Healthcare 2009

AFTER YEARS of little co-operation and poor relations with former minister Manto Tshabalala-Msimang, the changes in South Africa's Department of Health after the appointment of Barbara Hogan as the new minister has led to a positive approach among all stakeholders and open-hearted communication - hopefully, the start of real dialogue by all role players to meet the country's multiple healthcare problems and challenges. That's according to Kurt Worrall-Clare, CEO of the Hospital Association of SA (Hasa) and the association's legal affairs head.

Unlike the start of last year, when Hasa released its 2008 survey of the private hospital industry to the media in a tense atmosphere - while threatening to take legal action against the then minister concerning, inter alia, the planned regulation of private hospitals - the association is approaching this year in a spirit of optimism and a renewed call for constructive co-operation.

"Where there was considerable negativity last year we've now raised the mood to a level where people are in fact starting to discuss practical solutions. That's very encouraging," says Worrall-Clare. "That doesn't mean there are no longer any issues and problems. But at least there's an understanding and discussion that hopefully will continue so that we can keep coming up with original and innovative solutions - to the benefit of all South Africans."

Worrall-Clare says the meeting of hospital and business heads with several Health Department officials under the leadership of Deputy Minister Molefi Sefularo in December last year was very encouraging, and Hasa has again laid some of its proposals for co-operation (as outlined in its 2008 survey) on the table.

In addition to co-operation between the public and private sectors with regard to hospital facilities and resources to provide more efficient healthcare - especially within the framework of the Millennium objectives - it's now also time to join hands in other fields, especially to help solve the problem of the dire shortage of professionals (doctors and nurses, as well as in other health professions), he says.

There was co-operation recently within the private sector task team (PTT), which includes several role players - hospitals, pharmaceutical companies, equipment suppliers, funders and professional healthcare workers - to help SA and ease its hospitals' load after the outbreak of cholera.

"The PTT is currently expanding its efforts, in conjunction with the Health Department, to help Limpopo and Mpumalanga at our central point in the Matikwane area. That initiative is a good example of how the two sectors can work together and co-ordinate their efforts to meet patients' needs without either of the parties feeling left out. We'll continue the initiative, not only for cholera cases but also to ease the burden in other fields," Worrall-Clare says.

Training nurses also remains a major problem, with greater co-operation between the Health Department and the private sector that could yield great benefits. By lifting the moratorium on the private sector in training nurses - over the past few years, the private sector was only allowed to offer bridging courses - training can be resumed immediately. However, since comprehensive nursing training takes four years, it will be some time before the current shortage is eradicated.

Apart from nursing staff, the private sector can also help tertiary institutions in training professional workers in other health professions.

But it's not only the private and public sectors that have to work more closely together: role players within the private sector must also join forces to improve access to health services, as stated in SA's Constitution, as well as implementing the objectives of a national healthcare system - which all role players support in principle - says Worrall-Clare.

"Finally - and rather ironically - the extent of our success won't be measured by our individual contributions but by our joint efforts at solving the healthcare needs of SA and its people. Though there's a good deal of difference of opinion about various issues we must ensure those remain - and are dealt with - within the wider healthcare dialogue and communication process.

"It doesn't matter if parties have differences of opinion and debate those and challenge one another. However, it must be done constructively and be driven by a desire to reach innovative solutions. We are, after all, a nation of entrepreneurs with a remarkable ability to excel. What's more, we can also be determined - because it's now more necessary than ever for us to make a real effort to tackle our health problems and solve them," says Worrall-Clare.

In that context, Hasa is keen to communicate with SA's health authorities on an ongoing basis and put co-operation proposals, as outlined in the recently released 2009 survey on private hospitals, on the table - and hopefully start implementing them with the support and co-operation of other role players. n