SA: costly private care for privileged – second-rate care for everybody else

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THE upcoming International Nurse’s Day in South Africa, on Sunday May 12, will see the life-saving profession hailed as quiet heroines and heroes who save lives while working long hours for low pay.

The NEHAWU nurses union commented: ‘We salute these courageous and compassionate workers who do a sterling job everyday in delivering a much needed service to the sick of our country.

‘They courageously and diligently perform their responsibilities despite working in adverse working conditions.

‘This proves that our nurses are silent heroes and heroines, who need to be acknowledged and appreciated more and not be derided and second guessed everyday.

‘It is abominable to hear some economic commentators calling for the moderation of their wages and downplaying their role, because they do not work in a profit-making sector.

‘NEHAWU appreciates the role the nurses have played to heal the nation and improve the health status of our people, especially the increase in life expectancy from 57 to 60.

‘This is acknowledged to be one of the most rapid improvements in life expectancy that has been recorded.

‘We have also saluted the improvement in infant mortality.

‘Internationally, reports have consistently shown that there is a universal shortage of nurses.

‘The profession of nursing as a whole is overloaded, because of the nursing shortage.

‘They are overloaded by the number of patients they oversee.

‘They are overloaded by the number of tasks they perform.

‘They work under cognitive overload, engaging in multitasking and encountering frequent interruptions.

‘These foot soldiers are leading the fight against AIDS, TB and other fatal diseases.

‘They are the backbone of the re-engineering of primary healthcare and the rollout of the NHI in identified pilot sites.

‘In the nursing profession we have had such heroines as Cde Charlotte Maxeke and Cde Albertina Sisulu. In their memory, we recommit ourselves to work for better working conditions for all nurses.’

Meanwhile the Congress of South African Trade Unions has welcomed the announcement by Comrade Ebrahim Patel, the Minister of Economic Development, that the Competition Commission is to investigate the private healthcare sector.

The Minister told the Parliament on Wednesday 7th of May 2013, that ‘various stakeholders’ have raised concerns about pricing, costs and the state of competition and innovation in private healthcare.

‘Early evidence showed high prices and market distortions and that in some cases competition was prevented, distorted or restricted.’

He pointed out, that: ‘Competition authorities had ruled previously that the practice of setting common tariffs for medical procedures was uncompetitive.

‘In reality we’ve seen a growing trend of healthcare prices and cost increases and some commentators have made the point to us that health markets contain a massive concentration of power.’

A report in 2009 revealed that health expenditure in South Africa was 8.51% of GDP, much higher than the 5% recommended by the World Health Organisation.

However, that 8.51% is spent in a grossly inequitable way.

According to the National Treasury’s Fiscal Review for 2011, the GDP spend on health was split as follows:

R120.8 billion (48.5%) in the private sector, which covers just 16.2% of the population or 8.2 million people, many of whom have medical cover.

R122.4-billion (49.2%, only a fraction more) in the public sector, which is made up of 84% of the population, or 42 million people who generally rely on the public healthcare sector.

The remaining R5.3-billion (2.3%) is from donors and NGOs.

COSATU agrees with the Minister that the underlying problem was ‘uncontrolled commercialisation, whereby tenders come first and healthcare comes last’.

He added: ‘Inflation on items was costing medical aid companies about R2-billion a year and had resulted in escalated medical premiums.

‘In desperation, medical aids were reducing benefits “further and further”. The regulation of the private sector proved to be difficult. There is only one loser and it’s the patient.

‘When medical aids don’t pay in full, the patient is still the loser. While premiums are increasing, patient care is declining.’

The federation agrees in particular with his insistence that ‘health is a public good and not just any other commodity’, and echoes the minister’s comment that ‘there were two types of healthcare:

‘Costly private care for the privileged.

‘Second-rate care for everyone else.

‘Medical aid schemes punish the poor. Healthcare is simply becoming unaffordable to the people in the world.’

This is exactly what the federation refers to as the unacceptable ‘two-tier’ provision of service, in healthcare and other public services like education and public transport.

‘We welcome the pilot schemes already launched and call for the full scheme to be rolled out as quickly as possible,’ said COSATU.

‘In the meantime, however, while many people are still forced to depend on the private sector, COSATU fully backs the move to investigate possible price-fixing and to make sure that patients get full value for their money.

‘Should any companies be found guilty of collusion, their CEOs should be imprisoned,’ COSATU insist.

‘The solution to this crisis in our health service is the implementation of National Health Insurance (NHI), which will provide quality healthcare to all South Africans regardless of their income or employment status.’

However, nothing will change until the South African working class carries out a socialist revolution that expropriates the bosses and the bankers and brings in a socialist planned economy based on satisfying peoples needs and not providing super profits for the bosses and the bankers.

With sadness, the Democratic Nursing Organisation of South Africa (DENOSA) has pointed out that a report released by Save the Children South Africa shows that 21 babies die in SA soon after birth every day, due to preventable causes.

This report highlights the need for the country to focus on training more midwives in the country.

However, DENOSA has consistently opposed nurses who aren’t trained midwives being allocated to the maternity sections of hospitals.

Allocating non-midwives to maternity sections only increases the risk of seeing more babies dying.

This report is a bitter taste for South African nurses, who are joining nurses from around the world in celebrating International Nurses Day on Sunday the 12th of May.

South Africa, with its massive human potential and vast natural wealth, desperately needs a socialist revolution to create the conditions for a better life for all.