Thank you for your interest in St Bernard’s Hospice and the work that we do. It is hard to believe that we are already at the end of the 3rd term for 2019.
St Bernard’s Hospice is a member of the Hospice Palliative Care Association of South Africa (HPCA), a body who has been one of the key voices for advocacy of Palliative Care in South Africa. HPCA attended the board of healthcare funders conference this past quarter to hear progress towards adequate funding for palliative care services.
It is an area we are watching with keen interest and mixed emotions – unsure of how it will practically work once implementation is in a full swing.
The 2 main sources of funding for patient care in the future in SA will be from The National Health Insurance Act (NHI) where palliative care is accepted as an essential part of healthcare and Universal Health Coverage; and from the private healthcare funders.
The Council for Medical Schemes have identified palliative care as a Prescribed Minimum Benefit. However, there is not yet a clear mechanism for funding. So, apart from a few medical schemes (with limited palliative care codes), payment for palliative care is still haphazard in this area.
The private healthcare sector see the opportunities for palliative care payments and are developing or advertising palliative care services. Although they say this is not in competition with hospice services, the reality is that it is in direct competition for funded patients.
It is well known that it takes money to make money, which enables the private sector to arrange themselves much faster than we can in our not-for-profit sector.
The World Health Assembly (WHA) resolution on palliative care states that all healthcare workers should be trained in palliative care. This will enable patients to receive the care they need wherever they are treated. Currently there is a massive gap in palliative care need and availability of palliative care services. Trained palliative care workers are not commonly found in South Africa and the bulk of these will be found in our Not-for-profit settings.
As St Bernard’s Hospice, we always ensure we are a centre of excellence for palliative care. All our clinical staff are trained in palliative care as per HPCA standards. We are currently in process of having our standards reviewed, which will then be audited to ensure best practice.
The bulk of our Buffalo City Metro patients, due to our socio-economic demographics, will always be patients who live below the poverty line and thus we will always remain a non-profit entity. However, with the massive need for increased sustainability of services and the pressure placed on civil society to be less reliant on donors, the need to develop a small fee for service section, to those who are in the right financial position to afford it, is crucial to our long-term patient care retention strategy.
Patient Impact Snapshot:
By Melissa Knox: CEO St Bernard’s Hospice