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Public hospitals ‘are not ready for NHI’

By Londiwe Buthelezi. Time of article published Aug 30, 2012

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The lack of cleanliness, bad attitude and scarcity of health-care staff are just a few items on a long list of problems that may prevent South African public hospitals from complying with new legislation that is intended to improve the quality of health care provided in the public sector, according to provincial health MECs.

The National Assembly has already passed the Norms and Standards Bill, which aims to improve the services offered by public health facilities as South Africa transitions to National Health Insurance (NHI). The portfolio committee on health said it expected the bill to be passed by the National Council of Provinces before the end of the year.

However, provincial departments of health said yesterday that public hospitals were far from complying with the standards because of an alarming shortage of staff, while some hospitals were in such poor condition that they should not be housing patients.

A report on the baseline assessment of public health facilities conducted in 2011, which the provinces presented in Parliament, showed that 74 percent of facilities did not comply with cleanliness rules, while staff attitude was sub-standard in 69 percent and 55 percent did not have the required medicines and supplies.

Although the readiness of provinces to comply with the bill differed, Mpumalanga Health MEC Clifford Mkasi said his province had an 81 percent shortage of doctors and a 56 percent shortage of nurses. “Given the resources we have, I think we are not ready to apply standards at this stage.”

Hospitals being built in Mpumalanga under the hospital revitalisation programme were taking about 10 years to finish and the condition of the older hospitals was deteriorating. Four hospitals were being constructed or revitalised in the province and four others were in the planning stages.

The portfolio committee said if it was taking up to 10 years to build hospitals, the situation was catastrophic because by the time they were completed, their technology would be outdated.

The hospital revitalisation programme was implemented by the Department of Health to improve the condition of public hospitals ahead of the full roll-out of the NHI.

The MEC for Health in the Northern Cape, Mxolisi Sokatsha, said there were hospitals in his province where patients were still sleeping in passages.

The Northern Cape had three hospitals whose revitalisation was being implemented and one that was in the planning stages.

These institutions would take between seven and nine years to be completed, even though some were initially intended to be completed within two to three years.

Nevertheless, the Northern Cape Department of Health planned to meet the full set of national core standards by the 2013/14 financial year.

North West Health MEC Magome Masike said although the latest assessment showed that most of the province’s facilities were non-compliant, the critical factors that did not meet standards were within the hospitals’ control.

He said all hospitals had drawn up operational plans to spell out how they would close the gaps so that they could be fully compliant.

However, the problem was that the province had an infrastructure backlog of about R4.8 billion, yet its budget between 2013 and 2016 was just over R2bn.

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