For South Africans to lead healthy and fulfilling lives, they must have access to quality healthcare services when required. This means that those who cannot afford healthcare services must still have access, irrespective of their financial or health status. All South Africans must feel confident that when they require healthcare, they will receive quality healthcare services.
In South Africa, the root cause of health sector challenges lies in governance failures. As a result, we see poor performance, a lack of human resource planning and ineffective accountability mechanisms. The ANC’s response is rooted in the misguided belief that the only way to guarantee quality healthcare is by centralising the healthcare system through its National Health Insurance (NHI) plan. However, greater state control will only open the door to more maladministration and corruption, which have characterised almost all state-controlled entities to date.
The DA’s proposed alternative is to build on existing capacity and improve coordination between the public and private healthcare sectors so we can address our existing challenges and ensure universal health coverage. The DA is committed to universal access to healthcare for all citizens. By leveraging the strengths of the private sector in partnership with the public sector, we can improve healthcare facilities for all.
The DA’s Health Policy seeks to achieve the following:
- Strengthening healthcare systems and infrastructure by:
- Addressing the governance failures in the public sector by enhancing oversight and tackling instances of fruitless, wasteful, and irregular spending by establishing an investigative body known as the Independent Watchdog for Health Entities, which will supervise all regulators, all key hospitals and key health services. Furthermore, we will establish an independent National Health Appointments Authority (NHAA). This authority will be responsible for the nomination, appointment, and removal processes of members within the Watchdog (supervisory structures), shifting these duties away from the executive branch.
- Addressing the poor management of public hospitals by granting greater autonomy to all competent regional, tertiary, specialised, and academic healthcare facilities within the accountability processes (the Watchdog), under the supervision of the respective Provincial Ministers. Additionally, to tackle the issue of deteriorating health infrastructure, we commit to ensuring that all capital expenditures for healthcare facilities are financed and managed directly by the facilities’ administrators rather than by a public works department.
- Supporting a dissatisfied and burnt-out health workforce by implementing promotions based on merit rather than length of service, and incentivising leadership development capacity and professionalisation of our workforce by creating educational opportunities in partnership with both public and private institutions of higher education.
- Addressing market failures in the private sector by introducing social reinsurance and a risk-equalisation mechanism for medical schemes.
- Enhancing quality of care and patient safety by:
- Addressing the poor management of public hospitals by placing the Office of Health Standards Compliance (OHSC) under independent supervision. We will also ensure that the OHSC is fully capacitated with the necessary resources and authority to investigate and rectify concerns. Furthermore, we will eliminate political interference within the OHSC by ensuring appointments in the entity are made through the NHAA rather than the Minister of Health.
- Addressing the rate of high medico-legal claims through introducing compulsory mediation processes instead of approaching the courts as the first point of resolution. To reduce the time, it takes to conclude medico-legal cases, we propose establishing medico-litigation centres.
- Addressing the poor infection control in hospitals by ensuring that all hospitals have an assigned infection control monitor or teams trained, educated and responsible for monitoring and surveillance of infection and diseases at health facilities.
- Addressing healthcare resource shortages by ensuring every hospital has a qualified inventory manager and can order directly from suppliers, subject to checks and balances, when the need arises.
- Enhancing access to healthcare services by:
- Addressing the geographical challenges for healthcare access by enhancing the availability of healthcare services in underserved areas, investigating the viability of mobile clinics, and strengthening the capacity of mobile health services. Furthermore, the DA will ensure that every hospital has a well-defined risk assessment and mitigation plan to address geographical challenges that hinder service provision (such as droughts, which result in water shortages).
- Addressing health workforce shortages by removing any administrative barriers to employing our already trained doctors and nurses first and offering incentives to encourage them to work in rural areas.
- Addressing the lack of access to emergency care by ensuring that emergency access is guaranteed to all, regardless of income or type of coverage, the DA will implement a policy that will ensure that all priority 1 patients have access to emergency services at the nearest treatment facility. The DA will also encourage greater interdepartmental collaboration with the Police Service to enable Emergency Medical Technicians (EMTs) in “red zones” to service the public safely. A DA-led Department will provide training in the management of emergency scenarios to all healthcare professionals and ensuring that the procurement processes of ambulances take into consideration the terrain in which they will be travelling.
- Addressing the shortfalls in the Reciprocal Healthcare Agreements (RHA) by engaging with SADC, the AU and other governments for the signing of RHA agreements that specify the conditions of reimbursement for treating foreign nationals in our public healthcare system.
- Promoting healthy lifestyles and well-being through:
- Addressing the high burden of diseases by addressing the social determinants of health and behavioural risk factors. This will be done by scaling up Community Health Services for non-communicable diseases through community healthcare workers and ensuring strong referral pathways between health facilities and other social services.
- Addressing the poor state of mental health in South Africa by shifting underutilised resources from psychiatric institutions or other programmes to primary healthcare facilities. This will enhance access at the lowest possible level. Additionally, the DA will encourage the rollout of sensitivity training for healthcare professionals to equip them with the necessary skills to identify and appropriately deal with mental health issues in patients and combat prejudice.
By addressing governance weaknesses, improving service delivery, ensuring quality healthcare access for all geographical areas (urban and rural), and fostering healthier communities, the DA aims to build a resilient health system that can realise the objective of universal health coverage. The DA’s health policy provides a roadmap for getting our health system back on track.