SOUTH Africa's public health care system is cracking under the strain of endemic governance failures, corruption and poor - in some cases non-existent - political leadership.

Granted, we have one of the most dedicated health ministers this country has had - arguably the best. His passion for the job is unrivalled.

The days of ubhejane - a medically untested concoction of traditional medicine once billed as an answer to the HIV/Aids crisis - are over. No more denialism. No more dilly-dallying and bullying while people die.

But - and this is a big but - Health Minister Dr Aaron Motsoaledi can only do so much.

He can only set the norms and standards and dictate policy at a national level. He is also trying to set up a working mechanism to ensure monitoring and evaluation of the health system. What more can he do?

The rest of the public health care system rests with provincial governments. And they are at the heart of the malignant cancer that is chipping away at whatever good is left of the health system. The Eastern Cape, Limpopo and Gauteng have become classic case studies of "how not" the health care system should function.

As we report elsewhere in this edition, Gauteng's big hospitals are unable to diagnose cancer on time because the scanners are broken and fixing them takes time. The cause of the problem, we are told, is that the government takes time or fails to pay service providers.

How ironic that the cancer in patients is trailing the cancer of poor governance. It's a scandal.