Private hospital group Netcare has once again warned that with the healthcare system heavily reliant on a nursing workforce of above the age of 50 and not bringing in new nurses, this is becoming a societal challenge that needs to be addressed urgently.
Chair Mark Bower in a letter to shareholders published in Netcare’s annual report on Monday said the worsening shortage of qualified nurses in SA should be a concern at all levels of society, not only for healthcare service providers.
He said that between 2012 and 2022 the rate of population growth in SA significantly outstripped the number of enrolled nurses and midwives registered with the SA Nursing Council (SANC) and that reductions in approved student numbers in private and public sectors, coupled with shifting regulatory requirements, is contributing to the shortage.
“In addition to the current shortfall, our healthcare system relies on a large percentage of highly qualified nurses over the age of 50. Without enough new nurses entering the pipeline, we are heading towards a dangerous cliff in nursing provision. This requires far more urgent attention at the highest levels of government,” Bower said.
He also touched on the contentious National Health Insurance (NHI) Bill, which was recently passed by the National Council of Provinces (NCOP) and is now awaiting final approval by the president.
The bill creates a single NHI fund, which will purchase services from public and private providers that will be free at the point of delivery. It prohibits medical schemes from covering services provided by the NHI.
Bower said political actors have created a false impression that the private healthcare sector is against NHI.
“Ideological positions that vilify the private sector will only yield disastrous, unintended consequences for healthcare provision in a country with an already unsustainably costly and growing burden of disease,” he said.
“The NHI in its current form poses serious challenges of practicality and affordability. It lacks clarity on critical issues, including the services that will and will not be covered by NHI, the contracting structure for primary healthcare needs, how the NHI will be funded, and the accreditation of providers and pricing.”
Discovery in its annual report flagged the implementation of NHI in its current form as the second-biggest risk facing the group, second only to the global cost-of-living crisis and higher than SA’s energy constraints.
Discovery Health is SA’s leading medical scheme administrator, managing 39.1% of the total membership of SA medical schemes. That includes Discovery Health Medical Scheme, the country’s largest open medical scheme, which now represents 57.8% of the open medical scheme market.
Bower said Netcare is alarmed by provisions in the bill that stop medical aid schemes from funding services provided by the NHI.
“In effect, these provisions take money out of the national health system and pose a real threat of collapsing the health insurance industry in SA. International experience has shown us that single-funder healthcare systems, funded from taxation, are not optimal for expanding access to healthcare,” Bower said.
“We recognise that universal health coverage will take many years, if not decades, to implement fully. Our interpretation of the NHI Bill is that the NHI fund does not envisage purchasing services from private hospitals in its first phase. However, as we have said in the past, there are immediate public health needs that can be effectively addressed through contracting with the private healthcare sector, and Netcare stands ready to engage constructively on these solutions.”
With Tamar Kahn
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