Department of Health would guarantee the payment of private general practitioners (GPs) who worked in public clinics in the National Health Insurance (NHI) pilot districts, Health Minister Aaron Motsoaledi said yesterday.
The NHI envisions private practitioners being involved in public health institutions, and this is the first time that Dr Motsoaledi has fleshed out the proposal and guaranteed the payment of such medical officers.
The thinking is that private sector health resources will improve referral systems, as well as increase patients’ confidence in primary healthcare facilities.
Dr Motsoaledi was addressing journalists on the sidelines of the South African Medical Association’s (Sama ’s) conference.
Sama acting chairman Mark Sonderup said the GPs had always been willing to participate, but "it is a question of the hows…. Once those gaps (of uncertainty) are closed, the willingness will increase. They want to know how they will do that practically and how they will be remunerated".
The 10 pilot sites — which cover 20% of SA’s population — are being funded by a R1bn conditional grant announced by Finance Minister Pravin Gordhan earlier this year.
The idea of "sessions", in which private practitioners worked in public healthcare facilities, was not new, Dr Motsoaledi said yesterday.
"But it fell off the radar screen…. Part of the reason was because the fragmentation between public and private (healthcare) became so sharp. We are trying to reverse that trend."
But, at the same time, the department has for years drawn criticism for its failure to address a serious shortage of health professionals: in 2010, 42,5% of health professionals’ posts in the public sector stood empty, up from 33% in 2009 and 27% in 2005, according to the Health Systems Trust.
In order to deal with the shortage of doctors in SA in general, Dr Motsoaledi announced that the number of matriculants sent to Cuba for medical training would increase dramatically — 1000 matriculants will leave in September. So far 304 doctors have been trained in Cuba, where 406 are currently studying and 98 will graduate this year.
Students complete their studies in SA, and must pass final-year exams to register with the Health Professions Council of SA.
Only 1200 doctors graduate from SA’s eight medical schools each year. The Junior Doctors Association of SA has said three doctors could be trained in SA for the cost of training one in Cuba.
But Dr Motsoaledi said there were serious problems at both levels of SA’s two-tier healthcare system. "There is a problem, and a big one, in the public sector … the problem of quality, but the private healthcare sector has costs that are out of control….
"Because of this, there are two clear issues: the public healthcare sector needs to be overhauled, and the private healthcare sector has to be officially regulated," he said.