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.