Improvements Needed in South Africa's Public Health System

July 26 - The South African health industry has found that the country's public hospitals are affected by mismanagement and poor services. It has been noted that if the current state continues a national health insurance (NHI) scheme is likely to fail.

Alex van den Heever, Wits University School of Public and Development Management has said that, "we have public health expenditure with bad outcomes." He continued, "Raising more money for healthcare through the NHI doesn't guarantee that health outcomes will improve. The real problem is the administration of that service."

Major Factors in Public Health Problems

Roly Buys of the Medi-Clinic hospital group sites a "lack of accountability" as one of the major factors in the problems that exist. He recommends that hospitals in South Africa follow the examples of hospitals around the world and allow boards of directors that consist of members of the public to run the hospital in place of the government. "It makes a huge difference in the efficiency of hospitals," he claimed.

Another issue that has been highlighted is the lack of autonomy that is enjoyed by hospital chiefs. Chris Hani Baragwanath in Soweto had "little authority to make real decisions over critical management issues," said Jonathan Broomberg of Discovery Health. According to Broomberg this is the reason that health institutions are not run efficiently. The "hospital chief executives have little say in the hiring and firing of staff or the purchasing of new equipment. There is also no real incentive to collect money from patients who can pay as the money goes back to the Gauteng government and not to the hospital itself."

According to health industry sources, it is vital to collect clinical data about patient management in state hospitals. This would be the first step in improving the public health system so that the NHI can be properly implemented.