The question of trust in the government’s ability to run the NHI was raised at the South African heart congress last month.
Darryl Smith, a cardiologist at Linksfield Clinic who works sessions at Charlotte Maxeke Hospital, called it ‘an elephant in the room’.
‘Why should we trust the government with our money when there are no successful blueprints? Money has been poured into Chris Hani Baragwanath Hospital and Charlotte Maxeke — only for these hospitals to return to their former state. We have to ask why we must trust the government, not just with money, but with aptitude and ability’.
Nicholas Crisp, deputy director-general of health, said: ‘This pervasive distrust has to stop’.
Crisp has described our health system as ‘a complete shambles — a mess’. He said that public and private health care ‘are disintegrating quite badly and we need one another desperately to solve what we’re doing’.
The NHI will do away with provincial autonomy, said Crisp. There will be central financial control, with the budget being allocated to the provinces, municipalities, military, and public and private sectors.
‘You can’t have the private sector, which serves about 15% of the people, consuming 51% of health spend. How do we make the 67% of doctors working in the private sector available to the public — and ensure everybody gets health care when and where they need it without [them suffering] financial hardship?’
Crisp said that over time the benefits package would grow as more money became available: instead of 308 medical aid options under 78 medical schemes, there would be one.
He says resources are ‘locked up’ in private providers that exist because private funders can pay them. With just 8.9-million private sector beneficiaries — a number ‘rapidly shrinking as people downscale from comprehensive plans to hospital plans’ — the system is ‘simply unsustainable’.