IFP PRESS STATEMENT BY: 

DR RUTH RABINOWITZ MP
IFP SPOKESPERSON ON HEALTH

11th June 2008

South Africa has one of the highest standards of private health care in the world and one of the weakest public health sectors, hence our place near the bottom of the list in approaching the Millennium Development Goals. While the public sector cries out for attention the Health Minster is again focusing her department's time and skills on the private sector, allegedly to reduce costs.

The IFP is concerned about the steady increase in medical costs. However, we do not support current legislative moves to implement price controls in hospitals. We would rather impose minimum standards in all hospitals, public and private, make better use of private hospitals for state patients, foster private initiatives through incentives and enforce transparency in medicine, medical scheme and hospital costs. 

Current moves may well contribute to even further deterioration in both public and private sectors. 

The appropriate metaphor that comes to mind is: 

"Jack and Jill went up the hill to fetch a pail of water. 

Jack (the Public Sector) fell down and broke his crown, 

And Jill (the Private Sector) came tumbling after" 

Indicators on the nation's health, state that life expectancy is down to 50.

5.6million people have HIV, 489 000 are enrolled in the ARV programme with 350 000 on treatment, while 524 000 require treatment. 21 000 children are on HIV treatment while 123 000 need medicines. 

The TB cure rate is below 50% in 13 districts. 67 Out of 100 000 babies are dying before they are 5, of these 40 000 are preventable and due to inadequate health facilities, poor care and lack of transport.  This has put us near the bottom of the list of countries approaching the Millennium Development Goals.

If we look at the public facilities where health care is provided, the picture is dismal.  Equipment, blankets and food are stolen, staff is overstretched, and staff and patients fear for their lives. In many hospitals toilets are not useable.  In many clinics, treatment means Panado.

The Public sector needs all the help it can get. That help could come from private hospitals and from donors who are currently inhibited by political considerations in their efforts to help our government.

We believe that to reduce private hospital and health costs, we need greater transparency on regulating medical equipment and devices and we need to prevent medical schemes hiding profits in administration. Current proposals that call for collective bargaining between medical schemes, hospitals and doctors contradict the competition commission, which outlaws collaborative price setting. Furthermore the hospital association was not even consulted for the report on which the proposals are based.  

The IFP believes we should remove the moratorium on opening new private hospitals, the obstruction to hospitals employing specific categories of doctors and to private training of nurses. We should make hospital costs transparent. Private and public hospitals should work hand in hand to make use of every available hospital bed. The skills of the private sector should be contracted (best bidders not best buddies) to manage hospitals, clinics, mobile units, medicine delivery, nurse training, information systems and security. Only when the feud between private and public sectors is replaced by a constructive partnership, when there is better integration of health information systems, better coordination between hospitals, clinics and mobiles in rural areas and better co ordination at the practical and implementation level in strong districts, will we make progress toward achieving the Millennium Development Goals.