Motsoaledi told delegates at the Conference that the question on the minds of health ministers across the globe was how to provide access of good quality to all citizens.
“We are finally finished with the Whitepaper on NHI and are just waiting for the next available opportunity to present to cabinet,” he said. Motsoaledi said he anticipated that there would be questions about whether SA can afford universal healthcare.
“The question is rather can we afford not to?” he added. “There is no option other than to provide healthcare to all citizens because not doing so is not only unjust, it does not make economic and political sense.” He said accurate forecasting of how much NHI would cost is extremely difficult.
“Ten years ago we needed R10,000 to treat one patient with HIV,” Motsoaledi explained. “Today we need only R1,000 per patient.”
He said SA’s health system could leapfrog to the level of developed countries if it used technology, behaviour change and new business models. These changes would need to be rolled out at speed, on a mass scale and would need to be affordable to be sustainable. He added that government would work with the private sector as it was doing in Gauteng hospitals.
“We will utilise both public and private sector to provide healthcare for the citizens of this country.” Motsoaledi explained that the government’s school health programme found that of 280,000 school children screened, one third had hearing, speech or eyesight problems. “We need optometrists, speech and hearing therapists – the only way to get help for these kids is to go to the private sector.”
Referring to the Council of Medical Scheme’s annual report he said the cost of healthcare was ever escalating, but in analysing what was driving these costs, it was very clearly that it was diseases classified as Non Communicable Diseases (NCDs). Motsoaledi added that the answer lay not in building more hospitals but getting to the root of health problems. For example, a National Health Commission would be set up comprising public and private representatives to tackle SA’s quadruple burden of disease including the HIV/AIDS epidemic alongside a high burden of TB; high maternal and child mortality; high levels of violence and injuries; and a growing burden of NCDs,such as hypertension and diabetes.
“We must put laws, regulations and policies that help us reduce quadruple the burden of diseases to make sure that the costs (related to these) come down,” added Motsoaledi. He asked private sector healthcare providers to help the government meet the goals set out in the National Development Plan including increasing life expectancy to 70 years and ensuring an HIV-free generation under 20 years old by 2030.
“In order for the public and private sector to effectively work together, we must go to the private sector with a Register of Needs so that we understand the size and shape of the problem and what resources we need to fix them,” said Motsoaledi.
He concluded his address by outlining the three mechanisms to enable South Africa to leapfrog to universal health coverage that is on par with developed countries: harnessing technology; changing the healthcare business model and changing national behaviour to realise a health system that is equitable, affordable, and delivers quality healthcare.