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GOVERNMENT IS A LAW UNTO ITSELF!” not enacted”. That said, there have been improvements under Motsoaledi, says Moodley, “although the bar was set very low”. For example, government has put in place a 10 point plan, which delineates its top 10 health priorities. “That does set a framework and create more clarity. But it’s not just about government saying these are the 10 points. They need to engage with healthcare professionals, engage with suppliers, engage with hospitals and funders, get everyone together because that is the only way we can improve our fragmented healthcare sector.”
GORDON INSTITUTE OF BUSINESS SCIENCE
STEPS TOWARDS ENGAGEMENT
the initial three-year commitment of the participating companies comes to an end, many companies are reviewing the value of the potential spin-offs, he says.
THE GAME CHANGER
Amidst this stalemate, the mooted NHI could, fundamentally, change the game, says Moodley. “The Green Paper on NHI was published four years ago (August 2011) and we are still waiting on the NHI White Paper. So how do you build your business and plan for the next five years if you don’t know what is happening?”
Unfortunately getting all stakeholders to pull together is tough. “Industry needs to engage with government to understand how to improve trust,” says Moodley, who also feels that government has reason to be wary. “If I look, with a really critical eye, I don’t believe the industry has transformed from a black economy empowerment perspective. I think there is more room for improvement and it should be more proactive and more selfdriven; I think that tends to engender more trust from government.”
In August 2015, Business Day’s Tamar Kahn examined the progress being made on the NHI front in the wake of Motsoaledi’s comments to Parliament’s portfolio committee on health that the documents were ready to go to cabinet. Motsoaledi emphasised how the White Paper envisaged a role for the private sector, with services due to be purchased from both public and private sector providers, reported the newspaper. Unfortunately, plans to recruit private sector GPs to work in the NHI pilot districts has got off to a slow start, said Motsoaledi at the time.
That’s not to say that progress isn’t being made. Moodley, for example, was involved in the Public Health Enhancement Fund (PHEF), an initiative in which over 20 healthcare companies, such as Discovery, Aspen, Roche and Netcare, contribute a percentage of revenue into a central pool. “That pool makes up about R40 million per annum at the moment,” explains Moodley.
Moodley believes for the NHI to be successful companies need to change their business models and all parties need to change their approach. But he remains optimistic. “There has been massive progress and strides under Motsoaledi, but there is a long way to go. The NHI could be the game changer which either pushes everyone together or further apart.”
The PHEF works with government to identify areas of priority and then assists in funding these projects. Moodley explains: “The PHEF allocates R20 million a year to funding an additional 200 medical students. The other programme is a leadership academy; the Minister has admitted that there is a gap in healthcare management and leadership level, so another R10 million goes towards trying to improve the managerial and leadership qualities – this is something GIBS has been involved in. Another R10 million goes towards health Masters and PhD students, to get them to do research into critical issues like HIV and TB.” Department spokesman Maila also singled out the PHEF as an example of a successful collaboration. “We have a number of partnerships with business, such as the PHEF, which business is funding. We need to be working with business,” he stressed. In theory, the PHEF should be a way to bridge the gap between government and business, but while government buy-in is certainly evident, the department is shying away from full-on, proactive and open engagement with industry, says Moodley. As
Is this even achievable given the ill feelings which appear to be in evidence on both sides? Yes, says Moodley, and South Africa could look to East Africa as an example.
IT CAN BE DONE
Moodley, who is currently working on research projects in Tanzania, says: “I think East Africa generally seems to be better at these sorts of collaborative things. Not just public-private, but intergovernmental collaboration. The East African Community is more attuned to harmonisation and collaboration. For example, they are very committed to working with the private sector to get cardiac services running. I’m hoping we can measure a tangible outcome out of that.” That willingness to work together comes from an ethos of collaboration, says Moodley. “Globally, we are never going to leapfrog processes in the areas of health we want to unless we get this right. And this is not just co-operation between public and private, but also private and private. If we don’t get all the parties together then we’ll always only have parts of the puzzle.”
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