Healthcare is minister’s most critical patient

Dr Aaron Motsoaledi’s “to do” list is arguably the most daunting of any minister in Cabinet. He is faced with a national life expectancy of just 49 years; a woefully inadequate number of qualified medical practitioners and nurses in the public sector; just less than six million South Africans living with HIV/Aids; alcohol abuse at epidemic proportions; a significant increase in national levels of obesity and an increased risk of developing the chronic conditions that follow.

National healthcare is callously delineated between the “haves” of the private sector and the “have nots” of the public sector; operational inefficiencies exist in the public sector; there is poor quality of care in key programmes; and there is low morale among public-healthcare workers.

These are colossal challenges. What qualifies Motsoaledi to tackle what are — at some stage or another — literally life-and-death issues for 50-million people?

Even though he is a qualified medical doctor, his first major public-sector appointments were not in the healthcare field at all. Motsoaledi was MEC of transport and education in the Limpopo provincial government and also served as acting premier, before he was appointed to President Jacob Zuma’s Cabinet in 2009.

It was an appointment that was initially met with concern as Motsoaledi, regarded as an “unknown”, took over from Barbara Hogan, who had been running the health ministry for only six months before a Cabinet reshuffle. But, since he has been in the hot seat, Motsoaledi has quickly silenced his critics with fast and effective action on several fronts.

Regarding the HIV/Aids pandemic, the minister’s first foray into the fight was to acknowledge the failed policies of the previous administration and implement new evidence-based policies that have resulted in marked improvements.

At the moment, we have the world’s largest HIV/Aids treatment programme in which more than a million South Africans receive antiretroviral (ARV) drugs. And even though there is still a long way to go, it’s obvious that the country is on the right path.

Of particular note is the introduction of earlier treatment for pregnant women, as well as for patients co-infected with TB and infected children. In fact, our national programme to prevent HIV infections in babies has been 96.5% successful in eliminating transmission from infected pregnant mothers. The health ministry has also rolled out massive testing drives, starting in schools and universities. And measures such as male circumcision and microbicide vaginal gels are proving extremely promising in prevention.

Of course, it is the proposed National Health Insurance under Motsoaledi’s leadership that is making headlines. His strong views on the issue are well documented. He was quoted recently as saying: “South Africa’s healthcare sector is divided into public and private by the depth of people’s pockets.”

Under Motsoaledi’s guidance, the NHI policy document has been cleared by a Cabinet committee and now has to be approved by Cabinet itself, before the document is released for public consultation, which is expected to happen before the end of this year, enabling legislation to be promulgated next year. After the relevant existing legislation is reviewed, the NHI will begin to be phased in over the next 14 years.

Where does private healthcare fit in with all of this? Motsoaledi has stated that both the private and the public healthcare sectors need to be part of the country’s future NHI system. But he has advocated reining in the cost of private healthcare.

Other priorities for Motsoaledi are TB, maternal and child health and primary healthcare, which includes changing service delivery from the present curative model to the promotion of disease prevention and bringing initiatives closer to communities to make them more cost-effective.

Health Minister Aaron Motsoaledi will be the guest speaker on Bonitas House Call on September 3 on SABC2 at 9am

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