Hogan calls on sound strategies to ensure access to health care

New Health Minister Barbara Hogan has called for innovative ways to deal with the scarcity of resources in the public health sector, saying there was no point in getting desperate about the situation as it was a growing phenomenon in South Africa. Hogan was not able to attend the opening of the biennial conference of the International Association of Medical Regulatory Authorities at the Cape Town International Convention Centre last night, and her speech was delivered by Professor Craig Househam of the national health ministry instead. It is believed Hogan was delayed due to a meeting about policy with provincial heads of health in Pretoria. In the speech on issues of migration of health workers, Hogan called for tighter regulations of health professionals, saying review mechanisms could help improve their professionalism in the workplace. She raised concerns about the migration of doctors and nurses from outlying areas. She said the ratio of practitioner to patient continued to spiral downward between resourced health facilities in urban areas versus those in rural and often under-resourced facilities. “However, we cannot throw our hands in the air in desperation and exasperation. We need to use such meetings, as this one, to genuinely confront these challenges and emerge with innovative ideas on how to do more with less. “The scarcity of resources will be a growing and continuing phenomenon and therefore we need sound strategies to ensure ongoing access to healthcare while mitigating the factors that militate against that,” she said. Hogan said the industry also needed to “carve out” mechanisms to ensure that professionalism of health workers was not compromised. She said the huge gap between health professionals and their patients was concerning as it made communication between doctors and their patients difficult – therefore negatively impacting on their professionalism. As a result of this communication breakdown, there was also a growing sense of mistrust in the field as patients did not understand what help was being offered to them, also something that threatened the professionalism of health workers in the country. She said it was therefore vital for health regulatory bodies to continue playing a critical role in ensuring maintenance of adequate standards of professionalism. This could entail processes including the careful selection of medical students, monitoring of students in training, and the establishment of ongoing peer review mechanisms that would hold medical practitioners accountable. “We need to carve out mechanisms for ensuring that professionalism is not compromised by virtue of the nature of the populace involved. Instead, there should be even more vigilance when dealing with such populations and vulnerable groups.” Regulatory bodies in medicine therefore played an important role in ensuring maintenance of adequate standards of professionalism, said Hogan. “We need to strengthen these structures rather than weaken them. Their strengthening should, as a matter of course, also involve a careful balance in the composition of these structures so that while peer review mechanisms are maintained, there is equally a mechanism to ensure transparency and accountability.”