CONCLUSION

Our research brings together the perspectives of many individuals with significant experience of the South African health system and the debates that have been taking place to reform it. Responses have shown there is a between stakeholders that tradition

great overlap of opinions

However, it has been made clear by many of the stakeholders that they are fatigued by the endless debate on health reform and frustrated by

the lack of progress that has been made in realising any real change

in a health system so desperately in need of it.

For many, there is a powerful yearning to do something to change the current paradigm in healthcare. For many others though, there is a

fatalism, a perspective that despite

the debate there is no real desire from others to genuinely pursue change.

Concentric Alliance and SECTION27 acknowledge that collaborative action may be difficult for many stakeholders to envisage, with such

long experiences of disappointment and distrust.

However, it is our view that given the strong desire for reform and the need for collaboration to achieve it,

there are opportunities for focused action and consensus-building directed toward discreet objectives

that can be used to demonstrate commitment, build trust, and deliver reform of the health system.

We believe that these recommendations provide an opportunity

for movement on health system reform, by implementation of health reform efforts where there is already considerable consensus, and by the use of a more extensive consensus

building process or the implementation of pilots. Such movement has

the potential to build trust through collaboration.

While it is unlikely that trust will be developed immediately, the development of an approach that

has well defined outcomes and requires all parties to contribute and demonstrate their commitment

to health reform, and respect for other stakeholders, stands the best chance of repairing relations and

delivering upon a better health system for all.