Tag: South Africa

Categories : Healthcare Politics and Regulations Medical IndustryTags :

Only with Both the Private and Public Sectors Working Together Will NHI Succeed

On By ModernMedia
Photo by Hush Naidoo Jade Photography on Unsplash

For National Health Insurance to succeed in South Africa, a meaningful collaboration needs to take place between private and public health care so as to speed up the implementation of the initiative and overcome major obstacles.

This was the opinion of the five panellists who on the first day of the Hospital Association of South Africa conference in Cape Town spoke of how best the NHI could be rolled out by calling on private health care for assistance.

“’It’s fundamental to the economic growth that we so desperately need in South Africa, and a productive nation needs access to health care. So we do need to address the inequalities, we need to address the gap and do not need to preserve the status quo,” said Professor Roseanne Harris, of Discovery Health.

But a concern she raised is the risk of the introduction of a single funding model reliant on taxes, and the introduction of a monopoly market.

“And one of the implications of the bill is centralisation (of health care). There is a need for planning to ensure that it won’t have an unintended consequence of impacting service delivery and impacting on the rights of the healthcare personnel,” she added.

Harris said that both the private sector and public sector needed to go through a consultative process and that sustainable critical milestones needed to be put in place to hold the process to account.

Another panellist at the event Dr Simon Strachan of the South African Private Practitioners Forum (SAPPF), pointed out that the COVID pandemic showed how public and private health care could collaborate successfully.  Here service agreements between the two entities were met and were focused solely on fighting the pandemic.

“So to create the way forward, what we need to be able to do is to have a very clear understanding of what it is we’re trying to achieve, that there is robust trust, and that there is a groundwork for sustainable collaboration,” he explained.

An urgent need for this collaboration he said was the recent introduction of Section 33 of the NHI bill, which in its present form would have health care professionals working for the state at a fee the state sets, with benefits not included.

A second issue he said was the need for a successful funding model that will be acceptable to all South Africans.

Economist Nicola Theron of FTI consulting told the audience that structures already in place and used in the private sector could make for a smoother transition for the NHI. In particular when it comes to issues like the pricing of medicines.

“We are now at a point with the current NHI that there are talks about the lowest possible price at a reasonable return for healthcare providers. There is no indication of what return means,” she said.

“But what we have is an existing system of pricing which has been developed over time, and which should form the basis of pricing going forward,” said Theron.

By not getting the pricing right could lead to investment leaving South Africa, she warned.  She suggested in turn that it would be a better model to have multiple buyers that will stimulate competition.

Dr Ali Hamdulay, CEO, Metropolitan Health, said that a way forward would be to implement the suggestions that came out of the Health Marketing Inquiry that took a hard look at both the public and private health care systems, outlining the problems with both.

“So effectively by addressing the recommendations of the Health Market Inquiry  you’re actually foster an environment of culture and direction to work towards universal health care,” said Hamdulay.

Barry Childs, of Insight Actuaries, said that while fundraising mechanisms in the public sector needed to be improved, the introduction of the NHI offers a great opportunity to reform the healthcare system.

“As much as we talk about the need for reform of the private sector side, there’s been no meaningful reform of the public sector for many decades. And the NHI is a wonderful opportunity for them to introduce some better, more responsive financing mechanisms.” he said.

But for NHI to ultimately provide the services it promises, Childs said South Africa’s economy needed to improve, and more jobs to be created.

Source: Hospitals Association of South Africa

Categories : Environmental EffectsTags : 2 Comments

Opinion Piece: The Harsh Reality of South Africa’s Ongoing Sewage Crisis and its Undeniable Link to Drinking Water Quality

On By ModernMedia
Photo by Hush Naidoo Jade Photography on Unsplash

By Gerhart Britz, Director at Sanitech

South Africa’s sewage crisis has dire consequences for public health, waterways, and ecosystems. Outdated and poorly maintained wastewater infrastructure due to insufficient investment is one factor that results in poor waste management. The strain of rapid urbanisation with inadequate sanitation facilities in informal settlements and the exacerbating impact of climate change through increased rainfall events are also factors that contribute to poor waste management. Despite these challenges, there is room for optimism. Collaborative efforts between government and the private sector have the potential to address this dire situation, bringing forward practical, affordable solutions that hold the promise of a cleaner, healthier future for all communities.

A public health crisis: deadly waterborne diseases

South Africa’s persistent sewage crisis recently sparked a new cholera outbreak, primarily stemming from dysfunctional municipal sewage systems. Over 90% of the nation’s 824 treatment plants discharge untreated or partially treated sewage into our limited water resources. As of June 2023, the Department of Health had documented 1,045 suspected cholera cases across five provinces, with 197 cases confirmed by laboratory testing, directly linked to compromised water supply.

This crisis disproportionately impacts both urban and rural regions, where access to clean water and sanitation remains a pressing concern. Impoverished communities often rely on highly polluted water sources contaminated by sewage from overwhelmed treatment plants, further straining water purification efforts to meet safety standards. Recognising the intrinsic connection between drinking water quality and wastewater treatment is crucial, necessitating immediate attention and resolution.

However, a significant challenge faced by South African communities is the prohibitive cost of implementing waterborne sanitation solutions everywhere. With over four million latrines and roughly 50 million people lacking adequate sanitation, conventional waterborne systems are neither viable nor cost-effective comprehensive solutions.

South Africa’s water quality reports: red flags aplenty

The Blue Drop Report 2023, released in June 2023, paints a concerning picture of South Africa’s drinking water quality. While major cities maintain safe water, outlying areas face contamination and infrastructure challenges. Key statistics from the report reveal that the average Technical Site Assessment (TSA) score for water treatment systems is 69%, indicating partial functionality. About 15% of water supply systems are in poor or critical condition, with only 33% having Water Safety Plans, posing significant risks to water quality. Additionally, 50% of municipalities struggle with bad or poor microbiological water quality.

Wastewater and water wasting: two major risks

The 2023 Green Drop Report assesses wastewater treatment systems, showing a decline with an average score of 50%. Regional disparities persist, with Eastern Cape and Limpopo scoring lowest, while the Western Cape and Gauteng lead. The No Drop Report examines water losses, revealing a decline in overall performance in 2023, with an average score of 65%, which means that one-third of supplied water is wasted before it reaches consumers.

These reports collectively underline the urgent need to enhance drinking water quality in South Africa. Municipalities must focus on prioritising infrastructure maintenance and upgrades, implement risk-based water quality management, and strengthen compliance with standards. The Department of Water and Sanitation must offer more support to municipalities. Failing wastewater treatment facilities exacerbate drinking water purification, risking tap water safety and triggering further potential health and environmental crises. Therefore, they must take steps to safeguard water quality and address sewage infrastructure issues.

Rapid crisis intervention required

South Africa’s sewage crisis is a dire challenge that requires immediate action and innovative solutions. In recognising the inextricable link between sewage waste management and water quality, we must also acknowledge that this crisis cannot only be addressed by government without support from private sector industry leaders and experts. Portable water treatment package plants are available, along with small filtration and sterilisation systems for communities. Wastewater packaged treatment plants and solutions can help both alleviate immediate concerns and contribute to long-term sewage management strategies. Further neglecting the sewage problem and the critical maintenance of existing infrastructure will only deepen our water crisis. For this reason, the government needs to prioritise investment in sewage treatment infrastructure and implement practical, affordable solutions across all communities.

Mitigating South Africa’s sewage crisis

If municipal water supplies deteriorate further, sanitation specialists will be required to step in with a range of interventions. These extend from portable water treatment packaged plants to improve water quality at its source, to small-scale filtration and sterilisation systems designed for household use to ensure safe drinking water directly from the tap. From a contamination perspective, it is critical to reduce sewage entry into water courses, particularly in rural areas and informal settlements. This can be achieved through enhanced sanitation solutions, such as dry sanitation toilets, which are waste-contained alternatives to pit latrines.

From immediate relief to sustainable futures

Interventions will need to consider both immediate and long-term strategies. For short-term relief, containerised package plants can bolster sewage treatment facilities without the need for extensive infrastructure development, alleviating the strain on existing systems. Simultaneously, sanitation providers in the private sector can aid municipalities in implementing long-term solutions, including megalitre plans that feature efficiently packaged treatment plants. By adopting these smaller, cost-effective alternatives, it is possible to achieve the same capacity traditionally associated with larger concrete plants, in a fraction of the time to avert total system collapse and the impending health and economic catastrophes that would surely follow.

Categories : Healthcare Politics and Regulations Respiratory DiseasesTags :

Opinion: This Court Case will Literally Determine whether Some People Get to Breathe

On By ModernMedia
Photo by Wesley Tingey on Unsplash

By Aneesa Adams for Spotlight

In a pivotal case for access to affordable medicines in South Africa, the Treatment Action Campaign (TAC) and Doctors Without Borders (MSF) Southern Africa – represented by SECTION27 – earlier this year came together to help champion access to lifesaving new cystic fibrosis treatments.

Cheri Nel, a South African woman living with cystic fibrosis, and the Cystic Fibrosis Association started legal action against Vertex Pharmaceuticals earlier this year, challenging Vertex’s monopoly on the treatments. The TAC and MSF approached the court to be joined as amici curiae. Vertex, an American pharmaceutical company, holds the patents for both Trikafta and Kalydeco – medicines that have the potential to significantly improve the lives of cystic fibrosis patients. However, at a price of US $311 000 per year per patient in the United States (over R5 million), it is out of reach for most people living with cystic fibrosis.

The court application is for a compulsory licence, which, if granted, will mean another manufacturer of generics for Trikafta and Kalydeco would be permitted to enter the South African market. In this case, it is likely that competition between manufacturers would affect the price of this medicine, thus making it more accessible. A compulsory licence allows the holder of the license to produce a patented product without the patent holder’s consent.

Johannesburg-based investment banker Cheri Nel is the driving force behind a court case that may result in dramatically expanded access to life-changing new cystic fibrosis (CF) medicines. PHOTO: Supplied

Spotlight previously reported that Nel’s lawyers argued that by failing to register or supply their CF medicines in South Africa, make them available in South Africa at reasonable prices, or license other companies to supply the medicines, Vertex is abusing its patents. They further argued that Vertex’s actions are violating the Constitutional rights of people with cystic fibrosis in South Africa, including the right to health care. (Spotlight previously reported on the issue here, here, and here.)

Cystic fibrosis is a devastating multi-system illness known for causing frequent and severe lung infections, liver and pancreatic damage, lung failure, and can result in the potential need for lung transplants even in children from as young as two years old.

This case will set an important precedent that can influence access to medicines not only in South Africa but around the world. The involvement of SECTION27, where I work, underscores the broader issue of affordable access to medicines and the impact of intellectual property on healthcare access.

At present, MSF and TAC are awaiting the court’s decision to be admitted as friends of the court, while in the main application, the respondent (Vertex) has filed answering affidavits.

And while the clock is ticking in the courts, many families in South Africa are waiting and holding on to the glimmer of hope access to this medicine represents. For many who live with cystic fibrosis, a successful outcome of Nel and the Cystic Fibrosis Association’s application will mean a life where they can breathe easier.

Among those waiting is 6-year-old Janco Koorts.

A journey of hope

His mother, Tanya Koorts, says living with cystic fibrosis is like fighting every day for every breath. She says Janco had been diagnosed with cystic fibrosis at the age of two. She has since been on a mission to raise awareness about this life-threatening disease. It is hope, her family, and the support from the cystic fibrosis community that has kept her going, she says.

Reflecting on the start of their journey in the Northern Cape, she says, “The knowledge about cystic fibrosis is very little. We were lucky that Dr Jooste at the Kimberly public hospital diagnosed him so early on. After that, he sent us to the Red Cross Hospital in Cape Town and so our long journey of hope started.”

Later in a new job in a new city, the Koorts began again in Pretoria. They started Janco’s treatment at the Steve Biko Academic Hospital and then moved to the Charlotte Maxeke Johannesburg Academic Hospital.

“They don’t have much, but they do everything they can there to help. They also don’t have a lot of support but the people at Charlotte Maxeke helped Janco on his journey to stay breathing,” Koorts says, applauding the public health system.

Janco now has comprehensive medical aid which covers his monthly R48 000 medication bill and Koorts says she can now “breathe easier”. That, however, is just a fraction of the cost of living with cystic fibrosis.

When the Koorts family heard about Trixacar, a generic version of Trikafta, it only strengthened their resolve to save Janco’s life. The patent rights registered by Vertex Pharmaceuticals in South Africa, however, do not allow for the import of Trixacar. Trixacar is produced by the pharmaceutical company Gador in Argentina. Koorts will thus have to travel to Argentina to buy the medicine. This will cost about R400 000 to cover the travel costs and six boxes of Trixacar that will last six months, she says. (You can help the family fund this by donating here.)

‘a thief of joy’

Apart from the financial burden, having a young child with cystic fibrosis has affected the Koorts family mentally and emotionally.

“Cystic fibrosis is a thief of joy. Nobody speaks about fighting to save someone’s life,” says Koorts.

She says her family had to adjust to some of the social changes in their surroundings as well.

“At school, he has to fight for himself to stay alive. If we go to a restaurant and there are people smoking, it affects him and we have to move. So, as much as we have tried to give Janco a normal childhood, these social aspects will always hinder progress, and he is always reminded that he is sick. But I live in hope and so does he.”

In terms of her family relationships, Tanya says that her other children are healthy and for them to see their baby brother suffering every day hurts them.

“It’s painful as parents. Janco needs all the attention. I can’t go to a parent’s evening for my other kids. It’s difficult,” Koorts says.

She says she is proud of Janco.

“My child doesn’t know that he is dying. We fight every day so that Janco can have just one more breath.”

And that is ultimately what it is all about. From one perspective the exchange of documents in the High Court may seem abstract and full of legal technicalities. But let there be no doubt, for kids like Janco it is literally their futures that are being decided.

*Adams is a communications officer at SECTION27.

NOTE: This opinion piece was written by a staff member of SECTION27. Spotlight is published by SECTION27 and the TAC, but is editorially independent – an independence that the editors guard jealously. The views expressed in this piece are not necessarily those of Spotlight.

Republished from Spotlight under a Creative Commons Licence.

Source: Spotlight

Categories : HospitalsTags :

Department of Health in Last-minute Bid to Avoid Stand-off with Nurses over Uniforms

On By ModernMedia
Photo by Jeshoots Com on Unsplash

By Marecia Damons for GroundUp

The Department of Health is scrambling to avoid a stand-off with nurses who have threatened to work in their own clothes if a dispute over the provision of uniforms is not resolved.

Since 2005, nurses had received an annual allowance to buy their uniforms. But this ended on 31 March this year, after a new agreement was signed in the Public Health and Social Development Sectoral Bargaining Council in terms of which they would get uniforms instead.

As a result, nurses did not get the usual allowance in April – R2600 a year, according to Spokesperson for the Democratic Nursing Association of SA (DENOSA) Sibongiseni Delihlazo.

Instead, they were supposed to be provided with uniforms by 1 October 2023. The agreement stated that in the first year, government must provide nurses with four sets of uniforms, one pair of shoes, and one jersey. In the second year, government must provide three sets of uniforms, one belt, and one jacket.

The plan was that the procurement process would be centralised. But at another bargaining council meeting, in June 2023, the health department said it would be difficult to provide the uniforms on time.

Then on 12 July, Sandile Buthelezi, director-general for the DOH, issued a circular to all provincial health departments notifying them that the uniforms would be provided from January 2024 to January 2025.

The circular stated that the DOH would use a decentralised approach to providing uniforms by using provincial tenders.

“Provincial heads are responsible for participating and facilitating in tender processes through the bid specification in terms of colour, fabric composition and garment, development, review of the policy and monitoring and evaluation,” Buthelezi wrote.

Until January 2026, the circular said, nurses would be expected to wear the new uniform from Monday to Thursday and wear their old uniform from Friday to Sunday. From January 2026, when they would have both years’ issue, nurses would be expected to wear the new uniforms every day.

DENOSA responded to this a week later, and said the department’s circular went against the bargaining agreement.

Delihlazo said they proposed that if the department is unable to supply the uniform by 1 October, they must pay nurses an allowance as previously.

If the department failed to provide uniforms or pay an allowance, DENOSA said, its 84 000 members would embark on an indefinite protest action by wearing their own clothes to work from 1 October.

Delihlazo said the yearly allowance did not cover the cost of a full uniform. “Their uniforms are tearing and the colour is fading. So how can you expect nurses to wear uniforms if you don’t pay them a uniform allowance?”

He said the tender process meant the colour of the nurses’ uniforms and the quality of the fabrics might differ from one province to the next. The process also “opens a window of opportunity for corruption,” Delihlazo said. “Money may be given for uniforms but the tender process is porous.”.

Then, at a last-minute meeting of the bargaining council last Thursday, the department proposed to put on hold the supply of uniforms until 2024, according to a DENOSA statement. Meanwhile the health department would pay nurses an allowance of R3,153 by 30 November.

DENOSA said the agreement should be signed by the end of the week. If not, the union said, nurses would work in their own clothes.

The health department did not respond to GroundUp’s questions.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Expert Opinion Medical IndustryTags :

Opinion Piece: Commemorating Carers Week: Putting the Spotlight on South Africa’s Unsung Heroes

On By ModernMedia

By Donald McMillan, Managing Director at Allmed Healthcare Professionals

Donald McMillan

The caregiving workforce plays a crucial role in our society, but their efforts often go unnoticed. These individuals, known as carers, selflessly care for those in need due to factors such as illness, age, or frailty. Unfortunately, they face numerous challenges that can take a toll on their well-being. It’s important to raise awareness of their struggles and provide them with the necessary support. To bring these issues to the fore, communities are coming together between the 2nd – 6th of October 2023 to commemorate Carers Week.

Caregivers have an enormous responsibility that often goes unnoticed by society. The emotional strain that comes with caregiving can have a direct impact on their mental health and often leads to depression. They often devote their time and interests to the role of voluntary caregivers and face many challenges due to the lack of recognition and support from their professional peers and society in general.

Initiatives in place

In response to these issues, governmental efforts have been put forth to assist both caregivers and non-governmental organisations with the aim of alleviating some of the financial burdens associated with their work. A noteworthy instance of this support is exemplified in the community home-based care program run by The Association for the Aged (TAFTA), which secures government funding to informal caregivers. This initiative and others like it, combined with the Carer’s Grant are part of positive strides being made within this space. However, further support is still needed to ensure that caregivers receive adequate support as they strive to provide high-quality care to their patients.

The government alone cannot be the only one providing support to carers as society and the private sector each have to role to play in alleviating the burden that sits on the shoulders of carers, particularly within impoverished and rural communities. The logical progression is for the government and all stakeholders to channel their resources into a comprehensive framework that encompasses financial aid, training, and support services for carers. Additionally, the pursuit of affordable and inventive caregiving solutions cannot be neglected.

Rising to meet growing demands

As South Africa’s population ages and chronic illnesses surge, the demand for caregiving services has swelled to unprecedented levels. To adequately address these escalating requirements, several measures must be adopted. Establishing community-based networks of support can furnish practical assistance and emotional solace. Carers must also receive enhanced training and upskilling to hone their capabilities, all the while being granted the acknowledgement and admiration they rightfully deserve.

It is imperative for entities that offer caregiving employment to invest in training to equip carers with the tools required for high-quality care provision. The integration of emotional counselling facilitated by clinical experts constitutes another crucial component of the caregivers’ support structure.

Strengthening the system

The symbiotic relationship between government bodies, stakeholders, and relevant associations is pivotal in reshaping the caregiving landscape. The collaboration between the Department of Social Development (DSD) and the South African Association of Homes for the aged- (SAAHA), exemplified by their joint registration of care workers both formal and informal, signifies a significant step toward accountability and much-needed assistance. The synergy of corporate involvement and government funding has the potential to revolutionise the lives of caregivers in both formal and informal capacities.

Upskilling the informal carer workforce stands as a cornerstone for improving the quality of caregiving. Creating and running specialised courses tailored for caregivers is essential, as it not only enriches their knowledge and competencies but also bolsters their confidence, employability, and job satisfaction. These comprehensive courses should span various aspects, from personal care to dementia management, empowering caregivers to confront their daily challenges head-on.

Galvanising society

As mentioned, support for carers should transcend the boundaries of governmental programs and corporate ventures. The broader society has a pivotal role in elevating the status of carers. Displaying empathy, extending practical aid, advocating for improved resources, and propagating awareness about the struggles of caregivers all fall within our capability as members of the public. Initiatives rooted in communities, campaigns, and programs can collectively reshape perceptions and extend tangible support.

Carers are one of the important pillars on which our society relies, and more need for recognition of their contributions and tribulations must be given. By advocating for increased support, enhanced financial backing, and inventive solutions, we can uplift carers and ensure their endeavours do not remain obscured. With the collective resolve of government bodies, stakeholders, businesses, and the populace, we can pave the path to a brighter, more nurturing future for carers and their cherished ones.

Categories : Environmental Effects HospitalsTags :

Netcare Group Signs Landmark Clean Energy Agreement

On By ModernMedia

Netcare well on track with environmental strategy targets

Photo by Sungrow Emea on Unsplash

In a tangible step towards further reducing its carbon footprint, the Netcare Group has successfully agreed commercial terms for a Renewable Energy (RE) Supply Agreement with independent clean energy solutions provider NOA Group Trading (NOA).

Netcare chief executive officer Dr Richard Friedland noted that the development is a significant milestone in realising the Group’s environmental sustainability strategy, which has made considerable strides since its implementation in 2013.

“Improvement of our energy efficiency initiatives remains a key focus area of this strategy. Netcare has also committed to procuring 100% of its purchased electrical energy from renewable energy sources by 2030, supporting the Race to Zero global campaign with targets that exceed the requirements of the Science Based Target initiative (SBTi) aimed at limiting global warming.

“This transaction represents Phase 1 of achieving this aim and includes six of our facilities where RE will be wheeled through the electricity grid from a combination of wind and solar farms, covering up to 100% of energy consumption at these facilities. This represents approximately 11% of the Group’s total energy consumption which is currently being supplied by Eskom’s predominantly coal fired power stations.

“In combination with other initiatives already implemented under Netcare’s sustainability programme, this transaction will increase the proportion of Netcare’s total energy consumption that is derived from RE sources to around 26%,” he says.

Dr Friedland noted that Netcare’s management teams are actively working towards finding viable solutions to supply RE to the remaining municipal-connected sites in the Group while continuing to build on existing renewable energy initiatives. The Group’s environmental sustainability programme also continues to demonstrate an impressive return on investment to date, illustrating the commercial opportunities in environmentally conscious engineering.

According to Karel Cornelissen, chief executive officer of NOA Group, renewable energy will be wheeled through the national grid to the six designated Netcare facilities via the existing Eskom distribution transmission network and delivery of renewable energy to these facilities is expected to commence by the first quarter of 2026. “The agreement represents a significant step towards a clean-energy future by one of South Africa’s healthcare industry leaders, and we are pleased to partner with Netcare on this crucial advancement,” he says. 

Netcare joined the Race to Zero global campaign in 2021 and was the first healthcare institution in Africa to do so. The campaign strives to rally leadership and support from businesses, cities, regions and investors for a healthy, resilient, zero carbon recovery that prevents future threats, creates jobs, and unlocks inclusive, sustainable growth.

“The devastation of climate change to the environment and among communities is already resulting in enormous hardship and tragedy not only in South Africa but around the world. We cannot sit idly by while this happens. Urgent action must be taken by implementing innovative solutions,” says Dr Friedland.  

“During the past decade, Netcare has actively been engaged in several planned energy, waste and water management initiatives. This meaningful transaction is yet another step towards implementing appropriate green solutions while contributing towards a healthier environment for the people of South Africa in the decades to come and beyond,” he concludes.   

Categories : Hospitals Medical IndustryTags :

Hospice Palliative Care Association Rebrands as the Association of Palliative Care Centres

On By ModernMedia

As of the 1st of September 2023, the Hospice Palliative Care Association (HPCA) is known as the Association of Palliative Care Centres (APCC).

“This rebranding is not just a visual change,” says Ewa Skowronska, CEO of the APCC. “It is an important message to all medical professionals and the public that our members (many of whom still refer to themselves as hospices) offer quality, specialised and expert palliative care services. Too many people equate hospice with end-of-life only and many medical professionals refer very late. This leads to thousands of patients, and their loved ones, missing out on the holistic support that palliative care provides – support that, ideally, should be from diagnosis of a life-threatening illness and not solely in the last few days of life.”

The rebrand includes a new logo element that reflects that palliative care can be provided alongside curative treatments and into end-of-life care, including bereavement support (if needed). 

“Our members adhere to the Standards for Palliative Healthcare Services, 4th edition, 2020 approved by the Council for Health Service Accreditation of South Africa (COHSASA) and the International Society for Quality in Health Care (ISQua),” says Leigh Meinert, Advocacy and Operations Manager of APCC. “This is important as sometimes there is a perception that our members are only servicing patients who do not have private healthcare support and might not be at the same level as private organisations. In reality, they have decades of palliative care experience, and compliance with these Standards ensures an ongoing level of excellence.”

As much as 90% of APCC member’s services are provided to the patient in the comfort of their own home. The patient’s loved ones are also supported by way of an interdisciplinary team. Such a team typically consists of a medical doctor, nurse, social worker, and home-based carers who can work alongside the patient’s healthcare professional and support quality of life.

Palliative care covers conditions such as HIV/AIDS, drug-resistant TB, chronic respiratory diseases, cardiovascular and neuromuscular diseases, MND and more. “Both adults and children are catered for,” says Meinert. “While patients can move in and out of a palliative care service, they may remain beneficiaries of the services for as long as they (or their loved ones) need or wish to.  Patients may be discharged from the service if they are doing well and able to function independently.  This is always negotiated between the patient, family, and members of the care team. We encourage patients to engage with an APCC member from the point of diagnosis as this helps to dispel fears and provides insight into the holistic services that can be offered. We believe that all patients have benefitted from an improved quality of life through the supportive care received from APCC members.”

“APCC has a cloud-based patient care monitoring, evaluation and reporting system able to report in detail on interventions given to any patient,” says Skowronska. “Our members are comfortable working alongside the primary clinician or specialist.  They can provide a supportive extension of care to the patient and their loved ones and, in most cases, the APCC members inter-disciplinary teams collaborate and work alongside the referring doctors who are treating the patient. They also provide supportive care to the patient’s loved ones. This may include advanced healthcare planning, as well as psychosocial and spiritual support.” 

“Our palliative care definition says it all,” concludes Meinert. “Palliative care is the physical, psychological, social and spiritual care provided by an interdisciplinary team of experts to anyone with a life-threatening illness and their loved ones. Care is offered from the point of diagnosis and extends to bereavement support if needed. Over 90% of the care that APCC members provide is home-based with a focus on promoting quality of life.

We sincerely hope that this rebranding results in more people receiving the support that they so desperately need during some of the most difficult times in a person’s life.”

For more info, visit www.apcc.org.za

Categories : Healthcare Politics and Regulations HospitalsTags :

Concerns Raised at Public Health Conference over Freezing of Healthcare Worker Posts

On By ModernMedia

By Luvuyo Mehlwana for Spotlight

Photo by Hush Naidoo Jade Photography on Unsplash

The National Treasury’s Cost Containment Letter sent to government departments instructing, among others, the freezing of posts was one of the big themes underlying talks about building South Africa’s healthcare worker capacity during the Public Health Association of South Africa’s (PHASA) conference held recently in Gqeberha.

With Finance Minister Enoch Godongwana expected to deliver the medium-term budget policy statement on 1 November, the freezing of posts will further hamstrung already strained health services, some presenters at the conference warned.

An oversight visit to TB hospitals by members of the provincial legislature (MPLs) in the Eastern Cape in the first week of September (5 to 8 September) showed just how bad the staff shortages are. The only remaining hospital in Nelson Mandela Bay dedicated to TB services, Jose Pearson Hospital in Bethelsdorp, has had staff vacancies hovering around 20% since 2019. The hospital provides dedicated TB services to the western part of the province. MPLs heard that in some other hospitals, vacancy rates are even higher, and non-filling of critical posts in some cases results in further medico-legal claims against the department, as the current staff buckles under massive patient loads.

Last year, in response to a parliamentary question, figures the health department released showed that there were 3 892 vacant healthcare worker posts in the province. In the nursing categories, there was a vacancy rate of 15.3%. For paramedics (EMS) the vacancy rate was 10.7%, medical practitioners 8.4%, and pharmacists 13.7%. By June this year, in another response relating to specialist nurses, the vacancy rate in the province had dropped to 13%.

Dr Prudence Ditlopo Senior Researcher at the University of the Witwatersrand, was presenting her research on the impact of nurse workloads and professional support on healthcare outcomes at the PHASA conference. Ditlopo said nurses already have a huge workload and issues around budget cuts impact morale. “I am sure they are asking themselves what will happen to [them] when we [they’re] already understaffed.

“This is not the first time that this monotonous cycle has been happening. Yes, we understand the economic side of it, but at the very same time, what does it say about the well-being of the nurse practice environment, the patients, and the quality of patient care? If nurses see that they are overwhelmed by the workload, they will make sure to find ways that will enable them to cope.

“Enable them to cope” means nurses will find a way that works for them. If what works for them is only seeing ten patients per day, they will do that and they will be gatekeepers for other patients who are coming to the facility. That alone will influence the quality and standard of care in primary care in South Africa,” said Ditlopo.

‘Will create more problems’

Dr Busisiwe Matiwane of the University of The Witwatersrand’s School of Public Health also weighed in on the implications of the Treasury letter.

“In the current system, health professionals have to work for the government to fulfil their community service obligations. However, it can be challenging for them to be assigned to specific hospitals when it is time for their community service. Additionally, with the government announcing a freeze on posts, many individuals who are not government-funded may be compelled to seek employment outside of the government after completing their community service,” Matiwane told delegates.

“If these posts are indeed frozen, does that mean that the government will also halt the placement of individuals who are required to complete community service? The current structure dictates that if you fail to fulfil your community service, you will not be recognised by the statutory bodies as an independent practitioner.

“The implication of this proposal by the government will create more problems, as we already face the challenge of health professionals’ placement or their community services,” she said. “The main concern is whether the posts will be frozen and what will be done. I think this concern has raised questions for many people, who wonder what it means if they are unable to complete their community service or the internship. Does it mean they cannot work?” she asked.

‘protect what is already there’

Speaking on the sidelines of the three-day conference, director of the Rural Health Advocacy Project, Russell Rensburg, said the wage agreement on a 4.5% increase for the public sector had Treasury’s back against the wall since that was not budgeted for in their February budget.

“Treasury is playing hardball and the provinces must decide what they need. The national government must also decide what they need. If they follow through on this, they won’t be able to sustain the public health system. There is concern that doctors will leave as part of cost containment measures, and you can’t run a healthcare system without healthcare workers. But we will only know the true position of the Treasury when they publish the medium-term budget policy statement,” said Rensburg.

“I believe at the moment they are just testing the market. They are saying we must have one thing, but we can’t have both, so that is the game they are playing. Our position is clear on this issue. Before any salary cuts or job freezes, we need to protect what is already there. We need to retain this year’s cohort of community service doctors, pharmacists, and nurses because these people helped us during COVID-19. Some were interns during COVID-19 and they are the core that can build the health service in the post-COVID-19 era. So, the immediate priority is to retain those posts because we don’t know if there will still be community service going forward,” said Rensburg.

‘working with what we have’

Several speakers and presenters at the PHASA conference raised concerns about the existing scarcity of healthcare workers and urged the Department of Health to take action. The experts, academics, researchers, students, non-governmental organisations, and civil society members all agree that healthcare is a fundamental human right, but that right won’t be fulfilled without healthcare workers, as there cannot be health services without workers. The government’s key policy document on human resources for health warned as far back as 2020 that the country is facing a critical shortage of healthcare workers.

Dr Krish Vallabhjee, former Chief Director of Strategy and Health Support in the Western Cape Health Department, believes that management must use whatever resources are available to achieve good results.

Vallabhjee said, “Budget cuts are a reality, so whatever we talk about here and in many of these conference sessions, we can’t be talking about wanting more and more. We need to work with what we have. How can we repurpose the people we have? Can’t we use them more effectively to achieve the same effect?” he asked.

“Managers need to work with their staff instead of just sitting in some corner and making budget cut decisions. Managers need to engage with staff to address the problem of not having enough budget. How do we work together? What are our priorities? As managers, we must listen to what people are saying on the ground. What are the doctors, nurses, and local managers saying? We must be united. [It should not be a thing that one hospital, clinic, and the district [are] fighting for their own piece. We are one department and we have this problem of a budget. How do we unite and do the best we can?”

Government will clarify

In a cabinet statement issued on 14 September, Minister in the Presidency, Khumbudzo Ntshavheni said that Finance Minister Enoch Godongwana would clarify the cost-containment letter issued on August 31.

“Cabinet appreciates the current fiscal constraints which are not unique to South Africa but have resulted in budget shortfall. Cabinet has iterated that measures to address the budget shortfall must not impact negatively on service delivery. The Minister of Finance will shortly issue guidelines clarifying the unintended misunderstanding arising from the Cost Containment Letter issued on 31 August 2023. In addition, as part of the in-year performance review of progress in implementation priorities agreed to with Ministers, the President, and Deputy President will meet with individual Ministers to ensure that fiscal management does not derail the agreed to priorities.”

Source: Spotlight

Categories : Medical IndustryTags :

Discovery Group Posts Strong Year-end Growth in Profit

On By ModernMedia

Presenting its financial year-end results to investors and analysts, Discovery Group has reported profit increases of 24% across all of its opertaions. CEO Adrian Gore commented, “Discovery’s three business composites – South Africa, United Kingdom and Vitality Global – delivered excellent performances in line with the Group’s strategy and ambition.”

For the reporting period, Discovery posted an increase in normalised profit from operations, up 24% from R9 384 million to R11 661 million. Headline earnings increased by 5% to R5 490 million; normalised headline earnings increased by 32% to R7 678 million; and core new business annual premium income (API) rose 12% to R22 788 million. Embedded value increased to R98 176 million, which represented a 13.2% return on embedded value.

In a year characterised by significant macroeconomic uncertainty, Discovery continued its focus on delivering quality earnings and cashflow with a strong balance sheet; while following a clear growth strategy for each composite (SA, UK and Vitality Global). The Group invested in its proprietary Vitality Shared-value model, and intensified the focus on key initiatives while closing business areas with marginal benefits.

The Group remained financially resilient with high levels of liquidity and the financial leverage ratio (FLR) improving to 20%. Organic cash generation was robust during the year following growth in quality earnings, a significant recovery in Discovery Life’s cash generation following elevated COVID-19-related claims in the previous reporting period, and the reduction in the cost of new initiatives. The robust balance sheet and cash positions support the resumption of dividends, and the directors declared a final gross cash dividend of 110 cents per ordinary share.

Discovery’s saw excellent results for each composite. The SA Composite’s normalised operating profit increased by 22% to R9 096 million and new business by 11% to R16 818 million. Discovery Health showed strong growth across all metrics with prior investment in technology driving efficiencies and continued innovation. Discovery Life had a resilient performance with positive variances, with Group Life returning to profit. Discovery Invest generated significant growth in profit, given higher investment markets and other in-period gains. Discovery Insure delivered on its profit turnaround, following actions taken in previous periods. Discovery Bank continued with excellent progress across all metrics, as acquisition of quality clients accelerated over the year.

Normalised operating profits rose by 14% for the UK Composite and 49% for Vitality Global (US$44 million), driven by especially strong results from China.

Gore concluded, “Discovery’s growth strategy is based on the efficacy, repeatability, and scalability of our Vitality Shared-value model. It is a powerful platform from which to drive new business and enables us to pursue growth through our organic businesses and global partnerships. The Group is now focused on evolving the model into an integrated value chain with bespoke modules to drive growth and market leadership across each of the composites.”

Categories : Diet and Nutrition PaediatricsTags :

Activists Meet to Discuss Worsening Food Crisis for Children

On By ModernMedia
Photo by Thought Catalog on Unsplash

A group of activists for food access and affordability met yesterday (Thursday 21 September 2023) to discuss the worsening food crisis for children. Convened by the Nelson Mandela Children’s Fund and the DG Murray Trust, the meeting sought to identify urgent measures to combat rising rates of severe acute malnutrition and child hunger.

The activist group includes representatives of COSATU, the South African Council of Churches, civil
society groups and academics. It endorsed the proposal by the DG Murray Trust and the Grow Great Zero-Stunting Campaign for government and the food industry to contribute equally in making at least one product label of ten highly nutritious foods far more affordable to poorer households. This proposal requests food manufacturers and retailers to ‘double discount’ a list of ten best buy foods, with the amount of profit waived by industry matched by a retail subsidy by government.

“Data from the Department of Health shows that there were over 15 000 cases of severe acute malnutrition requiring hospitalisation in the 2022/3 financial year,” says Dr Linda Ncube Nkomo, CEO of the Nelson Mandela Children’s Fund. “But that is just the tip of the iceberg”, she says. “Malnutrition is the underlying cause of about one-third of all child deaths in South Africa today, this despite Section 28 of the Constitution which guarantees the right of nutrition to every child”.

The problem of acute malnutrition worsens the chronically high levels of food insecurity in South Africa,
with over a quarter of children under five nutritionally stunted. Poor physical growth is just one manifestation of much deeper damage being done to the life-long wellbeing of children, not least to their brain development,” says Dr Edzani Mphaphuli, Executive Director of the Grow Great zero-stunting campaign. “If we don’t stop stunting now,” Mphaphuli continues, “we shouldn’t expect learning outcomes to improve or our economy to grow.”

In addition to the double-discounted basket of ten best buys, the group called on the food formula industry to stop extracting massive profits from the poorest mothers, whose own malnutrition makes breastfeeding difficult. Given the high cost of infant formula, desperate mothers water down the milk to make it stretch further, which means that their babies don’t get enough protein and vitamins. It also called on government to ensure that every province has an effective programme in place to identify children at high risk and to provide nutritional supplementation to children failing to thrive.

The group undertook to monitor food prices actively and to challenge the food industry to make the third of young children who live below the food poverty line their responsibility too. “We are heartened that NEDLAC has tasked a multi-sectoral committee to review the viability of proposal to double-discount ten best buy foods”, says Dr David Harrison, CEO of the DG Murray Trust. “No sector of society – not government, not labour, not civil society nor industry – should be able to say that substantive proposals to feed South Africa’s children are too difficult, without putting a better option on the table.”