Why Primary Care as core benefit in the Basic Package? Rajesh Patel BHF The BHF Southern African Conference 22-25 July’07 Sun City

Health Insurance (catastrophic cover) Health benefit for health need Current System Alternate Paradigm Health Insurance (catastrophic cover) Health benefit for health need Commodity Social Benefit Focus: Individual Focus: Community Benefits Core: Referred care Diagnosis based PMB Core: Primary care Benefit category Traditional design Competition Solidarity Reference price Regulated price Allocative inefficiencies Coherent system for health services provision The BHF Southern African Conference 22-25 July’07 Sun City

Why Primary Care? The BHF Southern African Conference 22-25 July’07 Sun City

Hon. Henry Gluckman M.P., M.R.C.S., L.R.C.P. Community Orientated Primary Care (COPC) commission mooted National Healthcare System based on COPC Recognition that HC required rationalization The BHF Southern African Conference 22-25 July’07 Sun City

Herman A et al. 2002. Tender Doc The BHF Southern African Conference 22-25 July’07 Sun City

Alma Ata (1978) “Health for All” PHC The BHF Southern African Conference 22-25 July’07 Sun City

WHO Primary Care … most cost effective… improve health status (Not every primary care service is cost effective) The BHF Southern African Conference 22-25 July’07 Sun City

Norms and Standards for District Health (2000) Starting point towards Equity PHC based de facto BBP The BHF Southern African Conference 22-25 July’07 Sun City

Risk Equalisation: International Review Panel Include primary care The BHF Southern African Conference 22-25 July’07 Sun City

NHA Section 3 (1) (d) The Minister must… …ensure the provision of such essential health services, which must at least include primary health care services, to the population of the Republic as may be prescribed …; Circular 8 of 2006, CMS Promote hospital benefit as core benefit Inconsistent with NHA The BHF Southern African Conference 22-25 July’07 Sun City

Health Charter In development …Basic Package of health services The BHF Southern African Conference 22-25 July’07 Sun City

African Union: Conference of Health Ministers 2007 African Health Strategy: 2007-2015 34. This Strategy seeks to advocate and promote a coherent organisational framework that enhances efficiencies and effectiveness through: “Adopt a primary health care approach” … “Determining the package of primary health care that all citizens can access” The BHF Southern African Conference 22-25 July’07 Sun City

Time for Action! Commence Basic Package development in parallel with Health Charter Commence the long delayed PMB review as mandated in the MSA The BHF Southern African Conference 22-25 July’07 Sun City

Speakers Prof. Shan Naidoo Dr. S Pillay Critical Review of Basic Packages incl. Norms and Standards, and recommendation for BBP : Public Health perspective Dr. S Pillay Benefit design for the future Dr Neil Gower – National Secretary: Homeopathic Association of South Africa Complementary medicine and the PMB The BHF Southern African Conference 22-25 July’07 Sun City