Experts hail co-operation between public and private healthcare sectors

The unprecedented co-operation between the public and private health care sectors during the Covid-19 emergency will have long-term benefits for the wellbeing of South Africans, experts said this week.

Some suggested efforts to ensure the best use of hospital beds, intensive care units and isolation facilities may pave the way to “a more rational and integrated health care system”, as envisaged by the planned National Health Insurance (NHI) system.

Prof Ronelle Burger, of the economics department at Stellenbosch University, said: “I have been encouraged by the co-operation between the private and public sectors over the past two weeks.

“It has been great to see how there is a free flow of new information and useful parameters across disciplines and also across the public and private sector. I think people are pulling together, and this could benefit our health system in the long run and also help improve the integration of the health system, addressing these deep divides.”

Burger said the health system remained “deeply polarised” and the country had not seen much co-operation between the two sectors due to mistrust.

The Covid-19 collaboration is “a good demonstration of the importance of working together and the necessity of it. It may lay the foundation for further co-operation by creating tighter relationships of trust across the private and public sector,” she said.

Writing in the South African Medical Journal this week, Stellenbosch University health economist Lungiswa Nkonki and Wits University professor of public health Sharon Fonn said the Covid-19 crisis “has dramatically highlighted the need for a significantly more integrated health care system”.

They said the Competition Commission's Covid-19 block exemption for the health care industry could build trust between the two sectors and “will ease us into a more rational and integrated” health care system.

“We would have a healthier country if we could demonstrate the same degree of intersectoral action and social mobilisation across the public/private divide in the form of meaningful social compacts. There are excellent lessons to be learnt here, and this opportunity should not be wasted.”

Prof Leslie London, head of public health medicine at the University of Cape Town, said the Covid-19 crisis had shown that “there is no place for bargaining for better leverage” in the health sector.

One of the lessons was “the realisation in the population that they can expect and experience one co-ordinated health system where the needs of the population come first, and not the profits of the industry”.

Private hospital group Netcare said this week its facilities would treat state Covid-19 patients on a cost-recovery basis. This followed the Competition Commission exemption which opened the way for private hospitals to collaborate with each other and the state to ensure optimal use of beds, intensive care units (ICUs) and isolation facilities.

Netcare CEO Dr Richard Friedland said the company had spent R150m to enhance the readiness of its ICU and high-care facilities for Covid-19 cases, and had suspended non-essential elective surgery in preparation for treating public sector Covid-19 patients on a not-for-profit basis.

Mediclinic told the Sunday Times it had also terminated elective surgery to reduce pressure on its hospitals and minimise the risk to its health workers and patients amid the pandemic.

“For the same reason, visiting hours have been withdrawn temporarily as an additional measure to reduce risk,” said Mediclinic spokesperson Caryn Ross.

Psychiatrist Prof Renata Schoeman, head of the MBA health care leadership programme at the University of Stellenbosch Business School, said it was encouraging to see the two health care sectors working together.

“Private doctors are also volunteering to man helplines, and to provide support services to their public sector colleagues. It's been amazing to see this humanitarian solidarity for the benefit of the nation,” she said.