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DIAMOND FIELDS ADVERTISER In his State of the Nation Address last week, President Cyril Ramaphosa told parliament that: "This year, we will take a significant step towards universal access to quality health care for all South Africans. "After extensive consultation, the NHI Bill will soon be ready for submission to Parliament. The NHI will enable South Africans to receive free services at the point of care in public and private quality accredited health facilities. "By applying the principle of social solidarity and cross subsidisation, we aim to reduce inequality in access to health care. "Realising the magnitude of the challenges in health care, we have established an NHI and quality improvement War Room in the Presidency consisting of various key departments to address the crisis in the public health system while preparing for the implementation of the NHI. "We have a funded national quality health improvement plan to improve every clinic and hospital that will be contracted by the NHI. By introducing the NHI together with a multi-pronged quality improvement programme for public health facilities, we are working towards a massive change in the health care experience of South Africans." This commitment to the nation, by the highest office in the land, has assured even the doubting Thomases of the government's commitment to the implementation of the National Health Insurance (NHI). However, despite our concerted efforts to explain the concept of the NHI, there are sceptics who argue that the plan is unaffordable and that the government should first address the serious challenges in the public health care sector before rolling out the Universal Health Coverage (UHC) plan. The mistake that these sceptics make is that they believe that NHI would be based on the current cost of private health care, which is a fallacy. We are quite certain of the affordability and sustainability of NHI because our plan will be anchored on Primary Health Care. Primary health care has 3 components: • Prevention of diseases • Promotion of health and healthy lifestyle • The entry point into the health care system if you are sick, should not be at tertiary hospitals or specialist level but should be at the primary health care level, meaning clinics, GPs and allied health professionals at non specialist levels. The common practice that has developed over years in our country is that when people get sick, their first point of call is a hospital. They have very low regard for their local clinics. In fact, many of our people perceive clinics as institutions where children are immunised and get weighed only. Under NHI, we will change this. Primary healthcare is the heart beat of NHI. But even more importantly, we want to overhaul the system. The current system is more curative. In other words, we wait for you to be ill and treat you in our hospitals. We want to roll out a massive public education on healthcare to promote a healthy lifestyle. If you look at Cuba, where we thousands of our doctors have been trained, they have eliminated many diseases not because they have lots of resources, but because they focused on primary health care. This is the way to go. Currently our hospitals are not struggling to cope with the burden of diseases. Many of these diseases are preventable and if we can focus on educating our people about how to prevent them and educate them to test for early detection, we will go a long way to reduce the bur den of disease in our hospitals. Through NHI, we want to empower our people so that they are not just passive recipients of health care service but that they become active participants in shaping their state of health. We have already started educating members of the public about the negative effects on health of things such as tobacco, alcohol, sugar and salt. People should also be taught to appreciate the need to be physical fit and to control their weight so that they can contribute to staying healthy and keeping certain diseases at bay. Primary health care is sustainable and affordable. People are able to use health care at the entry level. If you have flu and consult a specialist, you are going to pay an arm and a leg, unnecessarily for such a simple and common aliment. It is like consulting an attorney or briefing a senior counsel. Both these professionals are lawyers but do not operate at the same level and as such their rates would be different. Imagine you have your goat stolen but you brief a senior counsel to pursue the matter of compensation for your goat. The legal costs due to the Senior Counsel will be much more than the value of the goat. This is just flushing money down the drain. The good thing is that the world is starting to wake up to the fact that primary health care approach is the way to go. Without Primary Health Care, any UHC plan would experience serious financial difficulties. Without an effective Primary Health Care system, the tertiary health care would be over burdened by simple things that should have been dealt with at primary health care level. Many of our tertiary hospitals are over loaded with work because they are treating too many patients who should not be there in the first place. You find hundreds of patients going to Chris Hani Baragwanath Academic Hospital to get treatment of minor illnesses such as flu. This is certainly not sustainable. As health professionals, we know that health is not just the absence of disease but a state of good physical, mental social well-being. This has to be extended to everybody and this right cannot only be reserved to those who have the financial means. This is why we have no option but to move with speed to implement the NHI. The former health minister of Ethiopia, who is the current Director General of the World Health Organisation Dr Tedros Adhanom Ghebreyesus, once shared with me how in his native country they had been achieve much better health out-comes such as reducing maternal mortality than South Africa despite the fact that South Africa has much more advanced hospitals than Ethiopia. His argument was simple. They used primary health care, deploying.com munity health workers throughout the country. Our current system is actually sick care not health care. In other words, our approach is taking care of the sick. Those who believe that they are healthy, they are not part of the healthcare system. They first have to be sick first to be part of our system. But when we apply primary health care system, those who consider themselves to be healthy, are part of the system. They have to undergo screening to avoid going to the hospital when they are very sick. We are encouraged by the words of President Ramaphosa that the NHI bill will be going to parliament soon. We have no option but to deliver on this Constitutional mandate of ensuring that we provide quality and affordable health care to all our people regardless of their economic or social status.
Created at 2019/02/19 01:23 PM by Mediclinic
Last modified at 2019/02/19 01:23 PM by Mediclinic