Government wants to control private healthcare — and then break it

We are our own worst enemies.

Instead of celebrating excellence, we embrace mediocrity and do our best to spread it around as widely as possible.

Instead of aiming for the skies, we want everyone to wallow in the mud.

We illustrated it this past week when President Cyril Ramaphosa signed the NHI Bill into law despite cogent, near-universal, criticism of the new Act in its current form.

His action underlines that we are in a populist race to the bottom — having broken the public health system, we now want to drag the generally excellent but flawed private healthcare system into the quagmire.

Let me illustrate. Look at the picture of a radiant Ramaphosa signing the bill last week.

Standing directly behind him is a smiling and clapping Dr Sibongiseni Dhlomo, the deputy minister of health.

To the good doctor’s right is the Limpopo health MEC, Dr Phophi Ramathuba.

In June 2017, the South African Human Rights Commission issued a 68-page report that found that the KwaZulu-Natal health department, under the leadership of Dhlomo, had failed its cancer patients‚ that it posed a serious threat to their lives, and was denying them their right to life and human dignity.

Cancer treatment in the province’s public system was a mess — oncology specialists and other medical staff had left in droves, there were no oncology machines (or they did not work) in most hospitals.

Patients waited for about five months before seeing an oncologist and about eight months for radiotherapy.

The consequences of this are clear to anyone — people die.

They die because the cancer may not be caught at an early enough stage and, by the time it is detected, it has spread in uncontrollable and deadly ways.

The SAHRC ordered the KZN premier to investigate the role of Dhlomo in the ongoing crisis, to immediately repair oncology machines, and within 10 days devise a plan to deal with the backlog of patients and the staff crisis.

One year later, on April 20 2018, the same SA Human Rights Commission issued a distressed statement saying it would “compel” Dhlomo to appear before it to answer questions about the ongoing “oncology crisis” in the province.

It said “after many exchanges of correspondence and meetings with the KZN provincial department of health‚ the commission remains concerned at the lack of meaningful progress”.

“The commission has noted the numerous reports that many cancer patients still lack access to timely and appropriate oncology health care and that some may have already died.”

Dhlomo was promoted to parliament, and to the deputy minister’s position, in 2021.

He is now one of the key people in the rollout of NHI in SA.

I am sure the families of the many people who were failed by the KZN health department while he was in charge will be comforted to know he is now rolling out NHI across the country.

Then there is Dr Phophi

Ramathuba. In August 2022, she hovered over a patient at a Limpopo Hospital and started lecturing the woman that she would make sure she paid her bill because she was Zimbabwean.

This poster woman for the Hippocratic oath said: “You are supposed to be with [Zimbabwean President Emmerson] Mnangagwa; you know he doesn’t give me money to operate.

“And I ’ m operating with my limited budget. When you guys [Zimbabweans] are sick, I’m hearing that you just say, let’s cross the Limpopo River, there’s an MEC there who’s running a charity department.”

Her entourage chortled behind her, fully entertained by this grotesque spectacle.

Then Ramathuba delivered her coup de grace: “Sorry sisi, but you won’t be discharged until you settle your bill.”

I recount these two anecdotes merely to illustrate that all the smugness we have endured from Ramaphosa and his comrades this week has nothing to do with making things better for ordinary South Africans.

It has nothing to do with fixing our broken health system. It has nothing to do with universal access.

Here we see a government that looks at something that works (the private healthcare system) and wants to control it — and then break it.

The cancer treatment crisis in KZN had started in 2015.

Members of the SA Medical Association had marched about it.

Dhlomo had done nothing about it by 2017.

It was only after the SAHRC intervened that there was (some) movement.

As for Ramathuba’s xenophobic ranting at a helpless patient, well, this is the bedside manner of the people who want to run your hospital.

Quality universal healthcare in SA is sorely needed.

We will not get to it via a government leadership that can’t even procure an oncology machine or treat a patient with compassion.

Their attitudes explain why public hospitals are broken, and why they should not be allowed to touch the few that still work.

JUSTICE MALALA