SPECIAL COVID-19 EDITION
BHF3into hea6lth0care°
June 2020
What we have learnt in the Telemedicine 04 context of medical schemes? 12 Enabling access for all SERVING MEDICAL SCHEME MEMBERS
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H T BHF360°into healthcare
SPECIAL COVID-19 EDITION
Editor in Chief: Zola Mtshiya Project co-ordinator: Sasha-Lee Lindoor Sub-editor: Peter Wagenaar Design & Layout: Mariette du Plessis
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Editorial e. [email protected] Published by the Board of From the Editor's DESK Healthcare Funders elcome to this special publication from the BHF in which we look Non-Profit Company W at the unprecedented COVID-19 crisis from a healthcare industry Registration no. 2001/003387/08 perspective. We hope you find it an interesting and informative read and that it will help inform your response to the pandemic as we navigate Lower Ground Floor, South Tower 1Sixty Jan Smuts Avenue these uncharted waters together. Cnr Tyrwhitt Ave Rosebank, Johannesburg Topics under the spotlight include the following: the different trajectories South Africa is potentially facing as the pandemic unfolds, and the need P O Box 2863, Saxonwold, 2132 for models that can test for the variables, even while so much about the virus remains unknown. Addressing COVID-19 effectively will require legal Tel: +27 11 537 0200 Fax: +27 11 880 8798 changes in respect of reimbursement, and the BHF’s legal department Client Services: 0861 30 20 10 offers some detailed thoughts on this subject. More than ever we need to e-mail: [email protected] stand together as an industry. A review of measures taken by a number of web: www.bhfglobal.com BHF members provides an encouraging picture of the industry’s participa- tion in assisting the various governments in combatting the pandemic.
An overview of what we have learned so far in the healthcare environ- ment calls, inter alia, for better co-operation and co-ordination between funders and providers. Two contributions focus on the critical role technology can play and the need to harness it effectively, especially telemedicine, a proven modality to enable access to healthcare. It can ensure that healthcare professionals reach more patients, while minimis- ing direct contact.
Enjoy!
Zola Mtshiya BHF Head of Stakeholder Relations & Business Development
B O A R D o f HEALTHCARE F UNDERS 1
SPECIAL COVID-19 EDITION | JUNE 2020 IN THIS ISSUE CONTENTS
4 What we have learned in the context of medical schemes
The question of sustainability is broader than just schemes’ obligations in respect of healthcare expenditure; retention of membership is also a concern.
8 The power of collaboration
»»p.4 Collaborations at global, national and community levels must be enabled, including the coordination of efforts to protect the public health at these levels. 12 Telemedicine Enabling access for all
Healthcare stakeholders should embrace telemedicine and make it an integral part of the system to allow us to prepare for another global health crisis.
14 INDUSTRY PERSPECTIVES »»p.8 »»p.12 Legal changes in response to COVID-19 pandemic. . .14 Trajectories for South Africa over next 12 months . . 16 Digital technology helping Africa combat COVID-19 . .18 Industry stands together in fight against COVID-19 . .21
26 IN CLOSING
COVID-19 Testing Sites ...... 26 »»p.21 In Memoriam: Dr. Clarence Mini ...... 28
B O A R D o f HEALTHCARE F UNDERS 3 What we have learned in the context of medical schemes
BY Charlton Murove On the funding side, the industry is The idea behind lockdown was to Head: Research, BHF grappling with questions of sustain- reduce the rate of infection in the ability on many fronts. While it was hope of not overburdening the health acknowledged that testing for coro- system. Lockdown has greatly impact- OVID-19 has brought many navirus was necessary, a single test ed a significant proportion of medi- challenges, chiefly health sys- was initially pegged close to R1 500. cal scheme members as their income C tem challenges. As the news To what extend should schemes was reduced – and consequently the of the pandemic spread across conti- fund this test for each beneficiary; affordability of medical scheme cover nents, there were many unanswered do schemes have to fund negative was threatened. questions. For example, will our health tests? Should hospitalisations be nec- systems meet the demand for hospi- essary, to what extent will schemes be The funding industry considered in- talisations? Suddenly, simple things exposed to hospital claims? These are novative ways of maintaining cover for we took for granted became difficult. just some of the concerns. beneficiaries as it grappled with the Supply of essential medication for possibility of leaving them without cov- chronic patients – will this be avail- The question of sustainability is broad- er in their hour of most need. The in- able during the pandemic; will we have er than just schemes’ obligations in dustry explored allowing beneficiaries enough supply and access to much respect of healthcare expenditure; to buy down to cheaper options, and needed essentials? Our vulnerability retention of membership is also a con- targeted contribution debt or contri- to the supply chain when cern. Governments’ response in the bution holidays through various chan- it comes to protec- SADC region was to institute stringent nels were considered. Any assistance tive equipment for lockdowns. This reduced economic that schemes could offer had to be in healthcare work- activity and only industries deemed to line with the legal framework and rules ers became ap- be providing essential services were of schemes; flexibility parent. allowed to remain operational. was limited. SPECIAL COVID-19 EDITION | JUNE 2020 INTROSPECTIVE
What we have learned in the context of medical schemes
Furthermore schemes’ ability to ex- linked to decisions by various profes- A role for telemedicine tend this helpful hand was limited sional bodies and hospital groups to This fear of spreading the virus when further by the fall in market values of suspend admissions for elective pro- patients access care led to significant medical scheme reserves further to cedures, as providers grappled with pressure on regulatory bodies to in- global economic decline resulting from how to deal with potential COVID-19 troduce long-awaited telemedicine the virus. Uncertainty with regard to patients while preparing for an im- measures. South Africa had not yet future claims when virus infections pending flood of hospital admissions adopted telemedicine, and this is an peak did not help the situation, either. during the virus’s peak period, as was opportune time as it ensures the pro- witnessed in most parts of Europe and tection of both practitioners and pa- Implications of a the USA. tients while maintaining access to care. decline in health It is introducing a new dynamic in how service utilisation This decline in usage of healthcare care is accessed across the country – When the lockdown was implement- services can also be attributed to helping bridge the gap in the supply of ed, there was a large decline in the patient factors. There was probably healthcare professionals, which is dis- utilisation of health services, such as general reluctance to access health proportionate relative to geography. hospitalisation, acute medication and services for fear of acquiring infection Health funders quickly embraced the consultations with healthcare pro- at facilities. News reports of entire development and are paying for tele- fessionals. The extent of the decline hospitals being closed due to multiple medicine consultations. varied across disciplines COVID-19 cases among hospi- and medical schemes. tal staff did not help either. Another positive on the regulatory front Some schemes re- Patients even avoided was the Competition Commission’s ported a more than visiting their GPs as re- suspension of collective bargaining in 50% drop in hos- ports spread of cer- the treatment of COVID-19. This was pitalisations. This tain practitioners be- once again a reflection of the unbal- could largely be ing infected by other patients.
5 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare
anced regulatory framework that places funders at a disadvantage when it comes to negotiating fair prices for health services. At the time of writ- ing, however, there was not much movement on a negotiation framework or platform to allow for collective bargaining for COVID-19 treatment. This is despite the expectation that funders should pay in full for COVID-19 treatment.
The fall in utilisation of health services brought challenges for private healthcare providers, both facilities and individuals. They depend on regular income from health funders as patients access care, yet had to remain operational during the lockdown while receiving reduced income – this put great financial pressure on them. The cost of running facilities increased as extra caution- ary measures had to be in place to manage the potential transmission of the virus.
Providers were not spared the financial impact of this, with some approaching funders for ad- vance payments. Obviously, this was not extend- ed as funders’ regulatory frameworks do not al- low for such payments.
What the coronavirus pandemic has also highlighted is that the preferred method of reimbursement (fee-for-service) has some risks associated with it.
Healthcare providers only earn income when a patient accesses services. If providers had a mix of fee-for-service and alternate reimburse- ment models, like global fees for facilities and capitation, their incomes would have not fallen as much as they did. In addition, funders would have been able to predict with more certainty the impact of the virus on healthcare expendi- ture. This reduction in uncertainty would have made funders more flexible in how they re- sponded to the pandemic.
CHARLTON MUROVE Head: Research, BHF SPECIAL COVID-19 EDITION | JUNE 2020 INTROSPECTIVE
The need to eliminate unnecessary utilisation Perhaps what is needed is better coordination between The fall in health services usage levels also brought other issues to the fore: providers and funders. They depend on each other to to what extent is the decline due to a provide effective patient care. The restriction on collective drop in unnecessary utilisation (waste in the system) and denial of access to bargaining took away the platform often used to discuss patients who genuinely need it? Obvi- ously, the response to these two pos- health system challenges, a discussion needed in the sibilities is quite different, but what is needed is a better knowledge of how private sector. patients access care. devising methods to defraud patients how to return the industry to normal. Wastage should be eliminated as much and funders. South Africa is likely to There were also requests from pro- as possible and this will need a multi- see similar trends. Vigilance on the viders for schemes to fund all protec- pronged approach that takes into ac- part of funders and patients will be tive equipment, as well as the testing count benefit design, patient education key to ensuring trust funds are pro- of all patients admitted to hospital for and managed care interventions. The tected. Monitoring of telemedicine is COVID-19. While there is merit to such debate about the extent of supplier- critical as this new platform may easily testing, very little assurance was pro- induced demand in the market will wid- be abused. vided to funders with regard to patient en, given the coronavirus experience. safety. Measures to limit the spread The relaxation of the lockdown by the of the virus were not standard across Patients who fail to access care as a South African government brought facilities; neither were they communi- result of the restrictions present a more challenges. After five weeks of cated. Thus, there was no assurance big risk to the industry. In most cases, strict social distancing and depressed offered to the funders on the safety of delayed access leads to complications, economic activity, it was apparent patients accessing facilities. which often require more intensive that the lockdown had to be relaxed. and expensive interventions. In other The impact of those five weeks on Perhaps what is needed is better cases, patients will pay the ultimate the economy was huge – return to coordination between providers and price – their lives. Perhaps more care work was essential. This was despite funders. They depend on each other should have been taken before the evidence on the health front that the to provide effective patient care. lockdown to ensure the availability number of new infections was con- of appropriate care and access. This tinuing to grow. The number of daily The restriction on collective bargain- might have helped mitigate healthcare cases was higher than just before the ing took away the platform often used providers’ loss of income. lockdown. to discuss health system challenges, a discussion needed in the private Challenges related to Healthcare facilities and profession- sector. Failure to coordinate between fraud, waste and abuse als were faced with tough choices and funders and providers led to various The fall in economic activity also brings had to open, despite evidence of ex- complexities like lack of standardised challenges relating to fraud, waste panding infection. This was unfortu- coding in the industry. The response and abuse. Internationally there are nately done in an uncoordinated way; to the virus has been compromised already reports of how fraudsters are there was not much communication at least partly due to the lack of such taking advantage of the pandemic and between providers and funders on coordination.
B O A R D o f HEALTHCARE F UNDERS 7 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare The power of collaboration A tool for progress in curbing the pandemic
Due to the international nature of COVID-19, collaborations are required at global, national and community levels. In this article we outline the tools that enable these and the coordination of efforts to protect the public health at these levels.
CO-WRITTEN BY Dr Tryphine The International Health obliging them to develop, strengthen Zulu, Dr Stanley Moloabi and Regulations (2005) and manage capacity to identify, DR. Selaelo Mametja GEMS The International Health Regulations assess, report and respond effectively (2005) (IHR), adopted by the World to public health risks and emergen- Health Assembly in 2005, provide a cies. These regulations also empower n 31 March, the World Health legislative framework for collaboration the WHO to make non-binding and Organisation (WHO) declared at international level. This document temporary recommendations for O COVID-19 a public health is binding on all WHO member states affected countries. emergency. According to the WHO, a and provides a regulatory framework public health emergency is the occur- for global management of public The Pandemic Influenza Prepared- rence or imminent threat of an illness health emergencies. ness Framework (PIP Framework) or health condition caused by bioter- adopted by the World Health rorism, epidemic or pandemic disease, The purpose of the IHR is to prevent Assembly in 2011 provides essential or a novel and highly fatal infectious and manage the public health risks guidance on influenzas with human agent or biological toxin that poses a arising from the worldwide spread pandemic potential. It encourages substantial risk of a significant number of disease. These regulations require WHO member states to share PIP of human fatalities or incidents, or countries to notify the WHO of their biological materials from influenza permanent or long-term disability. emerging public health threats, viruses in a rapid, systematic and
8 B O A R D o f HEALTHCARE F UNDERS timely manner, through the Global restore peace and order as well as a emergency preparedness; (d) rapid Influenza Surveillance and Response threat to life. and effective response to disasters; System, which is coordinated by the and (e) post-disaster recovery and WHO. For example, manufacturers of In the middle of March, the president rehabilitation. influenza vaccines, as well as diagnos- declared a national state of disaster. tic and pharmaceutical companies, This declaration was enabled by the The most crucial function of disaster will receive samples from the surveil- Disaster Management Act. A disas- management is to mobilise financial lance Bio-Bank. There are also benefit ter is defined as a progressive or resources to mitigate the effect of a sharing arrangements with for-profit sudden, widespread or localised natu- pandemic. Furthermore, the act allows organisations, which will receive sam- ral or human-caused occurrence that for the relief of persons affected as well ples from the PIP framework. causes or threatens to cause death, as for the movement of people and injury or disease; damage to property, goods, and the availability of goods National public health infrastructure or the environment; and services. These provisions pri- emergency tools or disruption of the life of a commu- marily make it possible to implement South Africa has two pieces of legis- nity. The effect is of a magnitude that and enforce public health measures lation to protect the public in case of exceeds the ability of those affected to such as travel restrictions, lockdowns, serious harm to health and life. These cope with its effects using only their social distancing and rapid upscaling are the State of Emergency Act no. 64 resources. of health services. of 1997 and the Disaster Management Act no. 57 of 2002. While both these A disaster management plan is a con- Ministers may also issue regulations, laws provide for the protection of life, tinuous and integrated multisectoral, directives and notices that are specific they differ significantly. multidisciplinary process of planning to COVID-19. To date, more than 50 and implementation measures aimed have been published, and it is impos- The State of Emergency Act is much at (a) preventing or reducing the risk sible to summarise them in this article. more stringent and can only be of disasters; (b) mitigating the sever- Within the health funding sector, the applied if there is the necessity to ity or consequences of disasters; (c) Council for Medical Schemes (CMS)
B O A R D o f HEALTHCARE F UNDERS 9 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare
issued several circulars to guide man- contribution to the table by voluntarily unaffordable, especially if the funding agement and funding of COVID-19. donating money, services and other industry has to follow a national strat- contributions in kind. The solidarity egy of extensive screening and testing Other measures deal with the exemp- fund is an example of how South Afri- for COVID-19. tion of the industry from sections 5 cans come together during adversity. and 6 of the Competition Act, and At the time of writing, negotiations HPCSA guidelines on telemedicine In typical South African fashion, soci- on the hospitalisation of COVID-19 (allowing telephonic consultations). ety also prescribed humour, the best patients in the private sector were The fact that the legality of circulars medicine, for itself, accepting with underway. The sector has excess has previously been questioned adds grace and laughter the partial lifting bed capacity, and this could be used another level of uncertainty on the of the lockdown further to the Presi- effectively to supplement bed short- preparedness of the industry to deal dent’s ‘mask event’ at the end of his ages in the public sector. There has to with public health emergencies. address. South African fears with be agreement on price, though. The regard to the reopening of schools nosocomial outbreak of COVID-19 The government is effectively using were also leavened with humour. in private hospitals has also been a national health regulations on com- Concerns included children losing cause for concern. municable diseases to coordinate their masks, sharing their masks and surveillance of COVID-19 in both the poor cough etiquette. South Africa has a high density of pri- public and private sectors. Tools that vate hospitals and from the outset, have been used include regulatory implementation the hospital groups should have decisions, circulars and guidelines. challenges designated several hospitals for In terms of mobilising resources for Pandemics are notorious for expos- COVID-19 only and allowed others to healthcare, the CMS has issued a cir- ing weaknesses in the health system. continue with the provision of routine cular outlining how COVID-19 ought While the Health Market Inquiry (HMI) care. This would have assisted with to be funded and has submitted the had identified some in the private infection control and allowed for the gazette to the Minister of Health. The health sector, these issues are now continuous provision of healthcare. HPCSA, on the other hand, has relaxed more clearly visible. High costs, for its rules on telemedicine to allow example, are a considerable barrier When the virus broke out in China, practitioners to consult with patients to diagnosis, treatment and care of that country upscaled the local remotely by electronic means. COVID-19 patients, including the trac- production of personal protective ing of contacts. equipment (PPE) for medical person- Community-level nel. This domestic production not measures Despite promulgation of enabling only reduced costs but also made Not only has government coordi- legislation, there are still many chal- PPE widely available while boost- nated efforts at a national level, South lenges. Although the cost of tests ing economic activity. There is no Africans at large have brought their has been lowered, they are still evidence locally of national efforts to increase capacity and negotiate affordable PPE, except in respect of “If you want the cooperation of humans around you, the provision of cloth masks. Localis- ing production of COVID-19-related you must make them feel important, and you do that by healthcare products and medicines would contribute towards stimulating being genuine and humble.” Nelson Mandela the economy.
10 B O A R D o f HEALTHCARE F UNDERS Perhaps it is high time “ to negotiate an alternative reimbursement mechanism that “incentivises the holistic management of COVID-19 patients.
While there is no specific treatment healthy patients at low cost (these for COVID-19 as yet, other thera- patients require minimal clinical care) pies are recommended off-label or thus making it affordable for schemes in the trial setting. Access to medi- to purchase isolation services; or (b) cine for all is essential. While the the state can provide such facilities. single exit price exclusions are not However, the latter strategy may applicable in the public sector, allow- result in the displacement of vulner- ing the private sector to purchase able patients. Dr. Selaelo Mametja medicines at a tender price or nego- Chief Research Officer, GEMS tiated tariffs during the outbreak The pandemic is also highlighting would be beneficial. While the Com- other deficits in the current private petition Commissioner has allowed health system. With fee-for-service, data that can be used to inform the some exemptions, the Medicines and there will be more disjointed efforts in pandemic response appropriately. Related Substances Control Act no. community screening, contact tracing 101 of 1965 rigidly regulates the price and referrals. Perhaps it is high time Furthermore, the pandemic has of medicines. to negotiate an alternative reimburse- highlighted the weaknesses of a ment mechanism that incentivises fragmented and inequitable health While the CMS has indicated that the holistic management of COVID-19 system. South Africa has sufficient the funding of COVID-19 complica- patients. In-hospital infection control resources in the private sector. The tions/severe COVID-19 is a prescribed measures require routine screen- reasons for the collaboration of the minimum benefit, there is much uncer- ing and testing for COVID-19. It is not public and private sectors have never tainty on the management of patients apparent who should fund this, par- been more compelling, and perhaps with mild symptoms and those who ticularly with regard to nosocomial represent an opportunity for govern- cannot isolate safely. Guidelines are COVID-19. ment to take on the role of a giant necessary to guide the management price negotiator on behalf of the of these patients. Considering the According to the National Health Act funding industry – a nice practice run HMI findings and the cost of private regulations that deal with notifications for its strategic purchasing role under healthcare, there is a risk that medical of communicable diseases, schemes the NHI? The volumes bought by the schemes may find it unaffordable to should report these to the National public sector could incentivise the fund the care of this group. Institute for Communicable Diseases private healthcare industry to pro- (NICD). To date, there has been no vide competitive pricing. The time to The risk can be mitigated in two ways: guidance on how schemes should do show that we can do universal health- (a) private health facilities can isolate this. Claims information contains rich care is now. JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare Telemedicine Enabling access for all
Globally and in South Africa telemedi- During a time of crisis, telemedicine has helped cine is facing certain legal, regulatory and reimbursement challenges, but healthcare provider organisations and caregivers there is nonetheless a need to facili- tate more widespread adoption better respond to the needs of patients. thereof.
n less than a decade there have Clinical applications of telemedicine In March 2020, the Health Profes- been several global public health include teleconsultations, telecardi- sions Council of South Africa (HPCSA) Icrises: SARS, MERS, Ebola, Zika virus ology, telegynaecology, and mental added a relaxation clause to the tele- and now COVID-19. We have already health consultations. It does, how- medicine rules, allowing its use during seen the benefits and importance of ever, carry some challenges and the crisis. This allowed patients to be telemedicine for COVID-19, which the limitations, e.g. with regard to surgery managed remotely as the country pandemic has brought into a new light. and anaesthesiology. went into lockdown. We are hopeful This is why healthcare stakeholders that telemedicine will continue to be should embrace the technology and As the coronavirus wreaks havoc on permitted after the crisis. make it an integral part of the system the healthcare system, telemedicine is to allow us to prepare for another helping healthcare provider organisa- improving access global health crisis. tions and caregivers better respond to healthcare to the needs of patients. It enables The telemedicine surge during the Telemedicine is a readily available the transfer of health information COVID-19 pandemic is helping to pro- solution that allows those follow- across distances using technologies vide care to patients who might need ing treatment for other conditions like email, telephony, video links and it after exhibiting potential symptoms to continue doing so, while potential social networks. In this way, tele- of coronavirus infection. COVID-19 cases can be filtered out medicine is bridging the gap between remotely. It has been available for a people, physicians and health sys- Telemedicine is presenting itself long time but not widely adopted, and tems, allowing everyone, especially as the ideal solution in this regard, entails the use of information and asymptomatic patients, to stay at linking patients remotely to hospi- communication technology to pro- home and communicate through vir- tals, primary care and consulting vide patient care and the sharing of tual channels, helping to reduce the disciplines, thus allowing access to clinical information between different spread of the virus to populations and healthcare while curbing disease locations. frontline medical staff. spread. Telemedicine solutions and
12 B O A R D o f HEALTHCARE F UNDERS SPECIAL COVID-19 EDITION | JUNE 2020 TELEMEDICINE
programmes allow people suffering a 24/7 lifeline between patients and from other medical ailments during providers. There is also a rapidly this time to receive care from home increasing need for on-demand acute without entering medical facilities, care via telemedicine. minimising the risk of their contract- ing the virus. Three primary roles of telemedicine during the crisis The CDC and the WHO are urging both 1. Simple screening of patients the general public and medical staff to remotely, rather than requiring use telemedicine solutions for non- that they visit a practice or hospital; urgent communications in order to 2. Triage of patients with cold and flu reduce the pressures on emergency symptoms, and remote care for rooms and clinics. Telemedicine is those who do not need medical being used to ‘forward triage’ patients intervention or could receive care long before they arrive at primary at home; care facilities. 3. Routine care for patients with chronic disease and on-demand Many chronic care patients can acute care to reduce risk of expo- schedule teleconsultations with their sure to the virus; and doctors to fill prescriptions and avoid 4. Protection of providers and face-to-face visits, hence minimising staff from repeated exposure to their risk of exposure to COVID-19. infected patients. Chronic medication can be delivered to patients’ homes. This allows for Limitations of and possible pitfalls of continuity of care. This digitalisation of telemedicine healthcare is streamlining things like 1. The treating practitioner may not the dispensing of medication, record- be able to obtain a full clinical pic- sharing and patient-tracking. ture from a remote location, so issues may arise as a result of this Telemedicine has proven to be a limitation; crucial lifeline for some rural commu- 2. Incorrect prescribing; and nities, helping to address workforce 3. Missed diagnoses, as these are shortages and reducing the burden now reliant solely on a history and on patients who might otherwise have reported symptoms without a to travel long distances for healthcare physical examination. services. This is particularly important in respect of healthcare professionals Although telemedicine is evolving fast unavailable in rural areas, e.g. psychi- and is a proven modality to enable atrists and consulting specialists. access to healthcare, it is impor- tant that it is used appropriately, Telemedicine also allows rural hospi- and its use should not compromise BY Professor Morgan Chetty tals to outsource diagnostic and other patient care. Telemedicine oversight CEO, KwaZulu Natal Managed Care services and thus help reduce pro- is therefore essential and this is the Coalition, The IPA Foundation of SA viders’ sense of isolation. It provides responsibility of the HPCSA.
B O A R D o f HEALTHCARE F UNDERS 13 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare Legal Changes aimed at addressing the COVID-19 pandemic
On 15 March 2020, the At the time of writing, the latest regula- The regulations also cover attendance tions in terms of the DMA were those at funerals, prohibitions on evictions, government declared promulgated by the Minister for alert places and premises closed to the the COVID-19 outbreak level 3 on 28 May 2020. They amend public, the sale, dispensing or trans- the alert level 4 regulations published portation of liquor and the operation to be a national disaster on 29 April. of the economic and public sector. in terms of the Disaster A decision of the Pretoria High Court Employers are required to promote Management Act, 2002 had held that businesses do not need physical distancing of employees, (DMA), which is adminis- to obtain a Companies and Intellectual including enabling them to work from Property Commission (CIPC) certifi- home or minimising the need for tered by the Minister of cate in order to conduct any business them to be physically present at the during the state of disaster. The court workplace. Employers must restrict Co-operative Governance held unequivocally that no law enforce- face-to-face meetings and take spe- and Traditional Affairs. ment officers should request a CIPC cial measures for employees with certificate from anyone and set aside known or disclosed health issues or the directives of the Minister of Small comorbidities that place them at a ection 27(2) of the DMA allows Business Development in this regard. higher risk of complications or death the Minister to make regulations, arising from COVID-19. S issue directions or authorise the The regulations stipulate that an issue of directions concerning matters employer must provide every No-one who is a clinically or labora- listed therein only to the extent that it employee who may come into direct tory-confirmed case of COVID-19, who is necessary for the purpose of: contact with members of the public as is suspected of having contracted part of their duties with a cloth face COVID-19, or who has been in contact (a) assisting and protecting the mask to cover their nose and mouth, with a carrier of COVID-19 may refuse public; or a homemade or other appropriate to submit to a medical examination, (b) providing relief to the public; item that covers the nose and mouth including the taking of a body sample. (c) protecting property; when in a public place. (d) preventing or combatting disrup- In May and early June court cases tion; or No-one is allowed to be in a public place against the regulations were heard (e) dealing with the destructive and or enter a public building or premises if and some, like the court case chal- other effects of the disaster. not wearing a cloth face mask. lenging the ban on tobacco products,
14 B O A R D o f HEALTHCARE F UNDERS are still to take place. In early June, the North Gauteng High Court set aside USEFUL LINKS the regulations under alert levels 3 and 4 as unconstitutional, but sus- The COVID-19 regulations issued on 29 April 2020 can be accessed pended its order for 14 days to give at https://www.gov.za/sites/default/files/gcis_document/202004/43 the government the opportunity to 258rg11098gon480.pdf . rectify the regulations. The COVID 19 regulations made on 28 May for alert level 3 can be accessed at: https://www.gov.za/sites/default/files/gcis_ The government decided to appeal document/202005/43364gon608s.pdf this decision, which has the effect of suspending the judgement pending The NICD guidelines can be found at https://www.nicd.ac.za/ the appeal. Therefore, the regulations wp-content/uploads/2020/04/COVID-19-Quick-reference- are still applicable as at the time of v12-09.04.2020_final-1.pdf writing.
COVID-19 is now a prescribed mini- schemes have said that members may or history of fever. The NICD therefore mum benefit in terms of the Medical have a limited number of COVID-19 does not recommend testing of per- Schemes Act, for the period of the tests, regardless of whether they are sons who are asymptomatic. pandemic. Medical schemes are symptomatic or not. Some scheme therefore legally obliged to pay for members may find themselves paying The Disaster Management Act puts testing and screening for COVID-19, for pre-admission COVID-19 tests a three-month time limit on the dec- as well as treatment and rehabilita- depending on the rules of the scheme laration of a disaster. The current tion. Private hospitals are insisting on in question. declaration is due to expire in the COVID-19 tests for patients being middle of June 2020. However, the admitted for elective surgeries, even The National Institute for Commu- government is allowed to extend it for when there is no clinical evidence to nicable Diseases (NICD) has issued periods of one month at a time and suggest infection. guidelines for when a person must has already indicated its intention to be tested for COVID-19. Only persons do so. A number of medical schemes have with acute respiratory illness with objected to paying for such tests and sudden onset of at least one of the fol- indeed they are not part of the pre- lowing should be tested: cough, sore BY Dr. DEBORAH Pearmain scribed minimum benefits. Other throat, shortness of breath, or fever Independent Legal Consultant
B O A R D o f HEALTHCARE F UNDERS 15 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare Looking into the crystal ball trajectories for South Africa over the next 12 months
The trajectories for South Africa do not present alternative pathways that trade off lives against the economy. All possible futures impact on both lives and the economy.
BY Dr Shivani Ranchod economic impact as companies close CEO, Percept to prevent the spread among their staff and people voluntarily stay home out of fear. OVID-19 has stripped away the illusion of certainty: there is no Alternatively, we may find that the Croom for denial. After months impact on South Africa is more muted of the world’s grappling with the dis- than the experience in Europe and ease, we still face many unknowns: the United States (the tortoise). This the precise physiological dynamic, is plausible given the youth of our the proportion of people who are population. asymptomatic, the length of incu- bation, the inter-relationship with Epidemiological modelling, like that co-morbidities, the duration of immu- undertaken by the Actuarial Society, nity and the extent of the economic allows us to test the ways in which consequences. We still await scien- the direct impacts of the disease may tific confirmation of key questions: unfold. Even this is fraught with all the will any of the vaccines work, will the limitations inherent in using models many treatments being tested prove as representations of reality; hence successful, and does the BCG vaccine there is a need for a model where dif- have some protective effect? ferent combinations of variables can be tested. Even when considering two simple disease trajectories for the country: Short- and long-term the hare and the tortoise, the precise implications ways in which we might respond is density, an immune-compromised The trajectories for South Africa do unknown. In the hare trajectory, we population and the cooling of tem- not present alternative pathways that experience an exponential increase peratures. Regardless of whether we trade off lives against the economy. in COVID-19 cases and deaths. This revert to higher levels of economic All possible futures impact on both is plausible given our high population restriction, there is likely to be an lives and the economy. In addition
16 B O A R D o f HEALTHCARE F UNDERS SPECIAL COVID-19 EDITION | JUNE 2020 LOOKING AHEAD Looking into the crystal ball trajectories for South Africa over the next 12 months
to official COVID-19 deaths, there are The response of individual South Afri- COVID-19’s implications also deaths from other causes that cans is also crucial: will we continue to for health system reform have been misclassified, prevent- abide by restrictions, how will individ- COVID-19 has given us a glimpse of able deaths from other causes due to ual businesses trade off commercial what is possible for health system inability to access an overburdened concerns against the safety of their reform: rapid innovation in digital health system and the mortality staff and customers, and will we inno- access to health, the deployment of impact of economic shock (though vate in extraordinary ways? community health workers to accel- there is little evidence from previous erate our response, home delivery recessions that this is substantial). A best-case future sees continuous of medicines in the public sector and investment in our health system to private sector doctors willing to roll up Part of the difficulty associated with avoid its becoming overwhelmed. their sleeves for the public good. thinking through future trajecto- Strong and clear leadership is needed ries is that some of the implications to ensure that the economic conse- The centrality of stewardship is are short term (ICU utilisation and quences are not chaotic, and relief beyond question. There are many deaths), while others are long term reaches the most vulnerable. Cycling things that would have made our (such as the impact of school closures between high and low levels of restric- health system more resilient but are on educational outcomes and the tions may prevent the system from missing because of lackadaisical regu- permanence of job losses). being overwhelmed – but we have to lation and oversight. Imagine if we had recognise that this will get more diffi- progressive telehealth regulations, The intrinsic uncertainty of the dis- cult to sustain over time. risk-based capital and a risk equali- ease trajectory is compounded by the sation fund. Imagine if we had strong wide range of responses to our reality. A worst-case future sees us fare purchasing of healthcare on the basis Some of these responses lie outside worse than the global north because of value and could purchase easily our control – in a global world we are both our health system and economy from public and private providers. affected not only by our borders, but are more fragile, we have fewer health also our trade decisions and our own workers and access to healthcare in The decisions about how to rebuild recession. rural parts of the country is poor. our economy, health system and social structures will have a long- Within our borders, the impact A health system collapse will have an lasting impact. We need leadership depends on government’s respon- impact not just on patients but also that is agile and responsive, that is siveness, the effectiveness of that on health workers. Weak leadership sufficiently devoid of ego to admit response’s implementation, the heed- exacerbates the situation by not being where reversals in decisions are war- ing of human rights and the myriad of sufficiently responsive and clear. ranted, and that nurtures solidarity complex trade-offs and decisions. Social tensions are high. and trust.
B O A R D o f HEALTHCARE F UNDERS 17 JUNE 2020 | SPECIAL COVID-19 EDITION TECHNOLOGY PERSPECTIVES DIGITAL TECHNOLOGY can help Africa combat COVID-19 in unprecedented ways
This digital transformation precipitated by the COVID-19 pandemic will only work if bold steps are taken to disrupt, diffuse and democratise our health systems.
BY Precious Matsoso gatherings; and online education tools, For instance, the Commonwealth has and Steven Davis webinars and Bing-streaming television. developed a COVID-19 tracker, a tool Co-chairs: WHO Digital Health The pandemic has sparked innovation designed to collect real-time data for Technical Advisory Group and forced adoption of these tools at governments, and a portal information- unprecedented speeds. They have sharing and health protection toolkit for ensured that work continues even health professionals. under the most difficult circumstances he COVID-19 pandemic accen- – with proper social distancing and Professional organisations have shared tuates the digital divide and effective remote operations. best practices on health protection technology gaps across Africa, measures to support them in the care T 3 but digital technology nonetheless Innovative of patients. The African Union, through offers unprecedented opportunities for tools to facilitate the Africa CDC’s working in partnership combating the virus and improving well- information-sharing with the WHO, has become an impor- being across the continent. The lockdowns and semi-lockdowns tant information source for COVID-19.4 across the world have forced countries The WHO is set to launch a COVID-19 A plethora of digital tools have been to rely on digital tools and information digital clearing house to provide more deployed across every aspect of the models that use complex and robust information on useful and effective digi- pandemic – reaching a wide range of tools that work across multiple sources tal tools already being used across the people: WhatsApp messaging options and capabilities. The trajectory of the globe to combat the pandemic, so that for citizen engagement and social con- pandemic has revealed the extent to Ministers of Health and other health nections; competitive meeting solutions which countries and the world are will- authorities do not have to re-invent for all types of business and social ing and able to digitise and collaborate. solutions time and again.
18 B O A R D o f HEALTHCARE F UNDERS While the opportunities afforded by and tracing of cases - not victimising or there were 4.1 billion internet users new digital and data tools are immense, stigmatising those affected. and of these 525 million were in Africa.6 they are not deployed consistently, uni- Infrastructure and data costs have formly or equitably across the continent The third global survey conducted by proven to be barriers to effective use or the world. The pandemic is shining the WHO in 2015 investigated how of internet technology for broad health a spotlight on the underlying systemic digital health tools can support uni- purposes. Nonetheless, the poten- challenges and inequities in our health- versal health coverage.5 Even though tial for the use of mobile phones for care systems and digital ecosystems. most countries had eHealth and/or ICT public health purposes should not be For example, the response to outbreaks strategies and plans, these did not nec- discounted in the COVID-19 response requires good surveillance systems and essarily translate into adequate systems and recovery. Mobile applications and well-functioning health information for information-gathering, or organisa- tools for tracking and tracing cases, systems, which are essential building tions for integration into a network of sharing information with citizens, blocks of any health system. Despite resources that can help with the clinical supporting health workers and volun- sound measures, these systems are management of patients, management teers, managing supply chain issues, still under-resourced and underdevel- of health facilities, disease surveillance and creating communities of support oped in many countries and regions. and more. These disparities and incon- to address mental health and other In addition, in some countries, surveil- sistencies are particularly visible when COVID-19-related issues are proving lance and close monitoring have been we look at the digital health capabilities effective across the world. achieved at the expense of the protec- of the 54 countries in Africa. tion of personal privacy. Any attempts at Other digital innovators are focusing surveillance must focus on chasing the According to the International Telecom- on using mobile devices and other digi- virus - not individuals, and the tracking munications Union, as of October 2019 tal tools to ease the burden on health
B O A R D o f HEALTHCARE F UNDERS 19 JULY 2020 | SPECIAL COVID-19 EDITION BHF TH360ºE 2020 into DheIGITAalthcL RaEVreOLUTION
Nowhere has this digital revolution been more apparent than in the global and regional health sector. Worldwide with infrastructure and human resource estimates of COVID-19 cases reached 3.1 million, with limitations. COVID-19 presents an 217 000 deaths by the end of April1. As at 28 April a total opportunity to bring about innova- tions that will help countries leapfrog of 33 237 cases and 1467 deaths had been reported in to more robust digital health systems 2 Africa . Leaders and everyday citizens have had real-time and upgrade those that are strug- access to information about the novel coronavirus and its gling through virtual health services, spread. With powerful use of data analytics, a continuous e-learning programmes and electronic feed of data from various sources has provided updates data exchanges. The pandemic there- on daily infections and mortality. Citizens across the fore offers a window of opportunity to transform health systems through continent and the globe have been tracking the progress digitisation in the post-recovery phase – of our massive campaigns to ‘bend the curve’ of this and it needs to be maximised. health crisis. This digital transformation precipitated by the COVID-19 pandemic will only systems. As the pandemic continues to These are designed to help the health work if bold steps are taken to disrupt, move across Africa, all these ideas must sector to manage health data, its gen- diffuse and democratise our health be explored and, if safe, effective and eration, compilation, analysis, synthesis systems. We need to engage the entire affordable, expanded for extensive use. and use. It is a means by which the use digital innovation community – including of information contributes to the effi- big multinationals, start-ups, research- Focus on optimising cient running of the health system and ers, hackers and social entrepreneurs technology use effective rendering of health services. – to bring digital health solutions closer It is time we accelerate the use of this The information that is organised and to communities and providers, to sup- unprecedented arsenal of digital tools managed includes patients’ electronic port social behaviour change, transform not only to combat COVID-19 across medical records, health management surveillance systems, strengthen our Africa, but to strengthen our current systems at different levels of care, measures to test isolate and treat, health systems. health system information tools crucial create mechanisms that fast-track for supporting policy-making, and capa- access to therapeutic interventions, Of course, all information systems and bilities to support providers of services diagnosis and treatment, simplify com- digital tools must comply with an indi- and routine data collection. These, too, munications and curtail misinformation. vidual country’s norms and standards. are in various states of development Further to this, we must extend all of There are pockets of excellence in some and maturity, requiring much attention. these more equitably to the remote areas of Africa, but in others these areas and communities that need them systems and tools do not function opti- Clearly the implementation of these the most. mally. National or sub-national digital strategies has not been fully achieved health strategies have been developed by most countries, partly due to capac- This is humanity’s first digital pandemic. and adopted by many countries. ity and resource constraints coupled Let’s use that opportunity for global good.
1. John’s Hopkins University of Medicine, 29 April 2020. 2. Africa CDC, Outbreak Brief 15: COVID -19 Pandemic, 28 April 2020. 3. Commonwealth Coronavirus COVID-19 Tracker, 2020. 4. Africa CDC JOINT actions to improve health security is an action plan signed between the two agencies to tackle health security. 5. WHO. Atlas of eHealth country profiles: The use of eHealth in support of universal health coverage, 2015. 6. ITU. Measuring digital development: Facts and Figures 2019.
20 B O A R D o f HEALTHCARE F UNDERS SPECIAL COVID-19 EDITION | JUNE 2020 INDUSTRY PERSPECTIVES INDUSTRY STANDS TOGETHER in fight against COVID-19
lot has happened in our world Individuals and businesses alike are treatment of GEMS beneficiaries who in just under two months working collaboratively and moving contract COVID-19. This will come from A and our lives have shifted swiftly in this regard. The true mean- the scheme’s risk fund to ensure that dramatically. We have been forced to ing of leadership lies not in directing members’ day-to-day benefits or savings relook at how we live, work and inter- but in serving people, and such lead- are not affected during this difficult time. act with one another. Some have lost ership has indeed emerged. their jobs; others have lost their loved Medshield ones. We are, however, encouraged GEMS Medshield stepped up by embracing that many have extended a helping The Government Employees Medi- telehealth, enabling members to access hand of support to families and com- cal Scheme (GEMS) has allocated doctors via remote consultation. These munities affected by COVID-19. around R900 million for the care and efforts have increased the capacity of
B O A R D o f HEALTHCARE F UNDERS 21 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare
healthcare professionals to consult hospitals to increase the number of medical advice on all issues relating with more people during a time when specialised hospital beds to care for to COVID-19 and other medical and contact is not ideal. In efforts to assist very ill COVID-19 patients. healthcare issues, the issuing of pre- in increasing resources for COVID- scriptions and, where necessary, free 19 testing, Medshield also donated CompCare Medical Scheme delivery of chronic medication. Boni- a Hyundai panel van and just over CompCare Medical Scheme is among tas also set up a self-help platform R500 000 to the National Institute for the schemes that paid for testing even on WhatsApp and a COVID-19 hub on Communicable Diseases (NICD). Fur- before COVID-19 was declared a pre- their website to ensure that all South thermore, its principal officer took a scribed minimum benefit. The scheme Africans continue to receive up-to- 30% salary cut in an effort to enable has been paying for member tests to date information about COVID-19. the organisation to shoulder the finan- help shoulder the financial burden of cial burden imposed by COVID-19. COVID-19 and, in turn, encourage an Medscheme overall increase in testing. Medscheme, which administers 17 Universal Health medical schemes, negotiated lower Universal Health established the Uni- Bonitas Medical Scheme rates with pathology laboratories versal Foundation, a not-for-profit Bonitas Medical Scheme extended for better testing of COVID-19. Med- entity to raise funds to help those in a helping hand by providing free scheme also offered members the need during the pandemic. Univer- virtual medical consultations to all option to buy down, and the opportu- sal has engaged with the national South Africans through a virtual care nity to pay contributions from medical Department of Health to establish app. Available to both members and savings accounts. Medscheme was emergency high care and ICU field non-members, the services include also able to relax its suspension rules SPECIAL COVID-19 EDITION | JUNE 2020 INDUSTRY PERSPECTIVES
to accommodate members struggling on COVID-19, the Botswana Public The Compensation Fund to meet contribution deadlines. Med- Officers’ Medical Aid Scheme started The Compensation Fund will com- scheme has also developed a rapid running a series of Facebook well- pensate affected workers through its response unit to provide quicker turn- ness programmes every Tuesday and existing illness and reduced work time around support to medical schemes. Thursday at 09h00. benefits.
Medimed BCIMA EOH Medimed offered financial support to BCIMA, the Building and Construction EOH released Sikhona, a corporate members by reducing premiums by a Industry Medical Aid Fund, continues crisis-management app to support record 50% during these financially dif- to support its members in the building corporates with high performance ficult times. and construction sector by offering strategies that leverage technology premier health benefits, which are to support people on how to solve Polmed vital during the crisis. COVID-19 challenges. Polmed, in partnership with Gift of the Givers, assisted in the free screen- Renaissance Health Engen Medical ing of 550 policemen at the FirstCare Medical Aid Benefit Fund screening station. Across the region, Renaissance Health Engen Medical Benefit Fund set up an Medical Aid Fund, a leader in private online doctor consultation platform BPOMAS health funding in Namibia, contributed to allow off-site medical consultations, To ensure that people are informed N$500 000 for the production of PPE risk screening and access to reliable and have first-hand expert information to help in the fight against COVID-19. information for its members. JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare
Cimas Medical Aid First Mutual Health health and assessing the overall Cimas Medical Aid supported the First Mutual Health donated $750 000 wellness of members, providing coun- Confederation of Zimbabwe Indus- towards food packs to support fami- selling where necessary. NMAS has tries in its coordination of the private lies in distress in Zimbabwe. also relaxed credit control for pen- sector response to COVID-19, and sioners to provide financial relief for plays a critical role in ensuring that Nedgroup Medical the elderly. all support centres receive the equip- Aid Scheme ment needed to function. Cimas has The Nedgroup Medical Aid Scheme PULA Medical Aid contributed ZWL 3 750 000 to the (NMAS) implemented a number of PULA Medical Aid is utilising its VAT fight against COVID-19 in the country, operatio-nal efficiency strategies to fund to help members. The fund was channelling funds to various facilities. increase TTO (to take out) limit, lift extended to cover influenza vaccines certain co-payments and reduce the for members registered on the chronic Cimas is also one of the schemes driv- need for certain motivations and doc- disease programme and those aged ing telemedicine in Zimbabwe through uments for admission. 60 and above. The fund has been criti- its Medic Express platform, which cal in allowing the dispensing of three provides quick delivery of medicines NMAS also introduced a number of months’ chronic medication, including to its members’ doorsteps. Addition- out-of-hospital benefits, e.g. providing that for HIV, for members registered ally, Cimas has developed an online care plans that include consultation, on the chronic disease programme. symptom checker that allows doctors pathology and radiology services for The scheme’s pensioner membership to help members to check COVID- COVID-19. The scheme continues to receives 100% cover for COVID-19, 19-related symptoms. provide support focused on mental and the 10% member co-payment SPECIAL COVID-19 EDITION | JUNE 2020 INDUSTRY PERSPECTIVES
on COVID-19 hospital admissions and diagnostics have been waived. It is encouraging to see how BHF members have stepped
IMPERIAL MOTUS MED up to tackle the challenges presented by COVID-19. Imperial Motus Med was one of the first medical schemes to introduce a Hosmed Medical Aid Scheme SUREMED HEALTH new influenza virus vaccine to pro- Hosmed Medical Aid Scheme devel- Suremed donated funds to support vide additional protection to high-risk oped a COVID-19 toolbox. the Gift of the Givers to mobilise beneficiaries over the age of 65, and resources in their efforts in the fight to beneficiaries who have been diag- MH Health and Momentum against Covid-19. nosed with cancer, asthma, chronic Metropolitan Group obstructive pulmonary disease, car- The MH Health and Momentum Met- It is encouraging to see how BHF diac failure and HIV. The vaccine is one ropolitan Group contributed about members have stepped up to tackle of a kind in supporting and strength- R5 million to the Solidarity Fund, while the challenges presented by the pan- ening the immune system and is being the group’s CSI team committed over demic. Many have set up hotlines and used to help patients fight COVID-19. R4 million to support the vulnerable response centres for a quicker turn- communities affected by COVID-19. around in response to cases. Several Bonvie Medical Aid Scheme The scheme has made R26 million in of our members have also applied to Bonvie Medical Aid Scheme developed no-claims safety bonus available to allow their members to use accumu- an app for its members to submit support members during these times. lated funds to cover their premiums COVID-19 claims; this will ensure during these difficult times. Some quicker turnaround in the authorising Working in partnership with Gift of medical schemes have also created and processing thereof. the Givers, the group has established new benefits packages, including risk a drive-through testing facility at its pooling, to cover diagnosis, treatment THE FOSCHINI GROUP (TFG) head office in Bellville, Cape Town. It and hospital care for members, irre- The Foschini Group donated 10 000 is also providing pro bono adminis- spective of benefits. t-shirts to workers who were deployed tration services to the Western Cape by the Department of Health to travel Department of Health with regard to Moreover, we have seen the industry through communities across South its contracting of private hospitals for mobilise and come together to lobby Africa to test citizens for Covid-19. All 10 COVID-19 patients initiatives. the Health Professions Council of 000 t-shirts are ‘Proudly SA’ manufac- South Africa to lift the telemedicine tured locally by TFG’s Prestige Caledon Momentum is also using telemedicine ban to permit doctors and therapists factory. TSG continues in efforts to to deliver innovative and easy-to- to use video or phone calls to treat help those in the frontline fighting this access medical support to increase patients. This has been critical in pandemic. COVID-19 screening and testing using enabling access to healthcare and, its Hello Doctor app. within the context of COVID-19, mini- Swaziland mising the risk of infection. Medical Aid Fund Medipos Medical Scheme Swaziland Medical Aid Fund donated Medipos Medical Scheme developed We honour all your efforts and encour- R200 000 to the eSwatini Resource a self-help kit to support a quicker age you to share all that you are doing Mobilisation Committee for the pur- turn around in testing and supporting with us so that we may continue to chase of PPE. members with self-help. speak as one industry voice.
B O A R D o f HEALTHCARE F UNDERS 25 JUNE 2020 | SPECIAL COVID-19 EDITION BHF 360º into healthcare
COVID-19 Testing Sites
SITES PROVINCE ADDRESS TEL Parkhurst Clinic JHB Stand 506 C/O 14th & 5th Ave Parkhurst 0117881526/7 Bosmont Clinic JHB Stand 1432 C/O Maraisburg & Griffiths Road, Bosmont 0114743413 Rex JHB Stand 782, 15 Rex Str, Roodepoort 0117602231 Weltevredenpark JHB Stand 2944, 1047 JG Strijdom Road, Weltevreden Park Ext 24 0116753038 Cosmo City JHB Cnr South Africa Road & Angola Road Cosmo City 0828575973 Braamfisher JHB Multipurpose Centre: Braam Fischer, Phase 2 0828186575 Barney Molokwane JHB Stand 2896 Ext 1 Orange farm 0118507519 Eldorado Park Ext 2 JHB Stand 3319, 101 Arlberg & Witterberg, Eldorado Park Ext 2 0119454203 Thula-Mntwana clinic JHB Stand 1947 Kanana park Ext 5 0827434572 Crown Gardens JHB Stand 106 Recreation Centre, Crown Gardens 0114332351 South Hills JHB Stand 618 C/O Geneva & Estantia Str, South Hills 0116231297 Shanty Clinic JHB 1000 Armitage Road, Orlando West 0119392015 Jabavu JHB 3123 Thumahole Street, white city jabavu, Soweto 0119844014 Michael Maponya JHB 1479 Nqaya Str, Pimville Zone 1 0119332503 Diepkloof Clinic JHB Erf No. 15643; 3790 Marthinus smuts drive diepkloof zone 3 0119851104 Halfway House JHB Erf 18&19 Market street & moritz, halfway house 0118053112 Diepsloot Clinic JHB Erf 5355, JB Marks Drive Diepsloot Ext 7 0114645396 Bophelong Clinic JHB Erf 3700 Freedom Drive Ivory Park Ext 6 0112611212 Charlotte Maxeke Academic Hospital JHB 0114898853 Tshwane Academic Hospital JHB 0123192257 Dr George Mukhari Hospital JHB 0125214227 Alberton IPS JHB 68 Voortrekker rd, New Redruth Alberton Netcare Mulbarton JHB Room 206 Mulbarton Medical Centre, 27 True N Rd Hospital Lenmed Lenasia JHB Lenmed in Hospital, Lenasia South Daxina Medical Centre JHB Krugersdorp Lab JHB Outpatient Depot, 1 Boshoff Street, Krugersdorp Soweto Healthcare Hub JHB Birchleigh Depot JHB 7 Leo Street Kempton Square JHB Kempton Square shopping centre Shop 61 Leicester Medical Mews JHB Suite 8 Leicester Medical Mews, 7 Leicester Road Bedfordview Germiston Houghton Hotel JHB 53 2nd Ave, Houghton Estate Cheltondale JHB 62 Orchard Road, Cheltondale Lancet Corner Richmond JHB Cnr Stanley & Menton Rd, Richmond Auckland Park Rosebank Lab JHB 3rd Floor, 8 Sturdee Ave, Rosebank Morningside JHB 173 Rivonia Rd, Morningside, Sandton
26 B O A R D o f HEALTHCARE F UNDERS SPECIAL COVID-19 EDITION | JUNE 2020 USEFUL RESOURCES
SITES PROVINCE ADDRESS TEL Groote Schuur Academic Hospital CT 0214045201 Tygerberg Academic Hospital CT 0219389354 Belville CT 2 Heide Street, Bloemhof Brackenfell CT Brackenfell Medical Centre, Cnr Brackenfell & Old Paarl Road Cape Town CBD CT Cnr Longmarket & Parliament Str Century City CT Smartsurv House, Century City Durbanville CT 15 paul Kruger Street Drbanville Kuils River CT shop 9 De Kuilen Shopping Centre Carinus Street Belville West CT 7c Solway Street, Belville West A Pinelands CT 91 Jan Smuts Dr, Pinelands Rondebosch CT Rondebosch Medical Centre, 95 Klipfontein Rd Simonstown CT 1st Floor Room 4 HarbourBay Medical Centre Stellenbosch CT Trumali House, Trumali Street, Harringtons Place Somerset West CT Arun Place Block 6 Unit F, Cherrywood Gardens, Sir Lowry's Pass Stellenbosch Oewerpark CT Stellenbosch Oewerpark Suite 12A Rokewood Road, Die Boord Inkosi Albert Luthuli Central Hospital KZN 0312402794 Lenmed La Verna Private Hospital KZN 1 Convent Road, Ladysmith Mediclinic Newcastle Private Hospital KZN 78 Bird St, Newcastle Central Life Empangeni Garden Clinic KZN 50 Biyela St, Empangeni Central Busamed Gateway Private Hospital KZN Busamed Gateway private hospital, 36-38 Aurora Dr, Umhlanga Rocks Berea KZN 1st Floor Mayet Medical Centre, 482 Randles Road, Sydenham Ahmed Al-Khadi Private Hospital KZN 490 jan Smuts Hwy, Mayville NHLS Port Elizabeth Virology PE 0413956120 Universitas Hospital Free State 0514052834 Mediclinic Bloemfontein Free State Room G07, Mediclinic Bloemfontein, Kellner Str, Westdene Kimberley Free State 112 mac Dougall St, El Toro Park Welkom Free State RH Matjhabeng, Power Rd, Reitzpark Polokwane Limpopo 44A Grobler Street Tzaneen Limpopo 71 Wolksberg Road, Ivory Tusk Lodge Thouyandou Limpopo Corner Mpehephu & Mvusuludzo near Cash Build Phalaborwa Limpopo Clinix Private Hospital No 86 Grosvenor Street
B O A R D o f HEALTHCARE F UNDERS 27 JUNE 2020 | SPECIAL COVID-19 EDITION In MEMORIAm
6 November 1951 - 11 May 2020 Remembering Dr. Clarence Mini
he Board of Healthcare Funders because of his resilience and the He was passionate about providing is deeply saddened by the re- efforts he made to keep the organ- support to enable people to develop, T cent passing of Dr Clarence Mini isation standing. He was a strong organisations to grow, and institu- from COVID-19. An industry legend, and decisive yet compassionate and tions to become efficient. He did not Dr Mini played a significant role at humble leader, who made a differ- tolerate inefficiency, always spoke the foundation level of at the BHF. After ence to the institutions and people truth and challenged the status quo. the departure of the late former MD, with whom he made contact. He chal- As part of the Value Input Accredita- Dr Humphrey Zokufa, Dr Mini sup- lenged leaders and policy-makers tion Committee, where he served as ported and led the team while the BHF to look closely at the realities of the a volunteer reporting to the MEC of was looking for a replacement. people and the communities who ben- Health on areas that need improve- efit from the healthcare sector. ment in public healthcare facilities He was deeply rooted in the organisa- and quality assurance standards, he tion at a time when the BHF required He volunteered his time to support was genuinely concerned about the leadership internally, when the organ- efforts to develop the public health welfare of others. isation was going through a period sector, sharing best practices and of political turmoil and was at risk of providing honest insights into its We are grateful to his family for sharing disintegrating. realities. He was not afraid to go into him with the industry, for understand- hospitals in townships and remote ing his passion and allowing him to He provided the leadership that was areas to gain an understanding of follow his purpose. needed and put the interests of the the realities faced by healthcare pro- organisation first. His views on UHC fessionals and community members. We have lost a leader and a legend, a were far ahead of their time, and he He was pivotal in the development of friend and a compassionate patriot. saw its value long before many under- young professionals in the sector, to Farewell Dr Mini, you will be deeply stood the concept. We are here today whom he served as a mentor. missed by all of us at the BHF.
28 B O A R D o f HEALTHCARE F UNDERS REGISTERED OFFICE Lower Ground Floor, South Tower 1Sixty Jan Smuts, Jan Smuts Avenue Cnr Tyrwhitt Avenue, Rosebank, 2196
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