Now, in the midst of the pandemic, is the time to make NHI work

2020-03-23 01:18

It is sometimes tempting to focus on the tree rather than the forest surrounding it. In this instance, the tree would be the Covid-19 coronavirus and perhaps the forest is the National Health Insurance (NHI) system. Before I am accused of writing in parables, let me put this in policy terms.

As everyone is rightly consumed by the immediacy of the Covid-19 crisis, the long-term goals of building a quality healthcare system that restores our collective humanity may be forgotten, at least for a little while.

This could be dangerous because, as a matter of course, healthcare services – especially hospital services – are often called into play during an emergency.

In Gauteng, we have a clear attitude to Covid-19 – we will tackle it head-on with all the skill, might and resources at our disposal.

There is no room for failure, and we shall win. However, there is an important message we must keep alive in the midst of the hustle and bustle of Covid-19 – we must continue to work even faster and smarter to improve all health outcomes.

The Covid-19 crisis can serve as an opportunity to accelerate the improvements we so desperately need to enhance the quality of our health system. Our response, therefore, must simultaneously address key issues such as funding, pricing, human capital and infrastructure.

This is what the NHI is about. Stakeholders in the public and private sectors of the health system are being provided with a golden opportunity to learn about the principles and practice of NHI as envisaged in policy and the draft NHI Bill.

Read: NHI in a time of mistrust

Among other things, the NHI is anchored on principles and features such as solidarity, collaboration, qualitative services, strategic purchasing, access where services are needed and that no one must be exposed to financial hardship.

The emerging spirit and experience so far on Covid-19 sees many of these principles and features of NHI taking root, and we should take note and learn from this experience.

In the first instance, solidarity even goes beyond boarders as countries such as China and Cuba offer assistance in many ways. Our business, labour and civil society sectors have pledged solidarity in the true spirit of the “South African response”.

Indeed, everybody understands that health is the responsibility of the individual and the collective that is South Africa. The strong are looking after the weak, the healthy are looking after the sick and the rich are looking after the poor. We are each other’s keepers.

In terms of collaboration, a strong sense of working together across the public and private sectors is also emerging. There are deliberations and actions being taken to share resources between private and public facilities.

Solutions are being negotiated on appropriate pricing, sharing of expertise and skills, cross-referrals (an old practice) and laboratory services, all of which may produce “strategic purchasing” outcomes.

Even panic-buying is being discouraged by all sectors in the true spirit of solidarity.

Access to Covid-19 testing is done at the expense of the state, no matter your income level, nationality, geography and, in some cases, the nature of your health insurance. What is important is that a patient has a need and the sector must respond to the need.

Those who can afford private medical services practically demonstrate “shared responsibility and costs”, and open up space for those who cannot afford to get public services faster. Again, this is solidarity and collaboration in action during the Covid-19 pandemic.

There is no room for failure, and we shall win. However, there is an important message we must keep alive in the midst of the hustle and bustle of Covid-19 – we must continue to work even faster and smarter to improve all health outcomes.
MEC Bandile Masuku

We all receive qualitative services under the Covid-19 crisis – we have the same protocols, the same treatment regime, the same basic prescriptions (except in complicated cases), the same expertise and equipment, and, sometimes, the same facilities and health practitioners.

Most of these are regulated by guidelines from the World Health Organisation, which sets the minimum standards of care in this regard. In this way, we ensure qualitative services for all.

It is worth noting two key lessons during this crisis.

Firstly, we must not forget to think about the system during the crisis. In other words, how do we use the crisis to improve the health system as a whole? Let us not wake up after the crisis and realise that we have lost valuable time.

Secondly, the Covid-19 moment could serve as the first practical example on how to implement the NHI and, so far, the experience is good.

This means that, contrary to what the doomsayers believe, the NHI is doable and will be achieved in our lifetime. All we need is the will from Team South Africa, which clearly exists in abundance.

Let us not allow narrow sectoral interests to divide and blind us to the fact that we need each other. Covid-19 proves that we do need each other.

Let us not only see the tree, but also the forest rising around it. Our heartfelt support goes to our dedicated healthcare workers. Let there be love in the time of Covid-19.

Masuku is MEC for heath in Gauteng

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March 29 2020