Editorial

Health Minister Aaron Motsoaledi's diagnosis will keep our health system sick

03 March 2019 - 00:00 By SUNDAY TIMES


Health minister Aaron Motsoaledi has earned a reputation as one of the straighter arrows in the executive. Despite it being widely acknowledged that the public health system is a mess, and that our hospitals are often badly managed, unhygienic and run by trade unions that can hardly be said to have the best interests of patients at heart, Motsoaledi has largely escaped the wrath of critics.
In two areas, however, Motsoaledi has attracted growing criticism. And rightly so.
The first is his handling of the mooted introduction of a National Health Insurance (NHI) scheme, which critics have said amounts to a nationalisation of SA's health services but which the minister has punted as a necessary measure to equalise the standard of health care offered to South Africans regardless of their socioeconomic circumstances.
In this effort he has been singularly unsuccessful. As the years pass, the NHI has remained a blur, and Motsoaledi has done little to clarify the outlines of this grandiose project. He has entangled himself in running battles with the private health-care industry, whose very existence would seem to be in the balance if he has his way.
Today, in Business Times, we report on Motsoaledi's latest contribution to the NHI debate, in which he, incredibly, urges us not to worry about what the NHI will cost.
"When we want to implement a particular programme of the NHI, we will cost it. I'm not saying that there is going to be no costing, but I'm saying costing the whole programme of NHI for the whole population over a lifetime period, you can't do." Perhaps that's how a doctor asks a for a blank cheque.
The second is that having picked his fight with the health-care industry, why not also take issue with the very people the health system is meant to cater to, and who better to vilify than foreigners, who are routinely blamed by desperate politicians for crime, for stealing jobs, wives and houses and - perhaps their greatest "offence" - selling goods at prices below which the local spaza shops are selling them?
So, it is unsurprising in an election year, when the ANC's record on delivering "a better life for all" will face scrutiny, that foreigners could become a convenient scapegoat for covering up shortcomings.
Motsoaledi has already earned something of a reputation in the foreigner-bashing department. For example, he told a National Education, Health and Allied Workers' Union's nurses' summit last year: "The weight that foreign nationals are bringing to the country has got nothing to do with xenophobia . it's a reality.
"Our hospitals are full, we can't control them. When a woman is pregnant and about to deliver a baby, you can't turn her away from the hospital and say you are a foreign national . you can't. And when they deliver a premature baby, you have got to keep them in hospital."
Today, we report on astonishing events at the department of health, arising out of attempts in the department to get foreign nationals to pay for their own treatment at state hospitals. Apparently a junior official "jumped the gun" by issuing an instruction to turn foreign nationals away from hospitals if they did not pay for their treatment upfront.
The department has now beaten a hasty retreat from this directive, even though it has been in existence for two weeks. Apart from being unconstitutional and unlawful, it goes against the spirit of what SA and its constitution represent. Of course, the department is not exactly helped by a government that is at one turn the great friend of Africa, and at another surfing on a wave of supposed populist resentment of foreigners.
Perhaps, though, if the department paid more attention to fixing our hospitals in such a way that they reflected the vast amounts of funding and human capital poured into them annually, instead of looking for scapegoats and picking on desperate poor people, SA may start providing the health service our people deserve.

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