1. Agenda Setting

New method of technology that will enhance state of current healthcare in all hospitals and clinics in South Africa as stipulated by National Develpment Plan 2030.

• The problem that have been identified are slow process of admiting patients.
• Application of forensic pathology in most cases where determination of cause of problem has to be identified.
• Smartphones applications in monitoring the health progress of the patient
• Filing system that is mostly manual.
• Political aspects of the problem that is caused by slow pace of service delivery at the hospitals.

2. Policy initiation

Based on occassion of need, a policy is proposed by cabinet or any member of parliament to look at possible solution that can curb or resolve the problem.

As a result of high cost of private clinincs, and need for medical scheme or aid by patients to access private clinics, government proposed healthcare that is affordable to all even if you have medical aid scheme.

Look also at previous policy pertaining healthcare if there is one in existence and study it carefully in order to reform the proposed one in line with old one.

On National Health Insurance

1. Policy makers must identify a public policy problem on which there is consensus among all relevant stakeholders.

• It has been identified that main problem is lack of better and high standard of provision of healthcare.
• Public facilities has be renovated to meet excellent standards.
• Implementation of modern technology that will speak to each other.

Who are stakeholders?

• Non-profit organizations
• Community members
• Health practitioners
• Patients
• Private clinics and others.
• Others

3.. Policy design

• Must be able to provide efficient modern technologically system once patients has been entered into the system.
• Historical background of patients from birth to current.
• Establishment of link between National Health Insurance within NDP 2030 to meet is objectives.
• Public Participation component whereby identification of the problem is addressed and process on how to resolve such problem
• Engagement through different public platform that include government gazzette, newspapers and national imbizos where people are request to make comments on the existence of proposed public policy that will be transformed into legislation.
• What is all of importance is the budget allocation for a particular policy to be designed and implemented. For instance, when NDP 2030 thought of means of making healthcare easier, what is important was budget allocation and huge amount that needed to be used to deliver the ultimate goal. As per stand presently, it has been a budget issue and number of qualified personnel that need to be remunerated in accordance with market related salaries.

 

• Stakeholders involvment such as medical schemes, and NGO who will be part of the accredited service providers.

Within policy design

1. Social construction – Looking at present situation at all healthcare and also what are the conditions of benefeciaries who are eligible to receive the services. And importantly the teleology of that service delivery.
2. Political implications – Politicians designed policies to benefit mostly disadvantaged communities. In this case of NHI, it is majority of South African who can not afford private medical assistance that seek to be maintained by government.

 

4. Policy analysis

The compromise of four stages that already has been addressed in agenda setting and policy initiation.

 

4.1. Defining the problem.

• The current healthcare system that is old and does not meet current modern society and technology
• Introduction of National Health Insurance.

 

4.2. Defining the goals.

• What is the ultimate end results for introduction of National Health Insurance.
• Is there gap to meet this need?
• Who is going to be involved and what are there current status within the government and communit?

4.3 Selecting the policy.

• Already the National Health Insurance has been introduced and the National Policy passed in 2012. There is pilot taking place in eight chosen district municipality in each provinces including Dr Kenneth Kaunda District Municipality in the Northwest.

5. Policy formulation

In this stage, the national health departement write a letter to speaker of parliament to introduce the discussion within the parliament before the president can assent and sign.

Once that has been introduced to parliament, a portfolio committee on health dedicated to the discussion, debate, criticism of the policy is established.

It is imperative that policy objectives are thoroughly discussed and displayed and what are the cost of implementation of this desired policy.

Another factor to be considered are what are political complexities in developing and formulating the policy.

6. Policy dialogue and advocacy

This will involve different stakeholders who will have interests on the subject matter and those include government officials from national health departement, community members and other stakeholders such as non-profit organization.

A workshop or seminar can also be intiated whereby different group of stakeholders engage each other on the proposed policy to be implemented. We can also look at national rally for the departement of health whereby extensive interogation and investigation of solution can be reached.

7. Policy implementation

After the policy has went through different stages within parliament and debated, it is then given to president to assent and sign it into legislation. However, it happens as a results of its contension that it has met constitutional requirements and if it does not, it has to be taken back to parliament to be amended or rectified.

As a results of current national health insurance being piloted across the country, it meant that national health departement allocated a certain amount of budget into the project and included capacitated personnel that needed continous training development.

• Special office under Foundation for Personal Development were established to look at the daily operational of the programme.
• Number of district healthcare clinics had to be identified and used for the programme
• Personnel within the system that already is in existence had to be briefed and trained to have understanding of the objective of the programme.

8. Policy evaluation

In a case of national health insurance, continous training and monitoring is taking place and the programme is meant to be piloted for a period of 5 years that started in 2013 in order to see whether it has met the requirment before it could be fully implemented as programme of government.

Engagement of stakeholders

1. An investigation will be conducted to get clarity from all stakeholders who played a role into the piloting of the programme to see what it has reached it objectives.
2. As a results of that investigation, information or evidence will be gathered that will be used in the policy evaluation process.
3. With information gathered, it will be used to share it or learn from it as to realised what more need to be done or whether the programme has met its National Development Plan goals.
4. Impact study will be conducted as to evaluated the outcomes of the policy implementation.

9. Conclusion

The eight stages are critical in giving final implementation and signing of policy into legislation. There is more of work to be done in order to make sure that the policy becomes the programme of government and aligned with the objectives of National Development Plan 2030.

1. Introduction

A proper government function well in accordance to its policies that has been formulated through process including public participation. Dror (2003:12) Public policy is very complex and dynamic process whose various components makes different contribution and also decides on major guidelines for action directed at the future mainly by governmental future. It fair to argue positively that without the interests of the public, no policy can be established as all public policies are meant to address their needs. But then we have poverty and societal division that are main challenges government need to resolve, the blog will look at how industry 4.0 will drive and move to the point of finding solutions through modern technological means. In meeting such challenges and addressing the needs, will innovatively look at what can technological means can be utilised in order to meet public interests.

2. Challenges facing community that results in poverty.

Identify health is paramount to the existence and success of the country’s contribution to healthy economy and also better labour force. In addressing poverty alleviation that sometimes is perceived as tool for societal division, we need to look at how healthy lifestyle play major role. However, Jobson (2015:5) criticise public healthcare system that it continues to deliver services albeit with some inefficiencies, inadequate quality of care in some facilities and poor infrastructure in some places.

Mayosi & Benetar (2014) also agrees about the implication of poverty and health as they said that when extreme poverty affects a large proportion of the population, as in South Africa, health is predominantly affected by a lack of access to the basic requirement for life, clean water, adequate nutrition, effective sanitation, reasonable housing conditions, access to vaccinations, good school and the childhood and adolescent nurturing that, with the availability of jobs, set the scene for improved health and longevity.

According to Bernstein (2011:19), believes that healthcare reform is an urgent and at the same time extremely difficult challenge for South Africa’s policy makers, one which presents opportunities and risks across both public and private healthcare sectors. Fair enough, it has its own challenges as explained in this blog, but let us look at how this can be assisted by Industry.40 through technological development.

 

3. Societal division in healthcare system.

It is through provision of healthcare that those who have the means of getting better service will remain with public health institution and those with better financial back up will continue to receive medical attention from private sector. Van Rensburg (2014:10) The impact of racial policies, early colonialism  apartheid and separate development led to a race-based division of health services into separate institutions, later aggravated by health services being organised into separate homelands, each with an own health department and own professional bodies. Further left the country with two-classification system of healthcare and rendered South Africa as extremely inequity in every spheres of life including healthcare. It is clear that those who afford will prefer to make use of private sector while the poorer will adversely utilise public facilities and this make the majority of the country.

4. Industry 4.0 assistance in resolving public healthcare.

It is important to realise the modern technology should come and rescue current challenges and contribute to the existing body of knowledge. According to Oni, et al (2016) upstream determinants of health9 including social protection, employment (formal and informal), education, forensic pathology) need to be monitored by integrating routine date sets across sectors and a coordinated analysis of intersectoral data to inform research and policy priorities and intervention. True, I will imagine current situation whereby a medical practitioner has to trace diagnoses of patient coming from another health facilities. It is quite difficult considering that they still use manual filing and tracing of patients, whenever a patient has to move, the patient must move with his or her own file.

A patient diagnosed with cancer for instance, and cannot be assisted by hospital in Vryburg in the Northwest province has to move to Klerksdorp hospital in the same province, however it is technologically challenging to trace all patient’s background before oncologist can treat or provide chemotherapy. Gilchrist (2016:14) followed on how patient can utilise technology and he referred to Guy’s and St Thomas’s Nation Health Service Foundation Trust that piloted the use of smartphones as health monitors whereby patient’s kits will compromise of smartphones ,scale, oxygen sensors and blood pressure cuff. Moreover, the idea is that patients will take daily readings of their weight, heart rate, blood pressure, and oxygen levels, then upload the data to smartphones via Bluetooth to be sent to BT’s telehealth service.

Once more, technology seems to have solution to saving life of patients especially those in intensive care unit. Toussaint & Gerard (2010:10) found that people with failed digestive system who need to be fed through an intravenous catheter in order to keep their body fighting and alive, these patients receives a highly concentrated solution of glucose and vitamins through this catheter inserted into major vein in the chest or neck.

5. Conclusion

Clearly, we can save more life by looking at historical background affected by inequalities and meeting it with introduction of modern technology through industry.40 into the system. Equally, this will enhance the systems and provide efficient services. We have seen how technology can provide patient background in cases whereby it is necessary to provide relevant medication for patient. In practicing transformation in culture and others sources, a look at technology is important and we cannot ignore its exposure into real life. Public services will be much better with the advancement of technology.

Reference

Bernstein, A. 2014. Informing South African policy: Reforming healthcare in South Africa. Centre for Development and Enterprise.

Dror, Y. 2003. Public policy making re-examined.New Jersey. Transaction Publishers.

Gilchrist, A. 2016. Industry 4.0: The industrial internet of things. Thailand. Apress.

Jobson, M. 2015. Structure of health system in South Africa. Johannesburg. Khulumani Support Group.

Manyosi B, M & Benatar, R S. 2014. Health and health care in South Africa- 20 years after Mandela. 371:1344-1353

Oni, T & Smit, W, et al: Urban health research in Africa: Themes and priority research questions. New York Academy of medicine.

Oni, T, Smit, W, Matzopoulos, R, Adams, J,H, Pentecost, M, Rother, H,A, Albertyn, Z, Behroozi, F, Alaba, O, Kaba, M,  Van der Westhuizen, C, King, M,S, Levitt, N,S, Parnell, S and Lambert, V,E. 2016. Urban health research in Africa: Themes and priority research questions. New York Academy of medicine.

Toussaint, j, & Gerard, R, A. 2010. On the mend: Revolutionizing healthcare to save lives and transform the industry. Cambridge. Lean Enterprise Institute, Inc.  

Van Rensburg CJ, H. 2014. South Africa protracted struggle for equal distribution of equitable access –still not there.  University of Free State. Centre for health system research and development.

One of the basic challenges facing South Africa is provision of better living and there conditions attached to it. A better nation increase economic growth as most people engage into mainstream economy through different means. However, one major challenge is huge expenditure to the department of health in order to meet constitutional duty of providing better living and right to life. South Africa is challenged with importing medical solutions from other countries and as a results what is supposed to be used for infrastructural development is reduced to accomodate this medical demand.

In his book, Things that could not be said, Reverend Frank Chikane extensively elaborate on HIV crisis they faced when he was still a member of Former President Thabo Mbeki cabinet, that there was a locked consensus with other countries to supply South Africa with vaccine for HIV and that resulted in the country spending chunk of the money to pharmaceutical companies. The solution to the problem was to develop industrialization especially introduction of black industrialists in order to find solution to any palliative illness and scientist that will develop medical solutions. This would have created jobs and reduce government spending on foreign pharmaceutical companies.

Another challenge to healthy living was nutritional aspects, that even if you provide a patient with medicine, if the patient didnt have good diet, the medication will fail to work. Now, one of the programmes was to push concept of allowing every community to plant vegetables and start to eat healthy as that would help in prolonging life of an hiv positive person and replace any kind of medication. As both they are meant to prolong life expectancy of individuals.

One major challenge has been that people between the age of 24 and 54 years are mainly dying as  a results of lifestyle choices and this leave older generation alive and not active in the economy. Those who were supposed to work and grow economy are fewer, while older people depends on state grants. The revenue collection through SARS is minimal while the expenditure is higher. Educating people and providing alternatives to current provision of medicines will reduce expenditure on government. Countries like Cuba and Arabs have lower intake of palliative patients as they embark more on educating their own people on better living conditions and lifestyle enhancement.