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The South African population suffers many, often severe, healthcare challenges, in part because of the high rates of unemployment and poverty prevalent in the country. Their healthcare challenges place a heavy burden on the public healthcare system and the national treasury. Despite these challenges, the National Department of Health has registered significant successes through a dedicated focus on HIV and Tuberculosis prevention and treatment, healthier lifestyles, child and maternal care, and improving access to quality healthcare.
The members of the Hospital Association of South Africa have not stood idly by. They have collaboratively and compassionately responded for many years to the healthcare needs of South Africans, expanding the envelope of healthcare provision to more than 9 million people and reducing pressure on the public sector. In addition, every year, across the country, tens of thousands of people receive pro bono care from private hospitals, specialists, nursing staff, administrators, and company executives. Together, they offer infrastructure, skills, time, and financial assistance to perform a variety of medical procedures for those who most need them.
Private hospital groups have also invested significant sums in various programmes that strengthen the healthcare system through education and training, building capacity, supporting research, and building leadership skills.
Finally, private institutions have generously worked with, and supported, non-governmental organisations who work towards a whole and healthy country.
The financial investments made by private institutions come from their corporate social investment initiatives. These initiatives are conceived and implemented consultatively and collaboratively with a range of stakeholders. At various times, these have included medical specialists who often suggest initiatives, Departments of Health, public health institutions, and non-governmental institutions. They are generally managed within the hospital groups by corporate social investment executives, appointed senior executives, and other staff who provide expert governance to ensure the maximum social impact.
Private hospitals’ social investments rest on a simple set of principles. First, to demonstrate an answer to the call, “Thuma mina" (send me), by providing vulnerable South Africans with quality healthcare. Second, to help communities in the areas where they operate to overcome many of their dire healthcare needs.
Aggregated corporate social investments by member hospital groups
Delivering medical help
They may differ in the specific number of skilled medical procedures they facilitate, but aggregated private hospitals, specialists and nurses provide a range of medical services to the population of South Africa that encompasses many different fields of practice:
- Cataract removals,
- Various urological procedures,
- Various ear, nose and throat procedures, including cochlear implants and donations of hearing aids,
- Maxillofacial and craniofacial surgery for severe facial anomalies, as well as cleft lip and palate corrections and mandible tumour implants,
- Orthopaedic procedures, including joint replacements.
Finally, emergency services for indigents are provided, including admission and further treatment of patients with a life threatening condition, for whom an appropriate bed cannot be found in public hospitals after they have been stabilised in emergency departments.
No matter how generous the financial and other commitments that private hospitals make, the scale of the healthcare challenges facing South Africa demand that creative means are found to maximise the impacts of investments. Fortunately, private hospital corporate social investment professionals have responded through several unrelated programmes that have had an aggregate effect. For instance:
- Fully equipped mobile cataract clinics perform thousands of procedures;
- Creative partnerships move beyond cataract removals to include job training for the blind;
- Preventative and primary healthcare initiatives, for example health screenings for, or in, communities surrounding private hospitals that tie in with celebratory health months such as World Diabetes Day and Heart Awareness Month;
- Human milk banks to provide donated breastmilk to premature and other vulnerable babies in private and public hospitals, if they cannot be fed by their own mothers’ breastmilk;
- Mobile libraries contribute to developing a more educated population;
- Play pumps tied to merry-go-rounds extract scarce water from the earth in water challenged areas;
- Staff volunteerism efforts extend the reach of private hospitals beyond financial investments in medical procedures to foster relationships between hospital staff and their communities.
Many of the initiatives described above provide a significant return on investment – for the country. They go far beyond making cheque handovers. They are, consequently, critical to developing South African society.
There remains a critical need to develop a robust healthcare system that can serve the population of the country well into the twenty-first century. Private hospitals’ contributions in this regard follow.
Strengthening the healthcare system
As is the case with healthcare systems across the globe, there is a constant requirement to build capacity, develop new leadership, and support research. In South Africa, with its disease burden and its corresponding expanding and reforming healthcare sector, this need is acute.
Accordingly, through a joint initiative the public health sector and others, including private hospitals, established the Public Health Enhancement Fund (PHEF) that was set up to “address South Africa’s healthcare resource limitations by building increased resource and management capacity."
In particular, the fund set as an objective the delivery of 1 000 doctorate graduates in the ten years after its founding to build the country’s research and innovation capacity, job creation, and economic growth.
- The fund identified four projects:
Increase the number of medical students. Since 2013, 456 medical school students have been supported by the fund.
- Establish an Academy for Leadership and Management in Healthcare;
- Create a National Scholars Programme. Since 2013, the fund has provided support to 204 scholars engaged in post-graduate studies in a variety of areas including non-communicable diseases and HIV;
- Provide support to the South African National Health Products Regulatory Authority. An amount of R10 million has been budgeted over a two year period, with planned outcomes including the development of staff capacity.
Over six years up to the end of 2018, the fund invested R158 million on building human resources for health, graduated 75 doctors, supported the final output of 27 research scholars, provided seed funding for the Academy, and provided support to the products regulatory authority.
Aside from the fund, private hospitals have embarked on several initiatives of their own. For instance, an aggregated R100m has been allocated by these institutions to support registrar training and the development of sub-specialist skills in the following fields:
- Trauma research,
- Infectious diseases
- Maternal and foetal health
- Neonatal pulmonology
- Foot and ankle surgery
- Emergency medicine
- Head and neck surgery
Private hospitals have also reached individual agreements with tertiary education institutions that aggregate into a number of collaborative working agreements, including with the:
- University of Cape Town
- University of the Free State
- University of Limpopo
- University of Pretoria
- Walter Sisulu University
- University of Stellenbosch
- University of Johannesburg
- North-West University
- University of Kwa-Zulu-Natal
- Sefako Makgatho University
Finally, instances have been recorded of private hospitals seconding skills to assist public institutions where agreements have been struck. One such instance has resulted in a private hospital providing assistance to a public sector hospital paediatric outpatient unit.
Partnerships and support for non-governmental organisations
Non-governmental organisations are essential for the delivery of medical services to those most in need for two reasons: they operate “on the ground" and therefore are directly in touch with communities; they often provide the infrastructure that enables the delivery of urgently needed services.
Partnerships between private and public health institutions are similarly critical because their combined capabilities and reach means that assistance is extended to as many vulnerable South Africans as is possible. For this reason, private hospitals warmly embrace partnerships with the Departments of Health and public institutions, and since 2013 with non-governmental organisations such as:
- The Sunflower Fund, to fund blood tissue sample tests for people joining the Bone Marrow Registry;
- Wheelchair Tennis SA, to fund wheelchairs to enable physically-challenged participants to play their chosen sport;
- Move-It Matters, a programme designed to get young people active in sports and exercise;
- Changing Faces, Changing Lives, which uses 3D printing for medical implants and prosthesis;
- Drink1 Give 1, which encourages the sharing of water and which has enabled the sharing of 60 000 litres of water;
- The Sandy Segal Winter Drive to raise funds and distribute blankets;
- Gift Boxes for Premature babies that have distributed 1 500 presents since 2015.
- Habitat For Humanity to build homes in townships.
Another non-governmental partner to private hospitals is Reach for a Dream, which provides terminally-ill children with the experience they most desire before they pass away. In one particularly innovative step, a hospital brought mini-cars into children’s wards to provide long-term young patients with a diversion and a smile as they often energetically “drive" through hospital wards but within set precincts.
Finally, the rate of violence and trauma in the country has drawn responses from private hospitals who severally but aggregated provide a range of appropriate services, including:
- Counselling of students who live in high-risk areas;
- Treatment and counselling for victims of sexual assault; and
- Outpatient support for victims of violent crime through the non-governmental sector.
The private hospital sector has invested considerably in both financial terms, and in skills and expertise, is responding to the various healthcare and related challenges facing the country. These investments have two objectives: to provide quality healthcare to those who struggle to find access to it; and to contribute to a future healthcare system that better serves the country and its citizens.