India inspires local doctor to target SA’s poorer patients

By: Janice Kew                                                    Published on: 16 March 2017

Source: Business Day

Nthabiseng Legoete started Qualihealth in May, opening the first clinic in Diepsloot, but with bank funding she now has three offering affordable healthcare.

Portia Lekgoto faced a dilemma: how to take her three-year-old daughter to a doctor without missing a day of work, while waiting in line at one of only two public health clinics in SA’s informal settlement of Diepsloot.

She decided to take her daughter to Qualihealth, a new private clinic a friend had told her about. While she had to pay R250 for the visit, she finished the consultation by mid-morning. “I am now going to drop my daughter off at her granny with the medication we have been given, and then I will go into work,” Lekgoto, 34, says. “This place, the staff are friendly and it’s nice and clean. I’ll definitely come back.”

People walking into a well-resourced health centre and getting immediate help is an unusual sight in poorer areas such as Diepsloot, home to about 140,000 people that was formed a year after Nelson Mandela came to power in 1994. More than 80% of SA’s population has no medical insurance and depend on a public health system that the World Health Organisation (WHO) ranks as one of the worst in the world, or on traditional healers who usually provide herbs as medicine.

Qualihealth was started in May 2016 by Dr Nthabiseng Legoete, a 37-year-old doctor, after visiting India, where she saw people with no medical insurance using private care at a hospital in Bangalore. By September, the clinic in Diepsloot, which offers primary care, was turning a profit and now sees about 3,000 patients a month. In March, with funding from the Development Bank of Southern Africa, she opened clinics in Tembisa, Soweto and Alexandra townships around Johannesburg.

India experience

“I chose to visit India because I knew there were pockets of excellence in terms of low-cost healthcare,” Legoete says. “I saw a production-line approach to a lot of services, where one person is dedicated to one function and becomes better and faster at that one thing. It creates a seamless process through the entire service.”

India and SA share some common health problems: high vulnerability of young children, poor sanitation, and diseases such as HIV, malaria and tuberculosis. Neither country has a properly functioning public health system, according to WHO. India ranks 112 out of its 191 member states, while SA is 175.

Shortage of care

“There’s a massive, massive shortage of quality affordable medical care,” BPI Capital Africa analyst Kate Turner-Smith says. “At R250, this is still a day’s wage for many to see a doctor, but it does mean getting better sooner and that is positive both for the person and for national productivity.”

Department of Health spokesman Joe Maila didn’t respond to calls, text messages or e-mails requesting comment.

Qualihealth clinics aren’t cheap for the people it target,s who may earn on average about R3,500 a month. Yet the fee buys patients access to doctors, physician associates and nurses, medication, antenatal sonars, and heart, blood and blood pressure tests. General practitioners in Johannesburg charge as much as R500 a visit for a consultation alone, and the average cost for insurance is R1,550 per person per month.

After Legoete took all her savings and borrowed from friends and family, she opened the clinic that operates seven days a week from 8am to 8pm.

State spending

“Our target market is employed people who are currently reliant on the public health system,” she says. “They are being forced to choose between going to work or getting a health check.”

She believes the Qualihealth clinics can also help the nation’s public system by relieving some of the pressure. SA spent R171bn, or 12% of its fiscal 2017 budget, on health. That’s set to rise by 8.3% a year until 2020, the fastest growing category of state spending after debt servicing and post-school education. As much as 38% of South Africans, at some point, turn to private healthcare, according to a 2013 report by consulting firm Econex, spending more than R140bn rand a year.

Qualihealth is providing quality for money, says Dumaluhle Sibanda, a 29-year-old assistant manager at a pizza restaurant who is at the centre to look after his one-year-old son while his partner is seeing the doctor: “For some this is still expensive, but I think it’s good value. Some of the doctors around here are more like traditional healers and the medication you get is not regulated medication, and while the doctors may have certificates, they are not professionally qualified doctors. Here you know what you are getting.”