Cape Town - Since Dr Aaron Motsoaledi launched the National Health Insurance (NHI) in April, his mission has been to transform South Africa’s health system. Part of this was getting private doctors to work at less-resourced state clinics.
This week his spokesman Joe Maila said Motsoaledi has been urging doctors to give a few hours of their time each week to work at state clinics of their choice for payment.
“The GPs are enlisting their names and we are consolidating them. We are further finalising the legal and contractual requirements to be entered into between the Department of Health and the practitioners,” he said.
Maila said most doctors were keen to work with the department.
But some private doctors in the Eden District - the Western Cape’s NHI pilot region - are sceptical of the department’s proposal.
Dr Petrus du Toit, who has a private practice in Oudtshoorn, said that while the NHI was good in principle so far it was being implemented from policy makers’ perspective and not from communities’ point of view.
He said specialists’ teams that would work in hospitals and schools should be appointed by local hospitals instead of health department headquarters as hospitals “know their community challenges better”.
“A lot of us feel we are being dictated to by administrators. The needs of the community are not being addressed properly,” he said.
Du Toit said local doctors also feared being dumped by the department as there was no “genuine relationship” between them.
GPs were previously contracted by the department to provide specialist services at hospitals, including surgery, orthopaedics and anaesthetics, but hospitals became antagonistic to private doctors and got rid of them.
“Let’s say I decide to adjust my practice and work at a local clinic every Wednesday and then the state decides to drop me six months later, what then happens to my practice? The department has left us in the lurch before,” said Du Toit.
Dr Johan Olivier, a convener for an informal association of GPs in Knysna, said there was no clarity on how much doctors were to be paid or whether they would work from clinics or treat state patients in their rooms.
Dr Martin Young, an ear, nose and throat specialist from Knysna who works at Knysna and George hospitals, said public-private partnerships were good in principle, but “the NHI will have to come with clear plans”.
Cape Argus