Page 46 - IRMSA Risk Report 2021

3.5

FAILURE TO MOVE FORWARD IN REFORMING THE
NATIONAL HEALTH SYSTEM
Past inequalities, poor public health care services and limited access to private health care are at the forefront in dealing with
the current pandemic. As much as Covid-19 created an impetus to invest in health care the risk is that we may fail to take
advantage of this opportunity to reform the National Health System.

SCENARIOS FLAGS SUCCESS STORIES
COUNTRY FLAGS C F
OWNING OUR FUTURE The CPAP or Continuous Positive Airway
1. LEADERSHIP
Pressure device was developed and is
2. INSTITUTIONAL CAPACITY being manufactured in South Africa at
a fraction of the cost of a mechanical
3. POLITICS ventilator. The Solidarity Fund will be
4. SOCIAL COHESION spending R250- million on 20,000 of these
devices as part of the National Ventilator
5. NATIONAL POLICY Project. Other success stories of South
Africans coming together to respond to
6. SERVICE DELIVERY
the country’s needs:
7. INEQUALITY
https://www.dailymaverick.co.za/
8. ECONOMY article/2020-07-24-teams-in-race-
PERPETUAL FAKE IT UNTIL WE against-time-to-get-oxygen-to-eastern-
HANGOVER MAKE IT, OR NOT 9. GLOBAL TRENDS
cape-hospitals/
10. CLIMATE
C – CURRENT (2020/21) F – FUTURE (2030)
Parliament’s portfolio committee on health met on 2 September 2020 to discuss the way forward around introducing the new National
Health Insurance (NHI) Bill. Support of the Bill is not easy in an environment that is complex and needs more collaboration, transparency
and creative solutions to deal with payment set-up and common treatment guidelines (to name a few). Budget cuts, labour unrest, the need
for capital, and corruption need to be tackled head on for the NHI to succeed.

TOP 5 CHALLENGES TO ACHIEVING TOP 5 RISK TREATMENT OPTIONS AND
TARGETS OPPORTUNITIES
1. Budget: Austerity measures include further health care 1. Explore alternative costs and efficiency measures, as well
budget cuts. as synergies with private health sector.
2. Revive nursing colleges and set up at regional level.
2. Labour Unrest: Rising labour unrest, coupled with
massive shortages of healthcare workers. Healthcare workers should study and work in their own
local communities.
3. Resistance to change in the private sectors has come 3. Robust stakeholder engagement plans and public
down – this opportunity may be lost if the Government
does not act swiftly. awareness campaigns.
4. Capital: Although the Covid-19 response plan budget 4. Call on big business and international sovereign loans
helped with system infrastructure, much more is backed by Treasury to set up low cost/affordable capital
required for infrastructure capital. funding to build much needed health care facilities.
5. Corruption: The R2bn Personal Protective Equipment 5. Technology to control, monitor and provide transparency
scandal negatively impacts service delivery, as well as on the Fund.
setbacks in public confidence.

FACTS AND FIGURES
BUDGET
• R235.3 billion allocated to Health, which equals to 4.5% of GDP (R5 240 billion) for 2020/21.
• 2.9% increase in Health Budget allocation for the next 3 years.
• R8.9 billion reduction in Employee Compensation for 2020/21. Total reduction over the next 4 years to 2024 amounts to R72.7 billion.
SHORTFALL
• Additional 97 000 healthcare workers required by 2025, of which 32 000 must be Community Health Care workers.
• Additional 88 000 healthcare workers required in Primary Health Care System
• R34 billion required to cover shortfall in healthcare workers.
• Nurses make up 50% of the healthcare workforce.
• Disparity in Healthcare Specialists: Specialist Per Person – Private = 69/100k vs Public = 7/100k
CORRUPTION
• R2.2 billion PPE scandal where only 28% of the 550 companies were licensed by SAHPRA to sell PPE.
• Unlicensed suppliers included a Solar Power Installer and an Auto Repair Shop.

Source: 2030 Human Resources for Health Strategy & Spotlight article, 24 September 2020, Daily Maverick article, 2 October 2020 & BusinessTech article, 2 September 2020,
Medium Term Budget Policy statement 2020 – 28 October 2020.

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