Public healthcare needs aid

MEC for health Dr Gwen Ramokgopa’s unannounced visit to Tembisa Hospital has again cast the spotlight on problems in the country’s health system.

The infrastructure upgrades at the hospital casualty, although welcomed, do not address problems of serious staff shortages, poor service and absenteeism crippling public health across the country.

In KZN, where it has become clear that the health system is collapsing, these problems, including a lack of equipment and specialists, demonstrate the danger of allowing the status quo to continue without drastic reforms.

The growing volume of patients who rely solely on public health services is also putting untold strain on the system. SA’s disease burden is also not helping as it places a greater demand for specialist care.

The high level of violence and road accidents also drain resources. It is important to think of the crisis as a societal issue rather than just poor management – and this is not to negate that management and political leadership are factors in current failures.

While the public health system is collapsing, private healthcare flourishes. There are more specialists, better staff ratios, levels of hygiene and services for fewer people. This is something all South Africans should be worried about.

The dual model in healthcare perpetuates the reality of some people being more equal than others by virtue of access to financial means. Public healthcare is for the poor and private healthcare is for the rich. The message this sends is that the rich deserve the best because they can buy it and the poor deserve the worst because they don’t have the same buying power.

The onus is on the state to ensure a functioning health system. State hospitals must get the basics right: staff must be at work, patients must be treated with respect and dignity, hygiene should be kept at the highest level, there must be equipment and support services such as catering, cleaning and security must be up to scratch.

But even if state hospitals were improved, it would not change that the system is overburdened. The duality of health provision has to be revisited. And this is why the debate around the National Health Insurance should be taken seriously.

There also needs to be a shift from tertiary or curative healthcare to primary healthcare. We need to act sooner rather than later.