Cosatu released Economic Policy

Cosatu released its Economic Policy document today (“A Growth path towards full employment”). Its views on nationalisation, changes in taxation, ownership, etc were widely reported in the media (http://www.timeslive.co.za/Politics/article658469.ece/Highlights--Cosatus-key-economic-policy-proposals).

The views on healthcare were, however, not so widely reported. It includes the following:

COSATU supports the DoH’s 10 Point Plan, but states that nevertheless, there is a need for the advisory committee on NHI to urgently conclude on path of transition towards the NHI, and mandate the National Treasury to translate the commitment to the NHI into Rands and Cents, by making the necessary budgetary allocations to phase in the system.

The key challenges facing the healthcare sector are :

1. Staff shortages;
2. availability of medicines (incl improved efficiency between warehouses, hospitals and clinics); Infrastructure backlogs;
3. Inadequate systems ( ICT, Management, Administrative support);
4. availability of equipment.
   
   • 70% of the case load in the public health system is now taken up by HIV/ AIDS cases, crowding out the capacity to treat other medical conditions.
   • There is a disconnection between national policy and the allocation of resources (e.g. a hospital CEO doesn’t meaningfully control staff, budget or procurement).
   • Under-regulation of the private health sector and overconcentration of resources. In this, COSATU proposes that “the state should minimize and where possible eliminate the profit motive, build internal capacity and should reverse reliance on Private Public Partnerships.”
   
   The COSATU proposals include:
   • Integrate Community Care Workers into the public service. The state should lead the process of training, particularly the training of nurses and doctors and resist the incursion of the profit motive in the process, Department of Health to establish a Nursing Directorate (Increase the Nurse/people ratio from 4 (per 1000 people) to 8 per 1000 and the ratio of physicians to 1000 people to 1 over the short to medium term from the current 0.69
   • Improved administration (incl an ICT system for efficient record keeping and information flows).
   • Improved medicine delivery systems to patients.
   • Review the pay structure, conditions of employment and career development in the health system.
   • The state should establish a pharmaceutical company:
   “The pharmaceuticals sector is also dominated by a few large players and plays an important role in the health system. In line with the need to address health disparities, a state-owned pharmaceutical company needs to be set up in order to produce medicines on a non-profit basis. This is important especially in the light of the HIV/AIDS pandemic and the vulnerability of the Southern African region to diseases. The state pharmaceutical company therefore puts the democratic state in a powerful position to have impact on the health profile of the Southern African population, not just South Africans and will reduce the vulnerability of the region from being exploited by multinational pharmaceutical companies.”
   
   The full document is available at: http://us-cdn.creamermedia.co.za/assets/articles/attachments/29577_cosatu_booklet.pdf