Universal accessUniversal access
A critical factor in our ability to ensure universal access to health care is equity in the distribution of resources.
Bluntly put, it is our ability to overturn the huge imbalance in resources between the private and public sectors, on the one hand, and between urban and rural areas on the other.
We have tackled this in two ways, firstly by redistributing financial and human resources in the public health sector and secondly, by legislation that encourages more efficient use of health resources in the private sector.
The impact of initiatives for redistribution in the public sector is visible:
Most of the 900 new clinics we have built are in rural areas.
There is a narrowing in gap between the health spending of best-resourced provinces - Gauteng and Western Cape and that of the least developed rural provinces.
Through community service and government-togovernment agreements, we have improved the professional staffing of rural facilities quite dramatically. This year alone, more than 3 000 young graduates are doing community services and the proportion in rural areas is the highest yet. And we introduced a unique system of allowances for 33 000 health professionals in rural areas and 66 000 professionals who have skills that are in scarce supply.
Despite all these measures, the health gap between the major cities and rural towns remains unacceptably high.
We need to boost the rural areas further and we cannot do this simply by siphoning grants from the urban areas. We would seriously urge Parliament to look more closely at the size of the health pie and at the relatively low priority that certain provinces attach to health care as a percentage of global social spending.
We seriously need to consider whether we can achieve peace, progress, social justice and better quality of health care on the current spending levels.
Health legislation
Various laws have been passed to safeguard private sector health consumers and promote better value formoney in that sector. These include the Medical Schemes Act and the Medicines and Related Substances Control Amendment Act of 1997, which advance the cause of more affordable and quality medicine.
The National Health Bill replaces the old Health Act of 1977 and ensures that the health sector is in line with theConstitution.
This Bill lays the foundation for rational health planning and the proper coordination of all the elements of the public and private health sector, and from this perspective of national interest, it requires that all health establishments be certified to provide health services.
Health care cannot be left to the whims of the market. Government has stewardship to ensure that every citizen has equal access to quality health services. The health agenda in the first decade of democracy has, necessarily, asserted the health rights of the poor and of vulnerable groups.
In order to fulfill our Constitutional mandate of access to health care for all, we have at times challenged the established practices of powerful interest groups. This action has not been malicious. It has been intended to serve the greater good.
The next ten years
During the next decade, we will focus on the following priority areas:
We will improve our understanding of the causes of deaths in South Africa in order to ensure proper planning and appropriate allocation of resources;
We will accelerate the revitalization of health facilities to reverse apartheid planning;
We will improve human resource planning and training to deal aggressively with the shortages and fair distribution of health workers throughout the National Health System.
We will implement a comprehensive school health programme as this will lay the foundation for health promotion among the youth;
We will accelerate the programme of making sure that medicines are available to all South Africans at an affordable price;
The goal of achieving equity between rich and poor, between urban and rural, between provinces and within provinces, will continue to drive our health sector reform programme;
We will increase the pool of those who havemedical aid and protect them against unscrupulous schemes.
We will promote solidarity in health by ensuring those who can afford contribute to the health of the poor and indigent.
The new decade is a new opportunity!
Dr Manto Tshabalala-Msimang
Minister of Health