Katharine Child: The Mail & Guardian
Setumo Stone: Business Day
Londiwe Buthelezi: Business Report
HEALTH Minister Aaron Motsoaledi yesterday announced plans to build six new academic hospitals and medical schools in the next decade, in a bid to address SA's pressing shortage of well-trained healthcare professionals. Motsoaledi made the announcement in Johannesburg when he introduced the department's Human Resources for Health Strategy, a key building block in the implementation of National Health Insurance. He said South Africa needed to achieve a fair and equitable distribution of health workers countrywide, adding that the shortage of healthcare workers came not only from having too few medical graduates, but also from inequitable distribution of staff between the public and private sector, leading to understaffing in rural areas. He said that in order to train more people a superior infrastructure was needed and the department was not only producing a human resources plan but equally producing a plan on infrastructure.
He said SA was producing 1 200 medical doctors a year but the number needed to be tripled at the least. The Democratic Alliance (DA) last year estimated that the public sector was short of at least 12 000 doctors and 46 000 nurses. The plan includes establishing a new medical school in Limpopo and refurbishing the Nelson Mandela Academic hospital in Mthatha. Motsoaledi said that was why the University of Limpopo Medunsa campus and the Turfloop campus were being demerged. He said Medunsa needed to be rebuilt to what it used to be in the past before the department wrongly thought it could change it. The new hospital structures will be at Chris Hani Baragwanath in Johannesburg, George Mukhari Academic hospital in Pretoria, King Edward VIII hospital in Durban and a new hospital in Nelspruit. Motsoaledi said a new Chris Hani Baragwanath would have to be built. The Minister said the new facilities, which would be built over the next 14 years, would cost more than the stadiums SA built for the Soccer World Cup - at a cost of about R10bn. The project had been approved by both President Jacob Zuma and Finance Minister Pravin Gordhan.
Fidel Hadebe, spokesman for the Minister, said a final cost had not been put to the projects as planning had not been finalised. The Treasury said yesterday it expected the planning and design phase to be implemented through private-public partnerships. The new institutions would complement SA's eight existing medical schools at Medunsa, and the universities of Cape Town, KwaZulu-Natal, Pretoria, Stellenbosch, Free State, Witwatersrand (Wits) and Transkei. SA has several academic hospitals such as Groote Schuur in Cape Town and the Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, the main teaching hospital for Wits students. Dr Motsoaledi said skills shortages had been a challenge for the Health Department, and the low intake of medical students at universities and early retirement of specialist professionals was part of the problem. He said the department would spend R1,24bn over the next three years to revitalise 122 nursing colleges. The Minister said the department was also creating posts for medical professionals at a district level. He said these district teams would consist of an obstetrician, gynaecologist, pediatrician, family physician and anaesthetist, adding that running to a private specialist for every ailment was abnormal and public healthcare should be the first step.
Motsoaledi said bad planning was to blame for the predicament South Africa finds itself in. He said some problems were self-made, and that evidence indicated that the training and production of certain key health worker categories had stagnated or reversed over the years. The weak management skills in the public service aggravated the situation even further. Motsoaledi said that staff did not like to work in the public sector and more had to be done to make sure management of hospitals were up to scratch. He said studies had demonstrated that it was not only financial incentives that made them leave but sometimes how they were managed or mismanaged. The public health sector had to ensure that environment in which health workers operated was conducive, he said. Despite his frequent complaints about the over-commercialisation of medicine, Motsoaledi dodged a question about how the Ministry planned to attract health care workers from the private sector back to the government sector. The Minister was critical of the costs of private healthcare and said many people told him he was mad about wanting to fix the public healthcare sector, but he told the audience "I will not stop this madness of mine". He said he had been told the healthcare sector was not going to work but it had to work – 84 percent of the population relied on the public healthcare sector.
