Give us five years, says health minister; ‘No one wants to work in an unhappy environment’

by Kerry Cullinan and Anso Thom There is no reason why South Africa’s dysfunctional health system cannot be turned around within five years, according to new Health Minister Barbara Hogan. “I was fortunate to oversee the transformation of the SA Revenue Service from parliament, and it was a joke in those days. “They didn’t even have ribbons to print the tax returns,” said Hogan, speaking at her first media interview since being appointed three weeks ago. “We are taking advice from those who turned Sars around, and others. We should be able to effect a turnaround in five years.” In the light of a vacancy rate of about 46 000 nurses and almost 10 000 doctors, Hogan said “no one wants to work in an unhappy environment”. “It is extraordinary that people can continue to work in hospitals where there is so much dysfunction.” The minister – a diminutive woman charged with one of South Africa’s toughest jobs – committed herself to engaging with the Democratic Nurses’ Organisation of SA and the National Education Health and Allied Workers’ Union to find solutions. She said she and her advisers had already identified that about 20 health districts were “in a bad way”, and this was daunting. “But we are blessed with incredible skills and dedication in this country. “I have been overwhelmed by the goodwill, both nationally and internationally. “People have told me that they will do anything; work long hours and over weekends to make the change. “I want to build on this impetus and the energy that has been unleashed.” Hogan said she now started work every day at 3am, when her head was clear and people weren’t phoning her. Speaking of her priorities, she said: “HIV/Aids has to be an absolute priority for the government.” “HIV is highest among people aged 25 to 40, and this is our economically active population.” Her immediate priority was to embark on a mass campaign to encourage pregnant women with HIV to have treatment to reduce the risk of their passing HIV to their babies. “We want to accelerate the prevention of mother-to-child transmission programme to have children born free of Aids,” said Hogan. “The uptake in some districts is low.” Hogan was deeply concerned that South Africa’s maternal and child mortality rated had worsened since 1994. “Many of the deaths of the 140 babies in the Ukhahlamba district (in the Eastern Cape) were caused by the poor quality of the water in that district. “It is critical that local government is also working properly so that our water and waste removal are performing optimally.” The minister said that both health and education had been identified as priorities by the ANC at its Polokwane conference, as “neither have been great performers since 1994”. “With both there are concurrent powers (in the constitution) and the provinces responsible for implementation,” said Hogan. “I can’t, as minister, instruct an MEC in a province to do something. I don’t want to tinker with the constitution. “But there are a number of misfits,” she acknowledged, adding that they needed to find smarter ways to deal with the lack of an integrated health system. “The relationship between the minister and the MECs is critical. We have to see ourselves working together as Team Health.” Hogan paid tribute to all who had given up “their time, livelihoods and families” to take care of those infected and affected with HIV. “I salute the work they have done. They are the silent heroes of our country. “The government is enormously grateful for the energy and love they are giving out. “I hope to engage with them and to help them with resources to do the work they are doing.” Hogan also said she was in no hurry to regulate the private health sector. “You can undermine an industry if your regulation is too stiff. I don’t want to rush into anything. “We need good relations between the public and the private sector, but if you have a poor public health sector, it doesn’t make sense to undermine private health.” – Health-e news