Health Minister Dr Aaron Motsoaledi has said investigations had been launched into private sector corruption manifested through medical aid fraud, inflated prices for procedures and supplies, and fraudulent medico-legal suites of malpractice against the state, which took away money that could benefit the public healthcare system.
Motsoaledi was speaking exclusively in an interview with Business Report following the Department of Health’s budget vote in Parliament.
During his budget vote speech, Motsoaledi faced strenuous opposition that implementation of the National Health Insurance (NHI) scheme would be a drain of public resources as the healthcare sector was endemic with corruption, poor management, and poor maintenance of infrastructure.
Motsoaledi said that was acknowledged by his department but he said there were similar concerns with the private sector.
“Are we saying corruption does not happen in the private sector? It is happening on both sides. It is up to us as South Africans how we get rid of it. I am told more than R228 billion is lost in the private sector,” he said.
“There must be control somewhere. It is our duty as South Africans to address it and be able to deliver quality healthcare to everyone, even the poor.”
Motsoaledi said he had received the preliminary findings of the anti-corruption forum that the government had initiated and still expected a report from the Special Investigations Unit (SIU) as part of an exercise to clean up the sector, including incidents from the Covid-19-era.
“Another huge practice of corruption in the healthcare system is happening with lawyers and medico legal litigation where huge amounts are paid out yearly that could help the healthcare system. Many believe it is the carelessness of the doctors but quite a large amount of it is fraud. We need the unit to look into that,” he said.
Motsoaledi cited a case in the Eastern Cape where a law firm had been found to have tried to claim fraudulently for irreversible brain damage for nine children, some of whom were concocted and others fictitious.
He said the corruption in the private sector was wide-ranging and included concerns that most deliveries of babies were by caesarean section, which reduced attendance time for doctors and provided a better financial opportunity.
“The implementation of the NHI is already under way. There is not a point where we will sit and say we are starting now. Even the United Kingdom which started its universal healthcare system in 1948 is still changing it as people are evolving,” Motsoaledi said.
“We have started with improving the health register so that a patient’s file can be accessible anywhere in the country, whether it is a public or private facility. We have initiated a public-private partnership in the Free State and we will move on from that.”
Motsoaledi said South Africa’s indictment on the lack of universal access to healthcare came from the World Health Organization’s (WHO) benchmark that if a country spent 5% of its gross domestic product (GDP), it would have an efficient healthcare system for its citizens but that South Africa, which already spent 8.5% did not have equal distribution which created the inefficiencies.
The health minister said the privileged in the healthcare system were those who qualified for medical aid and they constituted about 14% of the population at just more than 9 million out of the total population of 61 million.
Motsoaledi said the public healthcare system and fiscus inevitably bore the burden when patients on medical aid exhausted their cover and returned to the system for care
“There is the wrong assumption that people who qualify to use the private sector go away. The same people we pay to go away come back in September or so when they have exhausted their funds, and they want the same public health sector to provide services to them,” he said.
“We take R70 billion directly to subsidise public servants and then there is about R30 billion paid out by Sars in rebates. These are incentives for people to go away, but they still come back,” Motsoaledi said.
BUSINESS REPORT