Month: June 2018

With the release of the White paper for public comments, this provides an opportunity to listen and discuss with each other as South Africans to find the best way/s to translate the NHI within our context. We dare not fail on this ambitious challenge.

South Africa’s NPC recommended Universal Health Care (NHI) as the policy option in 2012, almost 3 years before the UN and WHO, as part of its recommendation to address the triple challenges of Poverty, Inequality and Unemployment. This was endorsed by all political parties in Parliament and must now be implemented.

In the 70 years of the UK’s NHS existence, there has never been a debate or question in Britain about whether the NHS should exist or not or that it should be reviewed.

Over the 70 years of the UK’s NHS existence passionate debates have and continue to take place on matters of governance, manpower (human resources), leadership and funding. These are real painful implementation issues, all meant to improve the functioning and better translation of the NHS concept in reality on the ground.

The current Minister of Health has led and championed Universal Health Care. He started the race, led the race and must complete the race. Translated properly, the NHI will not only address all the challenges we currently face within the Health System but also transform the system fundamentally and progressively Quality Universal HealthCare (NHI) will not be cheap and has never been cheap anywhere but must be implemented without further delays. NHI is the most important and only transformative process of our health System needed. The rich of our country must subsidise the poor to establish and provide universal health care. They must shoulder this responsibility with pride.

1. The National Health Service (NHS) was born on July 5th 1948 out of a long-held ideal that good healthcare should be available to all, regardless of wealth. When health secretary Aneurin Bevan opened Park Hospital in Manchester it was the climax of a hugely ambitious plan to bring good healthcare to all and in so doing transform the health system of the UK.
2. For the first-time hospitals, doctors, nurses, pharmacists, opticians and dentists were brought together under one umbrella organization, the NHS, that is free for all at the point of delivery. The central principles were clear: the health service will be available to all and financed entirely from taxation, which means that people pay into it according to their means. The rich must subsidise the poor to establish and provide universal health care.
3. It was the British response to address the severe effects of the 2 wars and great depression that had left the nation with severe Poverty and Inequality (“Health Disparities”).
4. Little was realized then that the NHS would become an important model for equitable access to Universal Health Care. Universal Health Care started in Norway in 1912.
5. Harry Leslie Smith, a 91-year old RAF veteran, born into an impoverished (poor) mining family remembers life before the NHS as a life/existence of “Hunger, filth, fear and death” and unemployment.
6. Many Notable Achievements since its establishment.

2009 – New NHS Constitution

The NHS Constitution was published on January 21 and sets out your rights as an NHS patient. The NHS Constitution was published on January 21 2009. For the first time in the history of the NHS, the Constitution brings together details of what staff, patients and the public can expect from the NHS. It aims to ensure the NHS will always do what it was set up to do in 1948: provide high-quality healthcare that’s free and for everyone.

2009 – New Horizons programme launched

The New Horizons programme was launched to improve adult mental health services in England. New Horizons brings together local and national organisations and individuals to work towards a society that values mental wellbeing as much as physical health. It aims to cover a person’s lifetime, from building the foundations of good mental health in childhood to maintaining resilience in older age. It also emphasises the importance of prevention, effective treatment and recovery.

2009 – NHS Health Checks

The NHS Health Check was introduced for adults in England between the ages of 40 and 74. Primary care trusts begin implementing the NHS Health Check programme in April 2009. It has the potential to prevent an average of 1,600 heart attacks and strokes and save up to 650 lives each year. It could prevent over 4,000 people a year from developing diabetes and detect at least 20,000 cases of diabetes or kidney disease earlier, allowing people to manage their condition better and improving their quality of life.

The NHS is turning 70 years in 16 days time. The UK is thus 70 years ahead of us.

Since then, Universal Health Care has become accepted as norm and the best option to address the national challenges of Poverty and Inequalities (Disparities) in Health. In the USA it’s called Obamacare (2014). Over 100 countries have adopted or are in the process of moving into NHI.

The WHO has declared Universal Health Care as best and only policy option to address Health Inequities globally and so has the UN in its Sustainable Development Goals, SDG 3: Ensure healthy lives and promote wellbeing for all at all ages.

South Africa’s NPC recommended Universal Health Care (NHI) as the policy option in 2012, almost 3 years before the UN and WHO as part of its recommendation to address the triple challenges of Poverty, Inequality and Unemployment. This was endorsed by all political parties in Parliament.

In the 70 years of the NHS existence, there has never been a debate or question in Britain about whether the NHS should exist or not or that it should be reviewed.  As South Africans. we should therefore not focus our discussion or debates on accepting the principle or the concept of Universal Health Care. We should take this as a given.

Like in many countries, the concept should be accepted as it offers the only and best option currently available. The NHI is in line with our Constitution and NHA. It is the most transformative concept to our Health System since the dawn of our democracy.

1. The current Minister of Health has led and championed Universal Health Care. He started the race, led the race and must complete the race. Translated properly, the NHI will not only address all the challenges we currently face within the Health System but also transform the Health system progressively and fundamentally.
2. Over the 70 years of the NHS’s existence debates have and continue to take place on matters of governance, manpower (human resources), leadership and funding. These are real implementation issues, all meant to improve the functioning and better translation of the NHS concept in reality on the ground.
3. With the release of the White paper for public comments this provides an opportunity to listen and discuss with each other to find the best way/s to translate the NHI within our context. We dare not fail on this ambitious challenge.

10 June 2018

Following the release of the OHSC 2016/17 annual inspection report on 5 June 2018, and the subsequent enquiries following the release of the report, the OHSC promised to engage further with the media.

This press briefing is aimed at clarifying certain sections of the report, mainly the interpretation of the scoring.

The Office has regulatory powers by law and assess facilities with established norms and standards, issue guidance to the norms and standards, certify facilities as compliant or non-compliant with norms and standards, monitor compliance and further receive and investigate complaints, the function of the Health Ombud. This is achieved through conducting unannounced inspections in facilities; health facilities are not pre-warned of the Office’s inspections.

It is important to mention that inspections are a snapshot in time, therefore findings will be for that particular moment an inspection is undertaken in a facility; however, what is required for patient safety and uninterrupted service delivery is consistent compliance with standards. In order for the OHSC’s inspection programme to achieve the best chance of this happening, the emphasis is on fostering the implementation of systems and processes within health establishments that will consistently deliver the desired outcomes. Therefore, the focus of the Office is not only to assess the outcome available at the time of an inspection, however, to encourage facilities to establish systems and processes to improve quality and safety.

The Methodology utilized by the OHSC Inspectors included, document review and analysis, observations, patient interviews, staff interviews and patient record assessment.

The Sampling of facilities for the 2016/17 inspections was opportunistic, the majority of facilities were the worst performing. There was also consideration of available resources such as the number of inspectors and the budget for the financial year.

Therefore, these findings should not be extrapolated as being representative of the overall performance of a province but should be used as a means of providing a glimpse or indication of performance in provinces.

Inspection tools developed from the National Core Standards (NCS) were used to assess health facilities. The NCS provide a common definition for quality and are based on the concept of Domains. A Domain is an aspect of service delivery where quality or safety can be at risk. A Standard is what is expected to be delivered in terms of quality care. These Standards are set high to promote patient safety and quality care. The inspections are designed to guide health establishments towards compliance with the norms and standards, in other words to highlight the steps and a process to be followed in order to achieve compliance.

The scoring framework considers scores in various functional areas in a health establishment and aggregated to determine a facility score. Facilities are then certified to be compliant or non-compliant with norms and standards using scores. There are six categories of the scoring framework; the first score is the highest =/>80% for a compliant health establishment. Scores between 70-79%, (compliant with a requirement); scores between 60-69% (conditionally compliant); scores between 50-59% (conditionally compliant with serious concerns); scores between 40-49% (non-compliant) and scores <40% (critically non-complaint).

Breakdown of scores of the 696 inspected in facilities in financial year 2016/17:

Total number of health establishments inspected = 696

• 80%: 5Health Establishments (2 clinics and 3 hospitals)
• 70-79%: 32Health Establishments (24 Clinics and 8 Hospitals)
• 60-69%: 79(64 Clinics, 2 CHCs and 13 Hospitals)
• 50-59%: 168(146 Clinics, 12 CHCs and 10 Hospitals)
• 40-49%: 240(219 Clinics, 12 CHCs and 9 Hospitals)
• <40%: 172(165 Clinics, 4 CHCs and 3 Hospitals)

Out of the 284 health establishments, five (5) heath establishments were found to be compliant, 279 health establishments were found to be complaint with various requirements and conditions. In FY 2016/17, the OHSC conducted inspections in 696 public health facilities.

In 2014/15 inspections, the baseline was high for most provinces. In the subsequent 2015/16 inspections, provinces showed a decline in performance and in 2016/17 slight improvements were noted.

For more information contact: Ricardo Mahlakanya: Mobile. 066 473 8666, and Email. rmahlakanya@ohsc.org.za

8 June 2018

The Office of Health Standards Compliance (OHSC) presented the findings of its 2016/17 Annual Inspection Report on 05 June 2018 to the Portfolio Committee on Health. The report showed that there is some improvement in certain areas; stagnation and decline in other areas.

The OHSC invites members of the media to a media briefing to explain the findings of the report.

The media briefing will be held as follows:

Date: Sunday, 10 June 2018

Venue: South African Medical Research Building, Cnr Soutpansberg Road, and Theodore Howe Streets, Prinshoff, Pretoria

Time: 14:00

For more information contact: Ricardo Mahlakanya: Mobile. 066 473 8666, and Email. rmahlakanya@ohsc.org.za

6 June 2018

The Office of Health Standards Compliance (OHSC) wishes to distance itself from the misleading heading that appeared in the Business Day on the 6^th of June 2018, related to the report delivered by the OHSC in Parliament on the 5^th of June with the heading, public healthcare in shambles.

The OHSC presented a report that showed some improvement in certain areas; stagnation and decline in other areas. The report cannot be characterised as an indication that the healthcare system is “in shambles”.

The OHSC has further noted that the 80% scoring is regarded as a pass mark for heath establishments; and the Office will engage with the media to explain the scoring system used in the report.

Issued by the Office of Health Standards Compliance

For more information contact: Ricardo Mahlakanya: Mobile. 066 473 8666, and Email. rmahlakanya@ohsc.org.za

7 June 2018

I would like to put on record that there has been an unfortunate and distorted misrepresentation of my assessment as the Health Ombud of the state of the Health System by certain sectors of the media following my appearance on the Tim Modise Network. This had the effect to decontextualise and disassociate my assessment and my recommendation.

My clear intention and recommendation recorded on the Tim Modise Network was for the Minister of Health, Dr Aaron Motsoaledi to consider leading and convening a multi representative group to explore new ways for the renewal of the Health System. Unfortunately, this has been totally ignored and lost by most in the media, I hope these can be reflected in the current debate as they are on the record.

As stated in my Life Esidimeni Report: Our legislative framework requires urgent amendments as it gives concurrent powers to provinces and municipalities but when all fails, only a Minister who has limited powers is held alone to account.

Minister Motsoaledi has worked tirelessly to successfully implement the recommendations of the National Development Plan and in driving the further transformation of the Health System through the National Health Insurance.

Issued by the Health Ombud, Prof MW Makgoba

For more information contact: Ricardo Mahlakanya: Mobile. 066 473 8666, and Email. rmahlakanya@ohsc.org.za