Beware of Building Heavyweight Health Structure On Weak Foundation

by Aug 16, 2009All Articles

BUSINESS DAY
COMMENT : Tim Cohen
29 June 2009

Johannesburg — NO ONE ventures into the healthcare debate without trepidation, but you cannot but agree with Human Sciences Research Council director-general Olive Shisana that South Africa needs a better and more equal healthcare system.
Shisana has been advocating a national health insurance scheme, which the African National Congress (ANC) has now endorsed. Although in principle the idea appeals, you can’t help feeling the ANC is trying to build a heavyweight infrastructure on a very weak foundation.
There are many examples, but the most obvious is the recent state doctors’ strike. The short history of what happened here as I understand it is nursing unions put up a good argument that their salary had lagged and the profession was being eaten alive by foreign employers enticing nurses away.
So government instituted this odd thing called the “occupational specific dispensation”, basically a pay boost. But they massively miscalculated how many nurses are on their books, so the health department’s budget went haywire. Doctors noticed how the pay of the people they normally boss around had risen, and were incensed. They are now demanding their own occupational specific dispensation.
Shisana, once director-general of health, should know the true state of the department well. There is a good argument to be made that she contributed to it after dismantling the Medicines Control Council as part of the virodene affair.
SA should definitely consider a new health system and a national insurance scheme, but first the government needs to demonstrate that it can run the one it has.
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