Public Private Partnerships will drive the success of NHI

Since the first Board of Healthcare Funders (BHF) conference in 1999, the BHF annual conference has attracted a line-up of local and international speakers who have continued to provide local, regional and international perspectives on various issues relating to the healthcare industry.

Dr Clarence Mini addressing the conference

This year’s theme, “Embracing Universal Health Coverage”, has ignited engaging discussions on the private sector’s role in National Health Insurance. The conference brought together industry leaders, government and the private healthcare sector to identify ways in which to ensure the success of what is said to be South Africa’s biggest healthcare reform system.

Speaking at the opening of the 18th Annual BHF Conference, Dr Clarence Mini, Acting Managing Director, BHF Southern Africa, pleaded with the Department of Health to consider partnerships with the private sector in implementing National Health Insurance, and to utilise the current available resources in private healthcare to support and help drive NHI.

He said, “As we look ahead at the pending implementation of NHI, as with any change, the journey towards universal healthcare will present new challenges. However, the promise of partnership, political will and good leadership might make the journey ahead a lot easier than we have all imagined.”

In his welcome address Ian Douglas Neilson, the executive deputy mayor of the City of Cape Town, echoed those sentiments with regard to the need for partnerships in implementing NHI, saying, “Last month’s approval of the National Health Insurance white paper by cabinet represents a substantial policy shift that will necessitate a massive reorganisation of our healthcare, both private and public, and this will present a challenge to both the public and private healthcare sectors in South Africa.”

He said, “Over the years, we have learnt that we will not succeed in achieving anything on our own, and we have to work in partnership with our communities, NPOs, and the private sector, as we have seen the threat of Republicans wanting to repeal ObamaCare, and how it is argued that, this will be a ‘death sentence’ for the US healthcare system.

“Only sustained, successful partnerships will enable South Africa to overcome the many challenges of our rapidly urbanising environment, and will in turn ensure that we become more resilient,” said Neilson.

Delivering the keynote address, Dr Precious Matsoso, Director General, South African National Department of Health, highlighted that, “With at least 3.2 million children screened for the NHI pilot phase between April 2014 to March 2017, at least 500,004 children were found to experience oral health issues, eyesight problems, hearing and speech problems.

“One of the findings from the pilot phase shows the high prevalence of stunting, with 27% of children under five considered stunted and 10% severely stunted.

“This is presenting a challenge to the Department of Education, as we are giving teachers children with hearing and sight problems, and waiting for them to be adults. This is a big problem, and South Africa cannot afford to sit back and not respond to the healthcare needs of vulnerable groups,” said Matsoso.

The Department of Health is looking to set up a National Health Commission. She said, “NHI will not be affordable unless we deal with health promotion and prevention, and the role of the commission will be to assist in dealing with the risk factors that drive our non-communicable diseases, and put in place the necessary structures for setting up the NHI.

“For this reason, we must prioritise and respond to the healthcare needs of South Africa’s children, and the National Health Insurance will go a long way towards the first steps to providing healthcare access.

“Immediate interventions are necessary, and we need to start with the 500,000 and the 3.2 million learners that were identified during the pilot phase, and expand further to other vulnerable groups. We cannot postpone. For us to be a successful and responsive nation, we need to work collectively as public and private sectors and civil society, together with development partners.”

“With six million South Africans who have immediate healthcare needs that have not been met, we cannot talk about economic transformation when we cannot meet the basic healthcare needs of people,” noted Matsoso.

She explained: The plan is to create an interim structure for the NHI, where we have a CEO who runs the system with a team of people. Our aim is to upskill, reskill and invest in our people to get them ready for NHI. This will require conscious efforts from academic institutions as well, as they would have to deliver on this capacity.

Within the legislative framework, a number of laws need to be amended, in particular the South African National Health Act and the Medical Schemes Act. Currently a draft bill has been published for commentary, and the Department of Health is inviting all in the healthcare sector, civil society, the public, and interested parties to submit commentary by 31 July 2017.

We also need to identify areas where we can consolidate various schemes, and this is going to be a process that involves schemes. Our aim is to create a structure that involves the Department of Health, the medical scheme industry, and the Council for Medical Schemes (CMS) in order to ensure that this reform is a success.
In closing, Dr Mini explained that, “When discussions on NHI matured in 2008, BHF members took a decision to consciously support government in implementing NHI. At that time, many people were not happy about the idea, and we supported NHI at a time when it was not favourable to support it, being fully aware that if the public and private sectors collaborate, we can make a success out of the NHI system and can begin to draw learnings for the rest of the Southern Africa region.”

He reiterated that the Department must look to the private sector for resourcing and utilise the already available resources in the private sector for the CEO positions that would be created for NHI. He cautioned that existing expertise within the private sector should be leveraged, and that NHI should not be politicised, but should be a collaborative effort that seeks to achieve the vision set by the United Nations to ensure that all people have access to healthcare, as a necessary human right.

BHF members include medical schemes, administrators and managed care organisations throughout the Southern African region, with membership in eight countries, namely, South Africa, Malawi, Lesotho, Zimbabwe, Namibia, Botswana, Mozambique and Swaziland.

Over 17 countries from around the world are represented at the 18th Annual BHF Conference on universal health coverage currently underway from 16 – 19 July 2017 at the International Convention Centre (ICC) in Cape Town.