To my mind

Finweek English Edition - - To My Mind - COLLEEN NAUDÉ colleenn@fin­week.co.za

A NUM­BER OF State en­ter­prises and de­part­ments have be­come syn­ony­mous with – to put it mildly – bad ad­min­is­tra­tion. Two of the leaders of this hit pa­rade are South Africa’s na­tional broad­caster and our na­tional air­line. The SABC has re­cently dis­tin­guished it­self with a tableau of in­ef­fi­ciency that would have been dis­missed as far-fetched had it ap­peared in a TV soap opera.

Over the years, SA Air­ways’ lav­ish spending has re­peat­edly ne­ces­si­tated costly in­ter­ven­tion, while the re­cently dis­missed CEO’s R20m exit pack­age has seen him fly higher in his pri­vate ca­pac­ity than was ever re­motely jus­ti­fied by his ac­tual per­for­mance in his post.

Act­ing CEO of na­tional car­rier SAA Chris Smyth has just an­nounced that the “third or fourth” re­struc­tur­ing pro­gramme in seven years has been a suc­cess and that it’s re­sulted in a sus­tain­able turn­around of 8% higher than the set tar­get. How­ever, that bit of good news, in which the air­line has re­ported earn­ings be­fore in­ter­est and taxes of R1,1bn, was put into per­spec­tive by the ad­mis­sion that SAA bum­bled very badly with the can­cel­la­tion of no fewer than 15 Air­bus A320s or­dered in 2002, for which tax­pay­ers are now go­ing to have to fork out about R1,5bn.

That type of fra­grantly in­com­pe­tent man­age­ment is also char­ac­ter­is­tic of (among oth­ers) the Depart­ment of Health, the ef­fects of which are felt by the en­tire spec­trum of South African cit­i­zens. Health­care is an emo­tion­ally laden is­sue with moral ques­tions about the fair­ness or un­fair­ness of the fact that ac­cess to firstclass health­care de­pends to a large ex­tent on a pa­tient’s fi­nan­cial means. Those types of dilem­mas form the ba­sis of the pro­posal that a Na­tional Health In­sur­ance Sys­tem be es­tab­lished.

It’s hard to fault the moral jus­ti­fi­ca­tion of ac­cess to top qual­ity health­care, ir­re­spec­tive of in­come. How­ever, eco­nomic re­al­ity is a dif­fer­ent mat­ter: such a sys­tem would cost tax­pay­ers an ad­di­tional R100bn – or 9% of do­mes­tic spending. Aside from the mas­sively neg­a­tive im­pact it would have on SA’s econ­omy, the pro­posal is yet an­other ex­am­ple of the at­ti­tude of de­ci­sion mak­ers who be­lieve money is the quick fix for any­thing and ev­ery­thing.

That fal­lacy will cost this coun­try dearly. No amount of money is go­ing to make one iota of dif­fer­ence to State in­sti­tu­tions and de­part­ments if spe­cific at­ten­tion isn’t paid to the im­ple­men­ta­tion and main­te­nance of healthy man­age­ment prac­tices.

The ghastly con­di­tions found at most State hos­pi­tals aren’t sim­ply the re­sult of too lit­tle money. Al­low­ing a hospi­tal with a once proud tra­di­tion of (among other things) train­ing of nurses – such as the JG Stri­j­dom (now the He­len Joseph) or the Jo­han­nes­burg Gen­eral Hospi­tal (now the Char­lotte Max­eke Jo­han­nes­burg Aca­demic Hospi­tal) – to de­te­ri­o­rate to such an ex­tent that to be ad­mit­ted could be life threat­en­ing has very lit­tle to do with the avail­abil­ity of money but points to a com­plete lack of healthy man­age­ment prin­ci­ples.

On sev­eral other ter­rains a lack of ef­fec­tive ad­min­is­tra­tion, main­te­nance and con­trol con­sti­tutes the un­der­ly­ing con­ta­gion that can’t be cured by merely in­ject­ing more money.

A sick at­ti­tude of en­ti­tle­ment feeds that lack of man­age­ment and di­rec­tion and man­i­fests it­self time and time again in un­equitable be­hav­iour, such as the award­ing – or ap­pro­pri­a­tion – of con­tracts, es­pe­cially within the pub­lic ser­vices sec­tor. Pump­ing in more money isn’t go­ing to ef­fect any change in State de­part­ments, such as the Depart­ment of Health and State util­i­ties such as the SABC and SAA, for as long as poor man­age­ment and con­trol keep on in­fect­ing those in­sti­tu­tions.

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