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'Public health care needs overhaul'

By unknown | May 28, 2009 | COMMENTS [ 0 ]

esterday the ANC Youth League came out in support of state doctors who are to march to Pretoria tomorrow to demand better salaries and improved working conditions.

esterday the ANC Youth League came out in support of state doctors who are to march to Pretoria tomorrow to demand better salaries and improved working conditions.

The ANCYL's intervention in the public health sector saga triggered several memories I have about public hospitals.

One memory is of how my mother ended up after a botched operation at the Mankweng Hospital in Limpopo in the late 1990s.

My mother had fallen off a bus and broken her leg at the shin.

She was admitted to the hospital but after her operation her leg was left crooked at the shin.

She was told that nothing could be done to straighten her leg.

Being a typical South African consumer, my mother never even thought of suing the hospital for the botched operation.

About three years ago my father - who was in his 80s - fell ill.

He suffered chronic high blood pressure and diabetes and was admitted to the local Lebowakgomo Hospital.

When a friend of mine heard that my father had been admitted to the hospital he warned me that people admitted there as ill as my father never came out alive. About a week later, my father passed away.

What I am relating are anecdotes that can be dismissed as real proof of inefficiency in those hospitals. My father could have died simply because the he was extremely ill.


But when dealing with these issues we also deal with perceptions. These perceptions are reinforced by reports of doctors working 40 to 60 hours nonstop.

Which patient would want to be operated on by an exhausted doctor who probably has frayed nerves as well?

Reports of a lack of equipment further compounds the lack of confidence displayed by many in the public health system.

Some reports from the auditor-general have shown that part of the problem is underspending.

This means that in some instances the money is there - but it is not being spent. Usually this is ascribed to "lack of capacity" in government departments.

The country needs to improve its efficiency and productivity and can't afford to have a dysfunctional health system.

The importance of a healthy nation in achieving sustainable human development is aptly articulated in the book edited by Professor Raymond Parsons and titled Zumanomics.

In an essay in the book titled Health policy and growth he argues that better health improves the productivity of the labour force, and ultimately contributes to economic growth and human welfare.

The essay goes on to say that good health enables people to perform daily functions.

"The objective of achieving a 6 percent rate of economic growth, and halving unemployment and poverty by 2014, as set out in the Accelerated and Shared Growth Initiative of South Africa (AsgiSA) policy document, will remain a dream unless South Africans get public health right.

"Many successful economies have consciously invested in achieving and maintaining levels of health as a prerequisite for their growth", concludes the essay.

South Africa faces major obstacles when it comes the public healthcare it provides its people, most of whom are poor.

This is in the context of the reality that post-apartheid governments tried to spread their resources equitably.

The challenges are also that because most people suffer from diseases related to a lack of proper nutrition and proper sanitation.

The government needs to come up with an integrated strategy to improve the quality of people's lives generally.

During an interview with Parsons I asked him what he thinks of President Jacob Zuma's enlarged Cabinet.

"Though it has been necessary for Zuma to strike a balance between politics and efficiency, his cabinet is strong on technocratic expertise," Parsons observed.

When asked about the cost of maintaining such a large cabinet, Parsons said: "No one will worry too much about the size and cost of Zuma's Cabinet if it succeeds in creating a delivery state."

An important function of that "delivery state with technocratic expertise" will be to deliver an efficient public health system by ensuring there is adequate equipment and by paying doctors salaries that are commensurate with their expertise.


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