The groundwork is being laid this month for far-reaching changes to healthcare in South Africa that will put it on a par with developed countries in Europe.
They will start with a National Health Act expected to be passed by parliament next month. It is aimed at a uniform standard of public health services throughout the country.
Meanwhile, plans are being made to set up a new government medical aid scheme by 2005 to which all state employees, and possibly other people, will belong. Ayanda Ntsaluba, the director-general of the department of health, said at a recent conference that the tax subsidies now received by employers contributing to private medical aid schemes for their staff might be reduced, while more would be spent on those using public health services.
It is intended to make membership of a medical aid scheme mandatory for all employed people in about three years' time and the government is investigating ways of making these more affordable for those in low-income groups. All medical aid schemes will contribute to a risk equalisation fund to compensate schemes with large numbers of high-risk members.
Public hearings on the National Health Bill will be held in parliament on August 18 and 19. But the bill does not cover the proposals for health insurance, which are being dealt with by officials in several ministries.
Kamy Chetty, the deputy director-general for health, explained that the bill did not duplicate the British National Health Service but created a uniform structure for public health services throughout the country.
It covers a wide range of subjects, from protecting the welfare and safety of young men attending traditional initiation schools to stipulating the number of beds in hospitals and ensuring the confidentiality of individual health records. It gives the minister of health additional powers to ensure there are adequate education and training facilities for healthcare personnel, and enabling a co-ordinated relationship between private and public health establishments.
Jo-Anne Collinge, the director of communications at the department of health, said the bill introduced a unitary system, but many of the structures it incorporated already existed and therefore did not call for new financial arrangements. There would be a bigger overlap between public and private medical care, as people belonging to medical aid schemes paid to
make use of facilities in public hospitals.
Two task teams have been set up to consult stakeholders about changes to the subsidy paid to employers and the establishment of a risk equalisation fund. They are due to report back in six months' time. (Source: Business Report, 6 August 2003).