We need to recognise the hard fact we are never going to be able to provide anything like the standard of health care that you can get in the private system. We simply cannot afford this level of care. Curative institutions are at the top end of the cost structure for health care, public health and home based health care, at the other end – low cost systems that can deliver a better quality of life and longer life, for the majority.
Our problem is that we spend 80 per cent of our budget on curative care of a low standard and some on community based health care and virtually nothing on public health. Somehow we have to reverse this priority of expenditure within our national budget.
I have been told that 85 per cent of all health problems can be dealt with at community level clinics. For me our focus as a country should be on providing a basic health centre within walking distance of all our people. We already have 1600 of these, perhaps we need to expand this network to 2500. We need to train an intermediate level of staff for these centres, people who are more than Nurses or Orderlies and who can deliver a baby, diagnose the majority of common ailments and dispense the majority of medicines. Each centre should be managed by a Committee elected by the Community and have all the facilities required. They should also have staff who can pay home visits and monitor public health issues.
We should tap into modern technology and provide a consultation service to all these clinics via the internet. This system should be serviced by experienced and well trained doctors and be accompanied by a video link and a system for dispensing the drugs required.
All our Hospitals should be handed over to the private sector and run as businesses. The one thing that stands out for me is the very low quality of care and attention that clients get from all State controlled and managed health institutions. The reports of corruption and waste are legion. Faith institutions manage their hospitals much better and even if they are not as well equipped, clients prefer them for treatment because they are clean, the staff treat them as human beings and the doctors dedicated and professional.
Public health issues such as clean water, waste management and control of communicable diseases where solutions are available – should receive a much higher priority. At present the failure of local governments in this field of service should be of concern to every Zimbabwean.
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