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Cape Town - Health Minister Aaron Motsoaledi told MPs on Wednesday that his emphasis on primary health care should not be ridiculed.
"It is the only thing that will make National Health Insurance (NHI) a success and sustainable," he told Parliament's portfolio committee on health.
He said health services had a tendency to focus on curative measures because they appeared to deliver results, but South Africa had to favour the preventative route to curb health care costs.
"The burden of disease needs to be reduced.... There is a tendency to be curative, so you tend to forget simple things."
He cited his campaign to limit South Africans' salt intake as an example of saving the health care system expensive and avoidable treatment.
"When I say control salt intake, we are doing it because that is primary health care."
It would prevent vast numbers of the population needing medication for high blood pressure and potentially dialysis - at a cost of R150 000 a year in public facilities - and in some cases organ transplants, he said.
"You will need new kidneys the health care system cannot provide."
He insisted that the NHI be run as a social service, and not along profit lines, but said "many people especially in Treasury don't agree".
No matter the cost
In practical terms, this meant that if a child in an informal settlement fell ill with meningitis it had to be treated and "it doesn't matter how much it costs".
Director general Malobona Matsoso said the pilot programmes for the planned public health overhaul were on track in 10 districts, and so were broader efforts to prepare for the system.
These included hiring 137 unemployed information technology graduates, and would result in improved billing and processing of medical aid claims.
Motsoaledi said the HIV/Aids programme - the biggest in the world - had raised the national life expectancy, but more, and preventative measures, needed to be done to achieve the goals of the National Development Plan.
The department would therefore drive a campaign to make sure every adult took an HIV test at least once a year, he said.
Motsoaledi and Matsoso said the department should be congratulated for having reduced irregular expenditure to R2m for the past financial year, compared to R24m the previous year.
