High Level Panel Recommendations for Health Sector: Prof Shisana briefing

The Committee was briefed by Professor Olive Shisana, Head of the High Level Panel (HLP), on the state of the health sector in South Africa, and the challenges faced with the implementation of the National Health Insurance (NHI) scheme. She said those with the worst access to health care were people in the lowest socio-economic group. Poor people were less likely to access good health care, despite the fact that it was very much needed. They would be found making use of services at primary health care (PHC) facilities and community hospitals, and seldom visited tertiary and academic hospitals, even when those services were available in the area. The poor were faced with several challenges to access health care. The cost of traveling was a barrier, as the health care facility could be far from where they lived. Medical scheme contributions remained unaffordable to them. Another challenge was the low morale of staff and their attitude towards patients. Prof Shisana gave a detailed presentation on the principles the NHI sought to achieve, the benefits of a National Patient Information System, the role of community health workers, membership of medical aid schemes, and the challenge of providing adequate medical facilities in rural areas. Members recounted experiences indicating concern at the quality of health care available to poor and rural communities. They asked why courses from emergency medical services (EMS) paramedic personnel had been stopped, as they provided a vital service. They laid the blame for the current “crisis” in the health sector on poor management and leadership. They recognised that the population was growing while financial resources were shrinking, and questioned why there was no control over foreign nationals receiving free medication at local facilities. The NHI had been piloted for nine years, and a Member asked if it would remain a pilot scheme for ever.