ID HEALTH POLICY
Bridging the Health Divides
Challenges in the Health Sector
Health Policy has not been effectively implemented. Financial and human resources are sorely needed to achieve our policy ideals. Government officials need to be properly trained in understanding how to effectively empower communities.
Real per capita investment in health has declined by 14,1% between 1995 and 2002.The public health sector does not currently have the resources to provide satisfactory health care to the majority of South Africans who cannot afford medical aid. The number of people that are covered by medical aid is stagnating and as a percentage of the general population is actually declining. The increasing cost of private healthcare has exceeded inflation by so much that its high cost prevents it from growing anymore. There is currently no effective cooperation between the public and private sector aimed at improving the quantity and quality of healthcare received by the majority of South Africans.
There are huge inequities in the health system with only 34% of total health expenditure being public while 66% is private. The private sector has not been able to provide public health care on behalf of the state due to a closed ordering system that is not suitable for interaction with the private sector. The public sector therefore has to cope with the enormous strain caused by more and more people making use of its inadequate services.
There are only 35% of doctors catering for 35 million people in public health facilities; while 65% of doctors cater for the 7 million people who are covered by medical aid.
• The Independent Democrats believes not only in health care for all, but in adequate health care for all. Wide consultation within communities is needed to achieve equity of health services in order to determine which groups should be prioritized in policy action, as well as how much more preference they should receive compared to other groups.
On HIV/Aids
South Africa has the highest number of people infected with HIV and the prevalence is increasing. Many rape survivors are still not receiving free antiretroviral treatment due to government inaction.
• Effective Roll-Out of the ARV Programme: Government must reprioritize it’s spending by progressively investing in the provision of ARV’s and appointing and training the needed staff to treat HIV/AIDS patients.
• More Emphasis and Support for Community Health Care Workers: Auxiliary social workers like community workers and home-based carers also need to be supported and educated.
• Political will: The ID wants a national campaign where all senior government officials, members of parliament, etc. have themselves publicly tested (with the results remaining confidential)
• Government Resources: Every government ministry must have an AIDS directorate working with the Health Department in co-ordinating a national strategy.
• Treatment Awareness and Education: Current government programmes have clearly failed at stemming the tide of new infections and the ID would institute a complete overhaul.
On Rural Health Provision
There are massive urban-rural inequalities regarding access to health services.
Compulsory community service has failed to solve the staff problem in rural hospitals, with 83% of medical doctors still being placed in urban hospitals.
• Incentive payments for rural doctors.
• Establishment of a local government infrastructure fund to acquire the needed facilities to attract more doctors to rural towns.
• Social Counselling in rural areas must be enhanced and people educated on all aspects of health.
• Ambulances that have off-road capabilities must be urgently provided in all rural areas that do not have adequate road infrastructure.
On TB
The number of TB cases in South Africa has massively increased from 109 328 in 1996 to 255 773 in 2003. Cure and successful treatment rates are disappointing at 53, 9% and 67, 8%. There is a lack of transparency in the financial expenditure on TB. We have failed to address the conditions (i.e. poverty, lack of adequate sanitation, poor nutrition, etc) that serve as a breeding ground for the disease. HIV/AIDS is exacerbating the problem. Our health system is under-resourced to deal with TB and other similar diseases. Health providers are not implementing the TB programme effectively and TB patients fail because of their ignorance, delay in seeking care, non-adherence to or completion of treatment regimens.
• The Independent Democrats will unify laboratories under a national collaborative TB detection and treatment plan.
• Financial control of TB must be transparent.
On Child Health
According to a Medical Research Council (MRC) study in 2000, South Africa’s Infant mortality rates are 60/1000, and under five mortality rates are 95/1000.This means that every hour at least 10 children under the age of five die from a preventable condition.
Poor children suffer disproportionately with the poorest 20% of children being four times more likely to die before their fifth birthday compared to the richest 20% of South Africa’s children. If drastic action is not taken soon, South Africa will certainly miss its Millennium Development Goal target.
• All aspects of neo-natal care must be evaluated to reduce South Africa’s under-5 infant mortality rate.
• The delivery of basic municipal services such as water and sanitation must be improved in order for many child illnesses to be prevented.
• The Independent Democrats call for child and youth desks to be available in all government departments to deal with the health and well-being of children and youth in a holistic way.
• The Independent Democrats also supports the active engagement of civil society on policy reform concerning the state of child deaths. This must be carried out by Parliament on an annual basis.
• PMTCT: There must be programmes put in place to encourage all pregnant women to seek counseling and testing for HIV with appropriate information and access to PMTCT being made available. Adequate support and treatment must also be provided after the birth of the baby.
On Disability
ID believes that we need to shift our focus on disabled people as “poor helpless individuals” to addressing the factors in society that continue to exclude and marginalise people with disabilities.
• The ID calls for properly trained staff to be appointed in the public health sector to assist the disabled with proper medical care and rehabilitation.
• More assistive devices and wheelchairs must be made available, especially in rural areas.
• More occupational therapists and physiotherapists need to be deployed to rural areas along with the proper specialized equipment that they need.
• There must be better administration of the Workman’s Compensation Fund and the Road Accident Fund.
• A National health audit must be conducted to evaluate the extent of accessibility to clinics for the disabled.
• ID will also call on government to ensure that patients with spinal cord injuries receive adequate health care and rehabilitation.
Health Policy has not been effectively implemented. Financial and human resources are sorely needed to achieve our policy ideals. Government officials need to be properly trained in understanding how to effectively empower communities.
Real per capita investment in health has declined by 14,1% between 1995 and 2002.The public health sector does not currently have the resources to provide satisfactory health care to the majority of South Africans who cannot afford medical aid. The number of people that are covered by medical aid is stagnating and as a percentage of the general population is actually declining. The increasing cost of private healthcare has exceeded inflation by so much that its high cost prevents it from growing anymore. There is currently no effective cooperation between the public and private sector aimed at improving the quantity and quality of healthcare received by the majority of South Africans.
There are huge inequities in the health system with only 34% of total health expenditure being public while 66% is private. The private sector has not been able to provide public health care on behalf of the state due to a closed ordering system that is not suitable for interaction with the private sector. The public sector therefore has to cope with the enormous strain caused by more and more people making use of its inadequate services.
There are only 35% of doctors catering for 35 million people in public health facilities; while 65% of doctors cater for the 7 million people who are covered by medical aid.
• The Independent Democrats believes not only in health care for all, but in adequate health care for all. Wide consultation within communities is needed to achieve equity of health services in order to determine which groups should be prioritized in policy action, as well as how much more preference they should receive compared to other groups.
On HIV/Aids
South Africa has the highest number of people infected with HIV and the prevalence is increasing. Many rape survivors are still not receiving free antiretroviral treatment due to government inaction.
• Effective Roll-Out of the ARV Programme: Government must reprioritize it’s spending by progressively investing in the provision of ARV’s and appointing and training the needed staff to treat HIV/AIDS patients.
• More Emphasis and Support for Community Health Care Workers: Auxiliary social workers like community workers and home-based carers also need to be supported and educated.
• Political will: The ID wants a national campaign where all senior government officials, members of parliament, etc. have themselves publicly tested (with the results remaining confidential)
• Government Resources: Every government ministry must have an AIDS directorate working with the Health Department in co-ordinating a national strategy.
• Treatment Awareness and Education: Current government programmes have clearly failed at stemming the tide of new infections and the ID would institute a complete overhaul.
On Rural Health Provision
There are massive urban-rural inequalities regarding access to health services.
Compulsory community service has failed to solve the staff problem in rural hospitals, with 83% of medical doctors still being placed in urban hospitals.
• Incentive payments for rural doctors.
• Establishment of a local government infrastructure fund to acquire the needed facilities to attract more doctors to rural towns.
• Social Counselling in rural areas must be enhanced and people educated on all aspects of health.
• Ambulances that have off-road capabilities must be urgently provided in all rural areas that do not have adequate road infrastructure.
On TB
The number of TB cases in South Africa has massively increased from 109 328 in 1996 to 255 773 in 2003. Cure and successful treatment rates are disappointing at 53, 9% and 67, 8%. There is a lack of transparency in the financial expenditure on TB. We have failed to address the conditions (i.e. poverty, lack of adequate sanitation, poor nutrition, etc) that serve as a breeding ground for the disease. HIV/AIDS is exacerbating the problem. Our health system is under-resourced to deal with TB and other similar diseases. Health providers are not implementing the TB programme effectively and TB patients fail because of their ignorance, delay in seeking care, non-adherence to or completion of treatment regimens.
• The Independent Democrats will unify laboratories under a national collaborative TB detection and treatment plan.
• Financial control of TB must be transparent.
On Child Health
According to a Medical Research Council (MRC) study in 2000, South Africa’s Infant mortality rates are 60/1000, and under five mortality rates are 95/1000.This means that every hour at least 10 children under the age of five die from a preventable condition.
Poor children suffer disproportionately with the poorest 20% of children being four times more likely to die before their fifth birthday compared to the richest 20% of South Africa’s children. If drastic action is not taken soon, South Africa will certainly miss its Millennium Development Goal target.
• All aspects of neo-natal care must be evaluated to reduce South Africa’s under-5 infant mortality rate.
• The delivery of basic municipal services such as water and sanitation must be improved in order for many child illnesses to be prevented.
• The Independent Democrats call for child and youth desks to be available in all government departments to deal with the health and well-being of children and youth in a holistic way.
• The Independent Democrats also supports the active engagement of civil society on policy reform concerning the state of child deaths. This must be carried out by Parliament on an annual basis.
• PMTCT: There must be programmes put in place to encourage all pregnant women to seek counseling and testing for HIV with appropriate information and access to PMTCT being made available. Adequate support and treatment must also be provided after the birth of the baby.
On Disability
ID believes that we need to shift our focus on disabled people as “poor helpless individuals” to addressing the factors in society that continue to exclude and marginalise people with disabilities.
• The ID calls for properly trained staff to be appointed in the public health sector to assist the disabled with proper medical care and rehabilitation.
• More assistive devices and wheelchairs must be made available, especially in rural areas.
• More occupational therapists and physiotherapists need to be deployed to rural areas along with the proper specialized equipment that they need.
• There must be better administration of the Workman’s Compensation Fund and the Road Accident Fund.
• A National health audit must be conducted to evaluate the extent of accessibility to clinics for the disabled.
• ID will also call on government to ensure that patients with spinal cord injuries receive adequate health care and rehabilitation.
