Motsoaledi announces major health shake-up

(Image: GCIS)

A "rapid response team", made up of clinical engineers, has also been set up to attend to the maintenance of hospital equipment on an urgent basis in "any province that experiences malfunction of equipment".

The team, which will be based at the Department of Health's office in Pretoria, will be appointed on 1 August 2013.

Announcing major changes to the health system - aimed at improving service delivery - Health Minister Aaron Motsoaledi said after lengthy consultations, he had taken a decision to decentralise several functions that were carried out at provincial health offices to hospital CEOs and hospital managers.

"A decision has been taken to implement a direct delivery system to certain categories of hospitals. It will start with central, tertiary, regional and specialised hospitals. This will also ensure more efficient supply to these hospitals and free up the depot to deliver more effectively to district hospitals and primary health facilities," he said.

Motsoaledi announced these changes before he signed a health development accord with the University of the Witwatersrand (Wits) Vice-Chancellor, Professor Adam Habib, in Johannesburg on Thursday.

"It has become very common in our country that whenever NHI [National Health Insurance] is mentioned, critics will immediately point to the serious weaknesses in the public health care system. They will point to the ineffectiveness of the health care system, the deteriorating quality of care, as well as constant stock-outs of essential drugs and other essential supplies.

"Quite often stories will emerge about non-functioning equipment, whereby patients are forced to wait for long times to the detriment of their health," said the minister.

He said a time for change had dawned on South Africa's health system.

"The time has arrived that we should part with such a scenario and usher in a totally new era of development. We believe that this is an area where things must be done so well that the rest of the country must learn from," he said.

As part of the major shake-up, Motsoaledi also announced that:

• Hospital CEOs have been given a "contingency budget" for emergency procurement of non-negotiables on an urgent basis to do away with delays and "stock-outs" of essential items. They will also be given the powers to buy equipment worth less than R500,000 on a quotation basis;
• A health care war room - called the Cost Centre Management System - is being set up at head office to monitor the availability of medicines and other essentials via other cost centres that will be based at regional and district hospitals;
• Clinicians will be given decision-making powers on matters relating to their services, including monitoring the availability of non-negotiables, availability of equipment and consumables, amongst other issues;
• A committee made up of clinicians will meet monthly to assess the maintenance of essential equipment, compile a list of equipment that will be forwarded directly to suppliers to eliminate the middle man.

"A team of eight clinical engineers is being put together with a view to dispatching them to hospitals to do a rapid assessment of medical equipment and to establish which equipment should be repaired or replaced," said the minister.

Motsoaledi said while these changes only affected Gauteng, he would soon present the plan to other provinces. He added that he was confident other provinces would embrace and implement it.

He said, meanwhile, that a partnership with retail and community pharmacies and chain stores was being considered to allow stable patients with a chronic illness, who do not need to see a doctor but have a need to collect their monthly medicine, to get their medicines at alternative points.

This would ease the pressure on the overstretched health system that already supplies millions of chronic medicines.