Out of weakness, strength can come if we walk together.

The weak rand is an opportunity to strengthen the healthcare sector, if government and the private hospitals work together.

This is the message I took home from the Health Parliamentary Portfolio Committee on Rural Health and Preventive Care, on 5th March 2013. The chair of the Portfolio Committee kicked off the session by reminding us that that health tourism to South Africa was on the rise.

The main driver of this trend is the quality of the healthcare our private hospitals offer, but we cannot ignore the fact that current low rand values make our services more attractive and more affordable to foreign patients. We are experiencing a window of opportunity to leverage both the strengths of our health sector and the weakness of our currency, to reinforce the quality of our healthcare at all levels and to establish South Africa as a health tourism destination for the long term.

Dr Dumisani Bomela, CEO of the Hospital Association of SA (HASA), explained how. The solution, he said, was for the private hospital groups, the public healthcare sector and the government to pool their resources and work together.

Government should contract private providers for certain procedures, such as cataract surgeries. This would alleviate waiting lists in state hospitals. Meanwhile, the private hospitals should play a larger role in improving skill levels across the industry, for instance by training more nurses a well as doctors. By twinning public and private hospitals, private hospitals could share their expertise in fields such as hospital management.

This is a well-tested concept, in both South Africa and other parts of the world. Mediclinic Switzerland facilities serve about 60% of Public patients, while it is about 35% for Netcare facilities patients attend its hospitals in the UK.

In a private/public partnership in Lesotho, Netcare was involved in revitalizing a hospital.

In the process, it reduced the number of beds from 409 to 309, increasing occupancy rates from 61% to 82%. In the new hospital, inpatient admissions rose 51% to 23 341, while inpatient days rose only 27% and the average length of a stay fell 16%. Outpatient visits rose a whopping 126%. At the same time, the death rate fell 41%, including a 10% decline in maternity deaths and an amazing 65% fall in paediatric pneumonia deaths.

Netcare achieved this by improving the hospital’s management and clinical systems, and introducing standards, policies and guidelines that required discipline and accountability. Improvements in the pharmacy ensured that needed drugs were kept in stock, and the incidence of theft fell. The laboratory began providing test results within the hour. Surgery wait times have dropped, and smoothly operating support systems keep the hospital clean and functioning.

Private hospitals are the key to sustainable healthcare in South Africa – but the door we must pass through is the public sector. The vast majority of our fellow citizens live in poverty with no medical scheme coverage, and they depend on the public sector to meet their need for healthcare. Most of them live in the rural areas, which aren’t served by private hospitals.

If government enters into public/private partnership arrangements with private hospitals to deliver care in the rural areas, we could dramatically improve quality and delivery. This must start at the level of primary healthcare and extend upward throughout the entire healthcare provision system.

And where does health tourism fit into this? Right at the top end. By pooling resources, improving the quality of care from the ground up, and removing bureaucratic blockages in the system, government and the private hospital industry can work together to make South Africa a place people think of first when they need sophisticated, costly healthcare.

The income from health tourism has the potential to trickle down in a life-giving stream to energize the entire healthcare industry, as well as supporting industries and suppliers. Now, while the rand is “weak”, is the time for us to unite and become strong.

If you would like some additional statistic presented by the HASA representing privates hospital to the Portfolio committee please write to me len@lda.co.za


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