Provinces need to toe the line - Motsoaledi
The Constitutional autonomy of provinces to determine their own healthcare priorities and how much money they choose to dedicate to these programmes has long been a massive hurdle towards overhauling South Africa’s healthcare system.
In an exclusive interview with Health-e News Service (SUBS: Cape Times/The Star/Mercury) Motsoaledi said that the national health department and provinces had systems in place which enabled them to agree on priorities with each province expected to budget for it and implement these plans.
He revealed that some provinces had recently failed to prioritise immunisation campaigns they had agreed to and that he had approached treasury directly. “I ordered them to take money and shift it to the immunisation campaign. No human being in their right senses can say they are not going to immunise a child, because they are putting their money elsewhere. You can’t willfully and deliberately sentence children to death through childhood diseases. If we say one of the cornerstones is primary healthcare and that all children must be immunized, then provinces have no choice, they must do it,” said Motsoaledi.
Motsoaledi said years of neglect of HIV was devastating South Africa and “changing everything as we know it”
Without referring directly to his predecessor Dr Manto Tshabalala-Msimang, Motsoaledi said there had been a failure to respond to the epidemic which was devastating communities and that the health department had not responded in accordance by securing the financial resources.
He also warned that National Health Insurance as a means to narrow the gap between the rich and poor was critical or it would destabilise the country. “So some are thinking they are sitting comfortably in the private sector because they are rich, it will just come and swamp you. Believe you me if the strike continued people were going to go to the private sector and demand treatment.
“Our problems are problems facing the entire country. We know our health system is extremely inefficient, both the public and private sectors. The only problem is that the public healthcare system had been overwhelmed by everything and the private sector looked good,” said Motsoaledi.
He said his department was responding to all the recommendations in the Integrated Support Team reports. The IST was appointed by previous health minister Barbara Hogan to investigate problems in the provinces after the Free State ran out of money in late 2008.
The reports have led to the establishment of a Chief Financial Officers forum from national and the provinces which will ensure that budgets are in line with the agreed priorities and ensure that provinces find ways to avoid the massive deficits that have become common over the last few years.
A forum with engineers has also been identifying infrastructure issues and removed hurdles that have seen some projects taking years to complete and some health facilities literally falling apart because there has been no maintenance.
“People the department engage with are telling me that for the first time in 10 years they can see something shaping up,” he said.