of the health officials or practitioners implicated has been prosecuted or have their medical licenses revoked.

Medical-legal claims are on the rise

Mboweni says that medical-legal claims against the provincial departments of health are a threat to the country’s fiscal. He estimates that medical-legal claims together with cases against the police amount to about R100bn. Between 2017 and 2019, claims increased from R80bn to R99bn. Departments have paid out about R2bn in 2018/19, half a billion more than the previous financial year.

HIV organisations and national Aids council to get a funding cut

The midterm budget document states that funds meant for the South African National Aids Council and organisations that work in the HIV sector will be diverted to support initiatives that deal with gender-based violence.

However, the health budget vote states that antiretroviral treatment programme is slower than anticipated. Only 4.8m people living with HIV are on treatment, a million fewer people than the set target. The country aims to have at least 6.1m people on HIV medication by December 2020.

Meanwhile, the human papillomavirus (HPV) vaccination grant will also be merged into the HIV, TB, malaria and community outreach grant from next year. The HPV vaccine is given to young girls to prevent cervical cancer in the future.

Fees fall for Wits medical students
Almost R9m from the National Department of Health will be used to settle fees for medical students from rural areas and township schools. This is part of the health ministry’s programme to support students at the University of the Witwatersrand.
2019/11/062019/11/11 08:30 AM

The Office of Health Products Procurement (OHPP) is an entity newly introduced in the 2019 version of the NHI Bill. Spotlight asks what it will mean for procurement under NHI.

While much remains unclear about the rationale for, and function of, the Office of Health Products Procurement (OHPP), the NHI Bill nevertheless gives us some important pointers.
2019/11/062019/11/11 08:34 AM

After a decade, it is extremely concerning that there is so little certainty on how the NHI will practically happen.

At this late stage in the game, where we are mere moments away from a National Health Insurance (NHI) Act, we probably need to establish how the NHI will be implemented.

In SA, government plans are a dime a dozen, but implementation of plans, successful or otherwise, is a rare occurrence. Having been at it for a decade, it is extremely concerning that there is so little certainty on how the NHI will practically happen.
2019/11/11 09:37 AM

The lack of basic health care, especially in far-flung of the Northern Cape, Came under the spotlight when the portfolio committee on health concluded its public hearings on the National Health Insurance (NHI) Bill in Springbok on Monday.

The committee conducted public hearings on the bill in four local municipalities in the province, including Sol Plaatje, Emthanjeni, Dawid Kruiper and Nama Khoi. 
2019/11/11 08:29 AM

The future of the country’s health system and the National Health Insurance (NHI) now rests in the hands of a doctor who grew in Mobeni Heights.

Last week, Precious Malebone Matsoso stepped down as Director-General in the Department of Health to pursue her PhD studies. She was at the helm for nine years.
2019/11/052019/11/11 09:33 AM

As Parliament holds its third day of hearings for the National Health Insurance Bill (NHI), it described past two days as “positive”.

The hearings got under way in the Northern Cape.
2019/11/052019/11/11 09:38 AM

The public has until the end of this month to make submissions on the National Health Insurance (NHI) Bill.

Parliament’s Portfolio Committee on Health started its second round of public hearings on the Bill over the weekend.
2019/11/11 10:22 AM

The Gauteng Health Department will need R6 billion to fix 32 public hospitals, including Steve Biko and Chris Hani Baragwanath hospitals, to enable them to meet the safety compliance standards of the Occupational Health and Safety Act.

This was revealed in a report given to the Gauteng provincial legislature’s portfolio committee on Health.
2019/11/11 08:28 AM

The latest Health market inquiry report that showed lack of competition in the private health care sector should serve as a wake-up call for our policy makers. The report was a reminder that our two-tiered health system is both unaffordable and unsustainable.

For a country with a very high disease burden, it is a travesty that only 16% of South Africans have access to medical aids Government should not only be looking at fixing what is contained in the report but should look at overhauling the entire system in a transformative way.
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