Medical deans’ prescription for SA’s public health emergency
The deans have five specific interventions they would like to see, to improve universal healthcare access and medical training
The deadly strike in the North West health department, and other crises in SA’s public health sector, have driven deans of medical faculties across the country to seek urgent and drastic responses from the government.
The South African Committee of Medical Deans says it does not think recent interventions on the part of the national Department of Health have pulled SA’s public health sector out of the crisis.
It says the problems in the healthcare sector are also hindering the proper training of medical professionals, both undergraduates and postgraduates, including at specialist and sub-specialist levels.
"The Cabinet’s recent decision to place the North West health department under administration of the national government, in the wake of the health worker protests, and the appointment of the intervention task team in the Gauteng health department to advise on a turnaround strategy, are indicative of a limping and failing health system‚" it says.
"The deans are calling on government to take drastic steps to address the systemic failures in the provincial health departments as a matter of priority."
The recent health workers’ strike in the North West brought into sharp focus the challenges facing the health system in SA‚ the group says.
"The deans are deeply concerned that industrial action by organised labour actively prevented access to healthcare for the most vulnerable members of society, and patients have died.
"These events follow several significant events in the national health system including the Life Esidimeni tragedy‚ the ongoing oncology service crisis, and the ever-increasing burden of diseases‚ which all demand some introspection among those managing health services.
"These do not support an environment for the eventual realisation of a health system based on the concept of universal health coverage."
The deans also expressed grave concern about the future of academic medicine because of chronic underfunding. "The constant failure to adequately fund internship and community service placements for graduating health professional represents a serious human resources challenge as well as ethical disquiet.
"The deans believe that the national government has a duty to ensure that all South African students and those with permanent residence status should be placed in fully funded posts as this is a legal requirement for practice in the country."
The group is also concerned that the additional training sites required to complete the training of the medical students from the Mandela-Castro Medical Collaboration Programme are still not fully prepared, with only 60 days left before the first group of 720 students arrive back in SA from Cuba.
The deans committee called on Health Minister Aaron Motsoaledi to work with Higher Education and Training Minister Naledi Pandor and National Treasury to urgently do the following:
1. Ensure all the training sites have been assessed and are ready to host medical students returning from Cuba by June 30.
2. Engage with organised labour to ensure industrial action does not limit access to healthcare for patients.
3. Work with universities to develop a policy and publish regulations to govern academic health complexes, under National Health Act of 2003‚ Chapter 7‚ section 51(a) and (b), to resolve issues related to policy‚ governance‚ organisation and management‚ and financing of academic health complexes.
4. Establish the National Tertiary Health Services Committee and the National Governing Body for Human Resources for Health (incorporating training and development) by the end of July. These National Health Insurance (NHI) implementation structures will enable the health and higher education and training sectors to jointly plan the short-‚ medium-and long-term future of health services, and health professions education and training. A joint workforce planning process will also ensure funding is available for guaranteed allocation in internship and community service posts.
5. Facilitate engagements with the Parliamentary portfolio committee on health to host public hearings during June and July 2018 on the crises in provincial health departments. Government should address the outcome of these hearings, using provisions in section 100 of the Constitution to address the systemic failures if necessary.