Let me first and foremost take this opportunity to welcome all of you to this press conference this afternoon. I know that many of you (especially in daily newspapers) are already panicking about your news editor's sharp axe looming closer, so I hope we are not going to keep you here for too long.
Let me also take this opportunity to acknowledge the presence of all MECs who, as you know, are attending the National Health Council meeting that I am chairing. The first thing I want to announce today is our continued programme of reducing the cost of healthcare in both the private and public sector. Last year we announced a massive reduction of antiretroviral drugs (ARVs) prices by 53% that led to a saving of R4.7 billion.
Today we are announcing a further reduction of an aggregate of 18% reduction in anti-TB medication and antibiotics, that amounts to a saving of R242 million. We will continue with our resolve to reduce the cost of healthcare and will inform you of further developments.
In the second announcement we wish to remind the public that the Department of Health is guided in its work by the 10 point plan and the four outcomes that we agreed to with the President. Point four of the Plan is enjoining us to overhaul the whole healthcare system and improve its management. Point three of the Plan talks about the quality of care in our hospitals. Point two talks about the implementation of the National Health Insurance (NHI).
These three points obligate us to take urgent steps in the manner in which our hospitals function and are managed. After studying the situation very well, it has come to our attention that our hospitals are not designated in accordance with uniform norms and standards as the practice is internationally. The result is that when one province talks about one facility it means a different thing than what is supposed to be a similar facility in the next province. Even the levels, skills and competencies of management differ in what are supposed to be similar levels of facilities. The same can be applied to delegations of what a particular level may or may not do. In some instances you find that a hospital is managed by a person who is in fact at a clerical level.
If we have to successfully implement the NHI and provide good quality services we need to correct these anomalies. Our starting point was a correct designation of our hospitals through regulations. A team has been set up by the national department and has been working on this matter for the past eight weeks. Today their report has been adopted by the NHC at its meeting which started this morning and the new designations will be gazetted next week for public comment.
These regulations are vital in order to:
- Maximise the efficiency and efficacy of utilisation of public hospitals by the general public
- Ensure the appropriate distribution of sufficient levels of skilled health professionals within the various levels of public hospitals in order to properly meet the needs of the people they serve
- Strengthen public hospital management by ensuring that public hospitals at various levels are restricted in size in terms of bed numbers and the level of services they may provide
- Ensure the operation of an effective referral network between various public hospitals
- Rationalise the operation of the public hospital system so that quality, human resources and other standards can be uniformly applied to various levels of public hospitals across the country
- Ensure that people who are appointed to manage public hospitals are suitably qualified for the job and are equitably remunerated as defined by the relevant hospital level and the package of care
- Empower the Chief Executive Officers of public hospitals to effectively run their institutions.
We need these regulations in order to ensure that public hospitals are in future constructed in accordance with international norms and standards that are designed to ensure good governance and administration as well as efficiency of the public health system.
The regulations propose to divide public hospitals into different categories namely:
- district hospitals of various sizes
- regional hospitals
- tertiary hospitals
- central hospitals and
- specialised hospitals
The broad nature of the health services to be provided at each level will also be specified in the regulations.
For instance, a specialised hospital will provide specialist services like psychiatric, tuberculosis, and rehabilitation health services.
A central hospital will provide highly specialised tertiary level health services to patients from around the country and may also provide quaternary services. These hospitals will be national referral hospitals and attached to medical schools as major training platform for health professionals and hence will not be found in every province.
This will mean that from now onwards our hospitals will be managed by appropriately qualified and competent managers at appropriate designations. For instance the regulations will provide that no hospital will be managed at a level below 12. No central hospital will be managed at a level below 15.
While there will be some transitional arrangement or grandfather clause it means that every new hospital to be built must comply with the new designations.
The third issue we want to announce today is our first step towards implementation of our re-engineered Primary Health Care (PHC) system which is one of the four central interventions of the NHI which will be released next week.
I would like to give you a report on what we have achieved thus far:
- I have appointed a task team consisting of the chairs of the three Ministerial Mortality Committees, Deans of the Faculties of Health Sciences and other experts to advice me on the development of District Clinical Specialist Teams
- They have met and have now come up with recommendations that have been adopted by the National Health Council.
The District Specialist task teams will consist of the following senior experts - anaesthetist, family physician and primary healthcare nurse, obstetrician and advanced midwife and paediatrician and advanced paediatric nurse.
Every district will have a team responsible for supportive supervision and clinical governance within its defined geographic area. The teams need to strengthen existing services and ensure equitable access to appropriate care for all mothers, babies and children.
This will be achieved by enhancing the clinical competence of healthcare workers, promoting improved health facilities and facilitating referral pathways to specialist services.
The focus of the teams will therefore be on facilitation, integration and coordination of staff, services, programmes and packages of care with the aim of improving health outcomes and the quality of care for mothers, babies and children.
The last issue I want to announce is the issue of the Nursing Compact as a follow up to the nursing summit. We promised the nurses at that summit that we will improve the nursing colleges and accommodation for nurses. We have identified 122 nursing colleges in the country and it's our pleasure to announce today that 72 of these will be refurbished, improved, extra space added where necessary and we will deliver these by the end of the current financial year. The total cost for this project is R272 million.
Thank you very much.
Source: Department of Health
