The DA believes that a caring government must ensure that accessible, affordable, high quality health care is available to every South African.
We subscribe to the nationally agreed Vision 2030 which sets out to significantly reduce the burden of disease, to raise the life expectancy of South Africans to at least 70 years, to ensure that the generation of under-20s is largely free of HIV, and to achieve infant mortality of less than 20 deaths per thousand live births and an under-5 mortality rate of less than 5 per thousand.
The DA pledges itself to pursue the goal of adequate universal access to health care for all South African citizens and to giving effect to the Constitutional provision for guaranteed access to emergency medical treatment.
“Everyone has the right to have access to (a) health care services, including reproductive health care; No one may be refused emergency medical treatment.” – South African Constitution: Section 27(1) and (3).
Based on our experience in running the Western Cape Health Department since 2009, we believe that such an outcome can be achieved largely within the existing administrative structures and the available resource envelope. Our experience shows that the actions of a politically-accountable provincial executive – and the cascading of quality and professionalism from that point through the entire system (primary, secondary and tertiary) – is the critical variable in tightening and improving the quality of health care.
The DA stands for universal access to health care for all citizens. We believe the key to this, over the next five years, is not big policy developments but making the current regional management model work.
Better health governance is most meaningful to the most poor and marginalised, who are not covered by medical aids and lack the resources to access private health care. For these citizens to play a role in the DA’s overarching vision – The Open Opportunity Society for All – their free access to health care needs to be ensured. This is an essential component of our proposal to combat poverty-related diseases and is an absolute minimum requirement if South Africa is to win the war against HIV/AIDS and Tuberculosis (TB).
The DA envisages a strong doctor-driven Primary Health Care (PHC) system, based on the social model of health and thus equipped to contribute to dealing with the full range of social determinants of health. This models allows for localised health care service delivery through strong community-based structures.
The DA will act to move public health to focus on wellness for all. The concept of ‘wellness’ is an outcome of growth, education and social development; it is thus a transversal issue with its outcomes most visible in the health sector. At present, the tendency is for patients to present themselves to in the public health system only when diseases become disabling. Wellness requires regular general check-ups and behavioural modification as happens among those fortunate enough to enjoy private medical aids.
Health is not just a medical issue. The social determinants of health need to be addressed, including promoting healthy behaviours and lifestyle.
(National Planning Commission, 2012. National Development Plan)
The DA envisages a society in which citizens take increasing personal responsibility for healthy lifestyles, and in so doing reduce the burden of non-communicable lifestyle diseases. The growing desire of South Africans to know their HIV status is an indicator of an appetite for such responsibility. The DA envisages citizens actively managing their health thereby freeing the public health system to focus more on basic health, disability, mental health and special needs cases.
The over-centralised and statist proposals contained in the National Health Insurance (NHI) Green Paper are not only dangerous but are unnecessary if the public health systems in all nine provinces can be managed effectively.
The NHI Green Paper also implies that the failings of public health are the fault of the private sector. The DA disagrees with this analysis. We envisage a solution where the strengths of the private sector are leveraged to improve public health through partnerships. Our vision is a system embracing public and private health service providers where the state offered service is of sufficient quality to compete with the private sector and to spur it on.