Company CEOs rarely go off-script when they release financial results. So it is worth paying attention when the head of a private hospital group does just that.
Earlier this week, Netcare CEO Richard Friedland called on the government and organised business to add health to the list of areas they are focusing on to boost investor confidence and revive SA’s economy — a pact that has so far tackled electricity, transport and logistics, as well as crime and corruption.
The government of national unity is wrestling with how to implement the National Health Insurance Act and fending off a barrage of court cases against the ANC’s contentious plan for universal health coverage that could take years to resolve.
Netcare is quite sensibly proposing that rather than waiting for the government to chart a path out of this quagmire, the private sector can and should step in to help. For starters, it could play a far greater role than it now does in training nurses, and that effort could be widened to help train other healthcare professionals too — from physiotherapists to medical specialists.
Netcare and rival Life Healthcare hospitals have extensive experience contracting with the UK’s National Health Service (NHS) and are willing to do so in SA too. Netcare for example, secured deals with the NHS in the early 2000s to provide ophthalmic and orthopaedic procedures, and contracted again some years later through its stake in the UK hospital business General Healthcare Group, which it has now sold.
And the private sector could help deal with some of the equipment shortages and maintenance failings that create intolerable conditions for patients and doctors alike.
SA’s public health system is in a parlous state: even the relatively well-managed Western Cape provincial health department is buckling under the latest budget cuts imposed by the Treasury and admits it cannot employ enough doctors and nurses to meet demand. Across the country posts stand empty as the backlog in cancer treatment grows and waiting lists for elective surgeries lengthen. These are not trivial matters: delays in radiation therapy worsen patients’ prognosis, and people waiting for joint replacements live with excruciating pain.
When budgets are squeezed, provincial health departments also cut back in ways less visible, curtailing access to costly life-saving treatments such as biologics and tightening the eligibility criteria for expensive care such as dialysis and organ transplants.
The national health department has long viewed the private sector with deep suspicion, fearing that outsourcing services will prove unaffordable and deliver profit to shareholders at the expense of the fiscus. It is missing the point: contracting private healthcare providers isn’t necessarily about saving money, but drawing on their expertise to do things more efficiently or provide specialised care.
As the Life Esidimeni scandal demonstrated, it is not private sector providers per se that are the problem, but the lack of government checks and balances to ensure patients are treated properly: at least 144 state mental patients died after the Gauteng health department ordered their transfer from private Life Esidimeni facilities to unlicensed NGOs. If those NGOs had been fit for purpose, it is quite possible no harm would have been done.
Collaborating with the private sector is no panacea. But it does offer scope to relieve some of the most pressing problems confronting the public health system in the short term. The government would do well to take heed.
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