SA public health service crisis
March 16th, 2011
The South Africa government notes “continued dissatisfaction of patients who face rude staff, long queues, dirty and unsafe clinics and hospitals.”
A speech by Department of Health director general, Dr Precious Matsoso, was read by Dr Carol Marshall at the launch of a Safe Care Initiative, themed on public health care standards and quality. Dr Matsoso said South Africa’s health care outputs were “very poor in relation to its inputs”.
“We believe that one of the problems of poor [health care] quality is continued lack of accountability in the system,” she said.
Dr Matsoso said a major weakness was an inability of the present system to hold managers to account. High patient ratio was often used as an excuse for failures or problems.
“I do believe that the sad state of our health system is due to a weakness in leadership and ethics,” Matsoso added.
Matsoso revealed that the department was working towards reinforcing governance at clinical level, defining the responsibilities of clinical teams and measuring outcomes.
“This will allow us to hold managers accountable and in turn create a safety culture which would include regular incident reviews and external investigations,” she said.
“We wish to make poor care and unsafe practices unacceptable, hold management and those who transgress to account and acknowledge those who do well,” said Matososo.
Marshall, who is heading the health department’s Office of Standards Compliance said they would “most definitely” not only target primary health care clinics, but also public hospitals where “we have seen very basic standards slip”.
She said it was envisaged that the Office of Health Standards would include an inspectorate, an ombuds office and early warning systems. “We envisage it as a public entity, within the public sector with a legal status reporting directly to the Health minister and parliament.Basically a regulator with legal powers,” said Marshall.
Another speech prepared by Dr Olive Sisana, Human Science Research Council CEO, and chair of the Ministerial Advisory Committee (MAC) on National Health Insurance, stated that is was “all good news for NHI implementation”.
Shisana had to urgently leave for the United States and her talk was delivered by MAC member Dr Keith Shongwe of Life Healthcare.
Shisana said research done by the HSRC revealed that the quality of healthcare was not uniformly inadequate, but that a critical component was to ensure that the primary health care system functioned well.
Of the more than 3 000 patients questioned as part of an unpublished HSRC study, 58% said they were “satisfied” while 27% indicated that were “not satisfied” with the health service.
Shisana said the ANC was informing government policy on NHI and that the “ruling party” decisions would be followed through by government.
She said challenges included a lack of management skills in the health system, a lack of in-service training, a failure to act on deficiences, unsatisfactory maintenance and repair services as well as poor disciplinary procedures and corruption.
Healthcare policy makers and medical personnel are meeting for two days under the SafeCare Initiative which will be launched in Cape Town this week. It is a quality framework aimed at developing and applying universal standards of service delivery in healthcare.
The project is a joint initiative between the US-based Joint Commission International, the Dutch based Pharm Access Foundation and the Council for Health Service Accreditation of Southern Africa and “is intended to support doctors, nurses and other care-givers working in the poorest parts of the world”
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