Opinion

Bad roads and health workers' bonuses are not the health minister's responsibility

Motsoaledi under attack for supporting National Health Insurance

17 June 2018 - 00:00 By POPO MAJA

Last week, at the height of an apparent co-ordinated onslaught on Health Minister Dr Aaron Motsoaledi, a woman called in during a radio talkshow and related a heart-rending story.
The woman, from the Eastern Cape, said that while she was growing up, roads in her area were so bad that ambulances could not reach certain households. Sick people who needed to be transported in ambulances had to be carried on wheelbarrows to the main road, from where they would be transported to the hospital.
She said that was the situation before democracy and she had hoped that once a black government was in power, the situation would change. To her disappointment, the roads in her village are still as bad as they were and even today ambulances are unable to reach certain homes. And who does she blame for the poor state of the roads? The minister of health. She was explicit. She castigated Motsoaledi for not doing anything to improve roads so that ambulances can access the villages!
To my surprise, the radio presenter did not engage her to state that the roads were outside the minister's authority. But perhaps the presenter was right not to clarify the caller. For the caller, there is only one government in South Africa and it should take collective responsibility for everything.
This is where things get a bit difficult. Workers at Charlotte Maxeke Academic Hospital embarked on a protest action and wreaked havoc, trashing the hospital and preventing other health professionals from attending to the sick because they are demanding bonuses. Who gets blamed? The health minister.Nobody is prepared to state the obvious, that Charlotte Maxeke is administered by the provincial government and that the issue the workers were raising could only be resolved by the provincial health department.
Be that as it may, when the news of the trashing of the hospital broke, the minister cleared his diary and immediately went there with officials of the Gauteng health department. Outraged by the vandalism and threats to human life, the minister rightly described developments at the hospital as hooliganism. His utterances led to a section of the progressive labour movement calling for his dismissal as minister. What a tragedy!
Surely the suitability of a minister cannot rely on an event. There is something dangerous developing in our country. Opinion makers and the media in general hold the minister of transport responsible for the deaths on our roads during the festive season. If the rate of road fatalities decreases, the opposite applies and the minister is showered with accolades.
While the minister can drive policy and legislation that promote road safety, it is the actual driver whose conduct can make the road safe for other users.
Equally, the health minister develops health policies and ensures that they are implemented, as the ultimate political principal with regard to health. But to expect him to tar roads in villages or to deal with issues of bonuses of health workers at a hospital would be unfair and unrealistic.
There are many bad events that occur in our hospitals which should not happen. But, equally, there are many great things that are happening in health facilities throughout the country. It is extremely unfair to use a few bad developments in our health system to agitate for the removal of the health minister.
Any serious appraisal of the minister should look at the bigger picture. And what is the bigger picture? It is under Motsoaledi's leadership that the number of people getting antiretroviral drugs drastically increased, from 400000 to more than 4.2million, an increase more than tenfold. Under Motsoaledi's administration, life expectancy increased by more than 10 years. These are facts.Under Motsoaledi's administration, the turnaround time to test for TB and get results was reduced from two months to less than two hours through the introduction of GeneXpert machines.
If a hospital used to treat 100 people and now has to treat more than 1000, of course the queues will be longer. The waiting period would be much longer. The pressure on the system will be more severe.
Does that mean the health system is collapsing? Not at all. It means that its resources, both human and otherwise, are being stretched to the limit.
With the full appreciation of these limited resources, most of which are locked in the private healthcare system, the minister is advocating an overhaul of the health system through the introduction of National Health Insurance.
NHI will bring equity to the provision of healthcare systems in the country. The rich and the healthy will essentially subsidise the poor and the sick.
It would be naive to think that those who are making money through the current system will fold their arms and allow the smooth implementation of the NHI. It is no secret that while the NHI was developed by the ruling party and adopted by the government, Motsoaledi has been its biggest sponsor and advocate. It is therefore not surprising that those who are against the implementation of NHI would use creative means to discredit him. If you discredit the container, people will not bother to give the contents a taste.
Those of us who are on the left and want to ensure that this government continues to press ahead with policies that reduce inequality should come out in defence of Motsoaledi because all that he is doing is to advance the interests of the majority and help them access quality healthcare, regardless of their social and economic status.
If we are not careful, we will be so infiltrated by the enemies of NHI that we will start to engage in acts of cannibalism among ourselves. Let us not allow the enemies of NHI to succeed by sharing sob stories that have nothing to do with our minister or stated programmes.
• Maja is the ministry of health's spokesman..

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