OPINIONISTA: How to harness the assets of private healthcare to respond to Covid-19 demands

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Many private beds are occupied by patients whose ailments do not necessarily require admission. Or these ailments could be dealt with in a short hospital stay along with supported home recovery. This excessive use of hospital resources is wasteful.

The burden of illness from Covid-19 is predicted to peak in July or August 2020. It is now late May 2020. How best can the SA healthcare sector use all its resources and assets in the Covid-19 emergency? The challenge is that the system is already highly strained, with disconnected structures that offer uneven and fragmented care. This impacts severely on patient outcomes. We can and must address that central weakness now.

But the burden of Covid-19 will require a pooling of all resources in a creative, productive way that bridges this vast divide. Covid-19 most severely impacts poor black people, as it does in other countries. This is especially true in a country with apartheid spatial geography and extreme living densities in townships and informal settlements. These factors are exacerbated by chronically poor nutrition that affects the health status of the poor, making them more vulnerable.

“Hyper-specialisation” even impedes productivity in a system where highly qualified people are doing work that could readily be done by far less skilled team members and relieve the specialists to attend to the severe problems they are trained to address. The lack of leverage and the “diseconomies of scale” result in a low throughput, overly costly system.

But communication systems are not designed for integration, and specialists may not send patients, or feedback, back to the GPs. In effect, the private sector funnels patients upwards to more costly services. As a result, the efforts of GPs are often marginalised. It can be a struggle to survive financially in this model.

 

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