With the Department of Health making significant strides in delivering services that meet the basic needs of all South Africans, the restructuring of the management system of public hospitals may be the next logical step towards achieving even greater results.
According to Graham Anderson, Principal Officer of Profmed, the medical scheme catering exclusively to graduate professionals, there are numerous achievements by Government that should be commended. “Health Minister Aaron Motsoaledi’s has been successful in his HIV/Aids campaign which has seen results in the reduction of HIV infection rates in the country. He has also made antiretroviral drugs more accessible to infected people making it easier for them to manage their illness.”
Anderson adds that a lot of funding has gone into addressing accessibility to all public hospitals, with forty percent of the current 4 000 health facilities having been created since 1994.
However, Anderson says that crucial to the future success of these initiatives involves not only appointing effective management in these hospitals, but looking into restructuring the system currently being implemented.
“One of the biggest challenges currently, is that hospital managers are not given autonomy. Currently all state hospitals fall under the remit of the Department of Public Works (DPW), whilst the running of the facilities is done by the Department of Health (DOH). This creates huge challenges for those who are put in charge of running the hospital. If a boiler blows up, or repairs need to be made to any equipment, the manager cannot phone a company directly, as he has to contact the DPW first for authorisation.”
Furthermore, Anderson says for a hospital to be run effectively, it has to be run like a business. “The CEO of a retailer can become the head of a mine or any other business, as the principle of running a company remains the same: cash flow, managing a budget and an understanding of the balance sheet. In the same way, a hospital also needs a manager that understands these principles.
“In addition to having this business acumen, the hospital manager also needs to be given both the budget and the responsibility to run the institution. If he walks down the hospital corridor and sees that a lift is out of order or a boiler is broken, he must be empowered to address these issues immediately and question his colleagues as to why repairs have not taken place.”
Anderson says a hospital manager with control of the budget will also understand the details of the hospital spend and can therefore recognise and root out inefficiencies and corruption. “For example, on a basic level they will know what it costs to feed patients every day and if one hospital is seeing a significant increase in the cost of food, then it is clear that some of this is being siphoned off by employees.”
Anderson says implementing proper IT systems is also crucial to the success of proper management practices being implemented in the public healthcare system. These systems will enable managers, CEO’s and administrators to keep track of vital information and will enable them to act quickly when a problem arises.
“Managers need a comprehensive IT system to assist them in assessing vital information. These amenities should be used in all the facilities across the country and can have a massive impact on the efficiency of the system. It will help with tracking patient information, following up on payments and processes and allowing for a smoother management of hospital and clinic operations and administration,” explains Anderson.
One of the other suggestions Anderson offers is that the private and public sector work together to share best practices. “Many in the private healthcare system would welcome the opportunity to assist in training new hospital managers to work in state hospitals.”
Anderson says that while resolving the problems in the public healthcare system will take time, getting in qualified managers who are equipped to run a large organisation and giving them the authority to do their job will go a long way in dealing with the current crisis.