Health and Wellness

The Western Cape Government remains committed to the progressive realisation of universal health care (UHC) as provided for in section 27 of the Constitution and continues to implement initiatives that strengthen our health system to ensure access to quality services where and when people need it.

Earlier this year we launched an innovative think tank process to further bring together the public and private healthcare systems in the province, to advance universal healthcare through a strong, transparent partnership between the public and private sectors, rooted in accountable governance and meaningful community participation. This is the Western Cape Model (WCM). By leveraging long-standing collaborations, shared learning, and robust evidence, we aim to strengthen primary healthcare and implement practical solutions that advance the Western Cape Model. We are committed to a health system that is fair, affordable, and responsive to the needs of all people.

We have undertaken chronic disease management pilot projects, such as those in Knysna and Bitou, to test coordinate service delivery models and new innovations in primary healthcare access. These include initiatives where patients on chronic medication can collect their government-issued medicines from private or retail pharmacies – expanding our footprint while making access more convenient for patients.

These pilots have provided valuable insights into the operational, financial, and governance arrangements required for integrated systems, including how to coordinate services across public and private sectors and strengthen the district health system.

With regards to readiness assessments for the implementation of the NHI – this is very difficult to do primarily because there are so many uncertainties around this fund, especially with regards to provincial funding and the future of provincial facilities and staff.

However, what we can say is that while the NHI is vague and untested, the Western Cape Model is delivering healthcare every day and is characterised by:

• A functional and integrated district health system with robust information systems in priority areas.
• A well-established quality improvement programme and an emphasis on patient-centred care, with the Office of Health Standards Compliance certification work embedded in our service model.
• Strong partnerships with the private sector, civil society, and academic institutions.

There are a number of challenges that have been identified with regards to the NHI fund.

1. There has been no confirmation from the National Department of Health or the National Treasury regarding cost or funding. In fact, the NHI proposes removing a large portion of the Western Cape’s equitable share which is meant for the delivery of the healthcare to the residents of this province.
2. The NHI proposes that tertiary hospitals - like Groote Schuur, Tygerberg and the Red Cross War Memorial Children's Hospital – be placed under the control of national government, fragmenting the integrated healthcare system that makes the Western Cape model work.
3. There has also been no consultation about what will happen our provincial employees once provincial funding and function has been taken away.

What we need to do is to protect the Western Cape Model in a way that builds a harmonised and equitable health system through a strong, transparent partnership and accountable governance.