Pali Lehohla. File Photo: IOL

JOHANNESBURG – Health is a challenge in many a country, especially the rising costs of care. The World Health Assembly (WHA) has expressed itself on this matter and urged countries to move towards Universal Health Care.  

In fact, access to health as a human right has been articulated, including by South Africa, in its move to the National Health Insurance (NHI). 

I am a member of the Independent Accountability Panel (IAP) for the health of mothers, children and adolescents. This is a panel established by the UN secretary-general consisting of 10 people, and we issued our third report at the UN General Assembly last month. 

The report titled “Private Sector: Who is Accountable” has been shared widely and delivered specifically to the health ministers in countries.

The report continues to receive action-orientated reviews as the questions raised in the report approach the WHA next year. 

South Africa's Health Minister Dr Aaron Motsoaledi’s recent experience of Life Esidimeni, listeriosis, Mediosa and the Thelle Mogoerane Hospital's klebsiella pneumonia deaths suggest that he is riding a tiger. Among his troubles in the recent past was Mediosa, a Gupta-run outfit providing health services in North West. 

So mediocre was Mediosa that Motsoaledi referred to it as nothing other than an ATM. 

Axed North West premier Supra Mahumapelo would have none of Motsoaledi’s insinuations. He was very pleased with the service, as he argued, that for the first time citizens experienced the Batho Pele Principles through the in-situ approach that Mediosa delivered healthcare and citizens appreciated this service. 

The Motsoaledi-Mahumapelo debacle is quite important to understand and I have had no better appreciation of this debacle than through the lens of the person who helps to clean my garden – work he has been doing for other households and me for the past 22 years. 

As a then bean counter of the nation, I was intrigued by the evolving transformation of the world of work generally, but of domestic service and gardeners in particular. 

A gardener can operate more than three households a week and for one of the households the gardener can pay with one day work per week for four weeks in exchange for accommodation for a month. 

Benefits to domestic workers can be a fairly complicated arrangement, especially with regard to medical aid. In 2012 the gardener got injured very badly. He was rushed to a clinic in Mamelodi, where he got service at the crowded facility and he survived.

However, recently there has been growth in affordable medical aid schemes that run on a business model for under R300 a subscriber a month. 

Compare this to the R5 000 per month I pay as a civil servant beneficiary or the members and Cabinet ministers' scheme of almost R13 000 per month – a category that is unaffordable even for high earners. 

But due to the new affordable schemes a few months back, we put our domestic helpers on this low-cost scheme. 

As fate would have it, shortly thereafter the gardener got cactus milk in his eyes at one of the households where he worked. 

By the time he arrived at my house, his eyes were swollen and he could not see clearly. We rushed him to a private doctor where he was treated for the effect of this in his eyes.

The treatment was obviously different from the one he got from congested Mamelodi seven years ago. But the idea of being called “Meneer” Mokgotho by a white medical professional took the crown. So impressed was he about this special treatment that the experience made him feel cared for.

Back to Mediosa, the individualised care made citizens feel cared for and this is where Mahumapelo as premier had a point, but quite correctly Motsoaledi as a health professional was able to see through the abuse, and underhanded dishonesty of this mediocre care by Mediosa, and called a stop to it.

But “Meneer” Mokgotho experienced another type of care – real medical care, quite different from Mediosa and different from the congested Mamelodi, but at an affordable medical aid of about R300 per month. 

Motsoaledi is fighting for this kind of care, which should in all probability be possible in Mamelodi when the Universal Health Care is scaled up to affordable levels of R300 per person through a National Health Insurance scheme, and not through the fleecing Mediosa or a buy-out of the public health system by the middle and high-class earners, but through active participation of all in this scheme, thus making it possible even for the poor to access good health care. 

This is what our IAP report on “The Private Sector: Who is Accountable” presents through its five recommendations. 

Minister Motsoaledi might well be the jockey who tames the tiger. 

Dr Pali Lehohla is the former statistician-general of South Africa and former head of Statistics South Africa.

The views expressed here are not necessarily those of Independent Media.

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