‘Want private sector help? Make State health care managers accountable’

Abstract

Well-off government health care managers are neither directly affected by the dysfunctional public system they run nor are they held accountable for ‘deliverables’, leaving them with ‘absolutely no incentive’ to partner with the private sector. That’s the opinion of Dr Kgosi Letlape, a former President of the World Medical Association, who founded the HIV/AIDS NGO, the Tshepang Trust, during his recent 9-year tenure as Chairman of the South African Medical Association (SAMA).
The Tshepang Trust was set up by SAMA almost a decade ago to initially address, in Letlape’s words, ‘the duality of some people having any treatment they want on one side, and a policy of non-(AIDS) treatment on the other’. Izindaba learnt that the Trust’s struggles to bring its private expertise to the public health care delivery table have made little progress in spite of a dramatic change in government HIV/AIDS policy and a massive health testing and counselling campaign.
Letlape believes that if South African public health care managers were held accountable for delivering measurable services, their reluctance to accept private sector offers of help would undergo a sudden transformation. He said the ‘crux of the matter’ was that public sector facility managers were not judged on delivering services to people, nor were they dependent on the services they ran for their own health care. ‘So if it’s not a deliverable in terms of their job and they’re not personally affected by the lack of care, how do we expect them to engage with us?’ he asked.