Pre-NHI clean-up: Motsoaledi enlists private sector.

Practitioners Foundation (SAPPF), are pitching in to help government clean up the primary health care delivery mess. Both agree with national health minister, Dr Aaron Motsoaledi, that a complete 're-engineering' of the dysfunctional public health care sector is needed for any variation of National Health Insurance (NHI) to succeed. However, Motsoaledi and his cabinet colleagues also believe that the private sector cannot be left to 'wayward' profit-driven market forces and is as much in need of re-engineering. In his budget speech to parliament on 31 May, the health minister said that under the present system, whether public or private, 'no national health insurance can ever survive'. He typified the system as 'unsustainable, destructive, extremely costly and hospi-centric or curative'. Incremental implementation of the NHI, as currently proposed, is due to begin next year. Government has fallen silent on detail and a time-line as the full extent of public sector staff shortages, management incapacity and financial and supply constraints begins to hit home. Dr Olive Shisana, Head of the NHI Ministerial Advisory Committee, said her team of experts had responded to all cabinet 'queries and issues' and it was now up to government to 'decide on what detail they accept or reject and to issue the White Paper for public consultation'. She added: 'There may very well be a small delay. I don't know, simply because of the legislative process, but it will happen in 2012, of that I'm sure. ' Motsoaledi appealed for patience as the health care sector and NHI policy were concurrently worked on. He identified two groups of people: those who legitimately hoped the NHI would ease their everyday health care hardships and those 'consumed by self-interest and greed that would shame even the devil'. He said the latter was waiting for any development and would do 'anything in their power to stop the NHI dead in its tracks'. In this policy hiatus, the most dramatic new development is the shift towards fixing basic delivery systems via public/private partnerships. Motsoaledi confirmed what the SAPPF had earlier told Izindaba, namely that the public sector would be reworked according to three main streams, including a district-based model in which a team of five specialists or clinicians would be deployed to head each of the 53 districts, focusing initially on maternal and child mortality. Last month Motsoaledi met with several private specialist bodies under the banner of the SAPPF, requesting …