As debates on the National Health Insurance (NHI) rages, voices are suggesting that public-private collaboration is a viable, practical alternative.
Two camps have emerged in the debate: those who believe it will bring equitable healthcare, improve national productivity thanks to better health and reduce inequality; and those who raise concerns about cost and poor governance, implementation, the risks of corruption, and the dismantling of private healthcare.
However, there are those who see potential for collaboration.
Healthcare in the Northern Cape, as South Africa’s largest province, has challenges, such as vast distances.
Dr Lindiwe Matebula, medical officer at the Robert Mangaliso Sobukwe Hospital’s (RMSH) oncology unit, says screening programmes in rural areas and resources in state facilities are limited.
“We only have one CT-scan machine, which caters for the whole of the Northern Cape.”
There was also no radiation therapy available in the province until five years ago, says Matebula, and patients had to go to Bloemfontein.
Once in Bloemfontein, that did not guarantee treatment, says Dr Allastair Kantani, clinical manager for hospital services and previous chief executive officer (CEO) of the RMSH.
Kantani said there was a plan underway to start radiotherapy services at the RMSH, but it would take time.
Icon had established a centre in Kimberley focused on private patients, and its Linear Accelerator machine, used for radiotherapy, had spare capacity, explains Dr Ernst Marais, chief of operations (COO).
As a large portion of the operational costs were covered by private and medical aid patients, the business could provide the service at cost to the government. Kimberley had received a grant from government ringfenced for cancer treatment.
“We collaborated with the RSMH and the DOH to see if we could not put our heads together to solve this problem (of no radiation therapy in Kimberley),” he said.
Marais said the size of the province meant that the group had to find transport solutions for patients, and accommodation for those needing up to six weeks of radiotherapy treatment.
Transport and accommodation were organised. Now patients have planned transport that fetch them from home; they are brought to the hospital, stay for the duration of treatment, and are taken home afterwards, says acting CEO of the RMSH, Dr Esmé Olivier.
In the five years since the project’s inception in 2019, 556 cancer patients have completed radiation treatment.
