GERALD VAN WYK: This is how the private sector can advance universal healthcare

The National Health Insurance Act (NHI) is a reality, although there is now reason to hope that the process of national dialogue envisaged in terms of the unity government will facilitate positive and more constructive engagement. In his opening of parliament address, President Cyril Ramaphosa was clear that the resources and capabilities of the public and private sectors would be needed to realise universal healthcare for all.   

The NHI envisages universal healthcare access, but stakeholders across the health value system remain concerned about the ultimate effect on both public and private sector patients. Some view the NHI as a step towards equitable care, but scheme members — about 17% of SA’s 60-million people — have questions about the effect on care quality and personalisation and wonder if they will become statistics in a dysfunctional healthcare system.  

These concerns are not born out of cynicism but from lived experiences within SA’s public healthcare system, which is characterised by staff shortages, ageing infrastructure and unequal resource distribution. The most pressing question so far from scheme members is whether they should cancel their medical aid membership in anticipation of this policy introduction. The unequivocal response to that concern is “no”. Indeed, several weeks ago the then health minister appealed directly to members not to consider cancelling medical aid cover. 

Even if access can be achieved, a significant worry is the level of choice that will be available. Patients are concerned that they may be limited to designated NHI providers, losing the freedom to choose their doctors and facilities. The doctor-patient relationship is built on trust and personalised care and is a cornerstone of effective health outcomes. Doctors and patients are worried about the treatment choices that will be available, and the constraints placed on them during this decision-making process.   

As the healthcare sector anticipates fresh engagement with and clear communication from government, it is widely understood that implementation will be step-wise and take around a decade and beyond to be completed.  In the here and now though, vast opportunities exist for the private sector to innovate towards managing costs and supporting development of the elements that will be part of universal health care coverage.  

To help bridge the access challenges with the NHI a collaborative approach involving public-private partnerships is crucial. Partnerships can bolster service delivery, better negotiate rates, provide supplementary insurance, and expand healthcare access in underserved areas. Private sector participation is essential to build from the existing strong base, and further enhance infrastructure, support research and development, and improve delivery efficiency.  

Successful private public collaboration already exists. The Central Chronic Medication Dispensing & Distribution programme is a partnership with the private sector and the national health department, where private sector capacity is leveraged to provide chronic medications to stable patients under the public health care system. Pharmacy Direct, a subsidiary of the AfroCentric Group, services 1.4-million of these patients across five provinces monthly.  

Under the National Health Insurance (NHI), we see the private sector playing a role in leveraging advanced technological solutions to bridge the gap between legacy systems and modern healthcare demands. The transformative role of hyper automation systems for instance may enable or make use of integration of decision engines, robotic process automation, artificial intelligence and natural language processing to enhance efficiency, accuracy and service delivery.  

These partnerships will facilitate seamless data exchange and interoperability, ultimately improving healthcare access and quality for all South Africans while the NHI framework takes shape. Policy-makers and implementers in SA have a great responsibility to promote clarity and certainty about what this act means for access to, and choice in, healthcare both now and in the long term.  

The act’s ultimate success depends on prioritising patient needs and concerns. Addressing these head on is crucial to building trust and ensuring that the NHI delivers on its promise of universal healthcare. Heeding Ramaphosa’s call, we continue motivating for, and driving, genuine collaboration between private and public health sectors in the interests of improving healthcare outcomes right now.  

• Van Wyk is group CEO AfroCentric Group.