The Hospital Association of South Africa (HASA) notes with some disappointment reports quoting the Health Professions Council of South Africa’s (HPSCA) Dr Kgosi Letlape as saying that “medical aids are a crime against humanity.”
His comments come at a time, says HASA, when the South African healthcare system faces a number of urgent challenges that must be addressed if we are to improve healthcare outcomes and if citizens are to enjoy quality and accessible care and are unlikely to assist the collaboration necessary to meet these challenges.
“Unfairly targeting one sector of the healthcare system that provides cover to millions of South Africans who are therefore able to receive necessary treatment while ignoring challenges like the debilitating shortages of doctors and specialists, the lack of infrastructure by which to produce the number of doctors we need, and the falling numbers of public sector hospital beds, is not helpful,” says Melanie Da Costa, Chair of HASA.
“For instance, in South Africa, there are only 60 doctors per 100 000 people in South Africa – the world average is 152 per 100 000. This one issue affects the entire healthcare system and goes to the heart of whether it is able to function well or not,” she adds.
According to economics research consultancy Econex, the lack of infrastructure and training capacity in South Africa lies at the heart of the doctor-shortage problem.
In a research report, “Identifying the determinants of and solutions to the shortage of doctors in South Africa” the consultancy notes that South Africa has eight medical faculties producing doctors, or one medical school per 6.6 million citizens. Across Africa, the number improves slightly to one school per 4.9 million. But compared to the rest of the world the challenge comes into sharp focus: in the Americas the ratio is one school per 1.2 million, in Asia it is one per 3.5 million, in Europe, one per 1.8 million, and in the Oceania region, one training facility per 1.2 million.
India and Brazil are two countries that faced the same challenge and have achieved success in increasing the numbers of doctors in each of their healthcare systems by finding a role for the private education of doctors and nurses. South Africa does not allow private education of doctors.
“If we are to address the healthcare challenges we face in this country the long term sustainable solution is the production of more doctors. If we tackle this challenge along with a robust primary healthcare approach and a determination to increase the numbers of public hospital beds available, which is substantially below the numbers we had available in the mid-1970s, more people can be treated, the burden of disease better addressed, and there will be improved access to quality healthcare,” says Da Costa.
According to Da Costa, It does not help to re-arrange the deck chairs and to become embroiled in false debates about whether or not medical aids are a “crime against humanity.” The real debate, she says, is why are we not allowing private medical schools to contribute to solving the doctor-shortage challenge if Government’s already tight budget does not enable the funding of new training institutions?