Dear Editor
Taxpayers will spend at least R1.5 billion over the next five years to develop an integrated electronic health record system for the public health sector, and it could cost a further R1.5 billion to implement it.
The Minister of Health, Dr Joe Phaahla, indicated in answer to a written parliamentary question (PQ) from the DA that his Department has yet to calculate the cost of implementing such a system. This despite the fact that an integrated electronic record keeping system is a requirement of the National Health Insurance (NHI) Bill that the ANC is trying to push through Parliament.
Proper patient record keeping is a crucial element of ensuring quality health care provision and the development and implementation of an integrated electronic system would certainly go a long way in the holistic treatment of patients, as well as potentially reducing medico-legal claims by preventing and improving management of medical negligence as the South African Law Reform Commission (SALRC) pointed out in its discussion paper published in 2021.
However, the Department of Health’s management of data has always been problematic.
In answer to a written PQ from the DA, Minister Phaahla stated that no medico-legal cases have been referred to the Health Sector Anti-Corruption Forum (HSACF) since its establishment in 2018.
While this would certainly be strange and worrying were it true, the fact is that the HSACF – a group of stakeholders from law enforcement including the Special Investigating Unit (SIU), civil society, health sector regulators, the private sector and the National Department of Health – have had successes in dealing with fraudulent medico-legal claims, including the case of an Eastern Cape attorney that was arrested for three counts of fraud of more than R100 million.
Minister Phaahla’s response to the DA’s question illustrates one of two things; either his Department is unable or unwilling to comply with the Parliament’s oversight mechanisms and structures, or it does not know how manage and access crucial data. How does the Department and the provinces expect to combat the sharp rise in medico-legal claims over the past few years if it cannot even manage to provide credible information to a simple parliamentary question?
The Department’s failure in this regard is stark reminder of the chaos that will reign should the ANC succeed in bulldozing the unconstitutional NHI Bill through Parliament. The ANC government has always over promised and under delivered. A number of provinces’ health budgets are swallowed by medico-legal claims. The HSACF was launched with great fanfare, yet the National Department of Health – a stakeholder – could not manage to obtain credible information and did not seem to question the information received from provinces. How on earth will the NHI – the touted next miracle cure – be any different?
Unless and until government addresses and rectifies the basics – infrastructure, staff shortages, backlogs, consequence management – the NHI will inevitably fail. It’s being built on a foundation that has systematically been hollowed out by cadre deployment, corruption and ineptitude and instead of treating the problems, the Department is simply slapping on a new coat of paint.
Regards
Michele Clarke MP
DA Shadow Minister of Health
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