Public-private collaboration: Could this breakthrough model lead the future of national health?

Thanks to the collaboration between the Northern Cape Department of Health, Robert Mangaliso Sobukwe Hospital and Icon Oncology, Mr Johan Mothibi Mooketsi could complete his radiotherapy treatment at the Icon Radiotherapy unit in Kimberley. Previously patients had to travel to Bloemfontein to access lifesaving radiotherapy treatment.

Yet in the Northern Cape, a remarkable success story has quietly unfolded over the last five years, impacting the lives of hundreds of cancer patients and demonstrating that the way to bring better health to the public on a macro scale may be to focus on practical micro solutions that, once proven, can be replicated around the country.

It arises out of a collaboration between the Northern Cape Department of Health, Kimberley’s Robert Mangaliso Sobukwe Hospital and private sector oncology service provider, Icon Oncology, with the shared goal of delivering the best possible care for patients needing radiotherapy services - which were previously far from home.

Jennifer Fuller, regional manager for Icon Oncology explains: “The average radiotherapy treatment journey spans between two to six weeks. Previously, the profound socio-economic and psycho-social toll of Northern Cape patients traveling far from their homes and families was immeasurable. During this period there was no radiation facility in the province, so patients had to travel to Bloemfontein for treatment. We collaborated with the Department of Health to treat radiation patients here in the Northern Cape. The result is a true example of how government and the private sector can work together when there is a shared focus on patient outcomes.”

Today, the province provides transport from far-off areas for treatment at Icon’s radiotherapy facility in Kimberley. If needed, accommodation is provided by the RMS Hospital for the duration of the radiotherapy treatment, which can sometimes last for six weeks.

Since the implementation of the project in October 2019, 511 cancer patients have completed radiation treatment. Previously all these patients would have had to travel to Bloemfontein to receive treatment.

“It’s a major success”, says Dr Alastair Kantani, clinical manager for hospital services in the Northern Cape. “It’s actually more than a success; it’s a lifesaving partnership. Personally, as a clinician, I’m proud of the fact that we, as a tertiary hospital, can give access to therapy services. Since this partnership, we’ve saved a lot of lives.”

Dr Esme Olivier, acting CEO of Robert Mangaliso Sobukwe Hospital says, “For me this collaboration between Icon and the Department of Health, specifically this hospital, is one of the best things that could happen for the sake of our oncology patients.”

“This is truly a complete collaboration” adds Fuller. “It shows that it can work - and I do believe that this can be replicated further into other provinces.”

Dr Olivier agrees: “I would really encourage every province to get involved with this. Even if they have their own radiation therapy units, just the collaboration and the expertise that Icon brings on board - they can even assist with nursing, whatever need there is that is not immediately available in public hospitals.”

Governance is key and monthly meetings are held between the two management teams to discuss patient experience, statistics, billing and other operational matters.

“This has resulted in continuous improvement of the project delivery over the past five years. This sharing of responsibility has led to the development of a very strong relationship and the interdependence has meant both parties have worked hard to make sure it works,” says Dr Olivier.

How it works – the patient journey:

• The patient journey starts at the tertiary state facility, Robert Mangaliso Sobukwe Hospital, where the resident oncologist will consult with the patient once diagnosed by a surgeon or radiologist. If radiotherapy is indicated, the patient is referred to the Icon Radiotherapy unit in Kimberley.

• A planning CT-scan is done by an Icon radiotherapist at Robert Magaliso Sobukwe Hospital.

• The treating oncologist and the Icon planning department, draws a plan on the CT-scan to determine the dose and area of radiotherapy that the patient will receive, using a sophisticated, state of the art planning system. The oncologist can access Icon’s planning system remotely and can do this work from anywhere.

• This constitutes a 15 min radiotherapy session every day on Icon’s linear accelerator, until the required dose is delivered, and treatment is completed.

“The Northern Cape initiative exemplifies the potential inherent in bridging the gap between public and private healthcare sectors. It showcases how collaboration can transcend obstacles and provide specialised healthcare services and treatment to all citizens. As the country grapples with the challenges and concerns raised by the National Health Insurance (NHI) Bill, this collaborative achievement stands as a testament that the seemingly daunting task of implementing universal healthcare coverage can indeed be navigated. We must commend the vision of the Northern Cape DoH, management from the Robert Mangaliso Sobukwe Hospital and all other stakeholders who have made this project such a success,” explains Dr Ernst Marais, COO of Icon Oncology.

“It is through collaborations like this one, that we excel in providing the best possible treatment to our patients. Like Hellen Keller said: ‘Alone we can do so little, but together we can do so much’,” concludes Dr Olivier.