Bully Ramathuba hits a sore spot

LIMPOPO Health MEC Dr Phophi Ramathuba’s recently videoed tongue-lashing of a hapless Zimbabwean patient for free-riding on “her” hospital services was bullying of the worst kind.

She should not only be fired from the provincial cabinet but should be severely disciplined by the Health Professions Council. Neither will happen.

Far too many in the ANC agree with her sentiments, if not her manner. The HPCSA is an ANC lapdog, not a professional standards body.

Despite prodding and pushing, it has consistently failed to stir itself against doctors within the ruling party who have trampled on medical ethics. Think Life Esidemeni scandal, where managerial corruption and incompetence led to the deaths of at least 144 psychiatric patients.

But Ramathuba’s disgusting outburst has an upside. It signals that the long suppression by the ANC and a politically correct media of public discussion on whether millions of people should freely and illegally flock to an imagined South African Eldorado from sh*tholes elsewhere on the continent, is well and truly over. So, to start, let’s not mince words. Forget the euphemisms of “undocumented visitor” and “economic migrant”.

They’re “illegal foreigners” and it has nothing to do with prejudice or abuse. It’s a simple legal definition. That’s how they are described in South Africa’s Immigration Act of 2002, which replaced the extraterrestrial, other-worldly connotations of the Aliens Act of 1991.

Right now illegal immigration is one of the most emotive issues in politics throughout the Western world. It pits the cherished beliefs of privileged left-wing elites against the growing anger – fanned by expediently populist politicians – of the working classes and unemployed whose interests they claim to have at heart.

Their embattled ideology – that foreign nationals crossing borders, despite not having the requisite documentation and despite not being asylum seekers or in imminent physical danger at a time of conflict – should be met with warmth, forgiveness and public benefits. Their mechanism for killing any debate on the issue is to vilify any resistance to illegal foreigners as xenophobia that will lead to violence.

On the contrary, it is the suppression of debate on how best to manage the desire of millions on the continent to come to South Africa that fuels the frustration of ordinary citizens who feel displaced in their own land. It’s the pompous pieties of those who are not at the sharp end of the influx that gives firebrands the flammables with which to stoke violence against the kwerekwere.

It’s an issue on which the ANC has swung 180 degrees. Before 1994’s first democratic election and until recently, the song sheet has been one of brotherly love, especially to those bordering nations that paid a high price for harbouring ANC exiles.

Fences were dismantled or allowed to fall into ruin. Enforcement of immigration regulations – except, ironically, for skilled workers and investors trying to enter the country legally – was effectively abandoned.

There’s another perverse irony arising from the ANC’s historical obligations to our neighbours. It’s the political and diplomatic support that it has given to the likes of Frelimo in Mozambique and, especially, Zanu-PF in Zimbabwe, that has helped these despotic regimes to survive. The ensuing oppression and economic collapse are major push factors to seek a better life in South Africa.

It’s not an either-or situation, as it is dishonestly sometimes posed to be. There are compelling economic reasons to facilitate migration by skilled workers, just as there are compelling moral reasons to embrace political refugees and asylum seekers. The caveat is that both streams need to be legally regulated.

Ramathuba is absolutely correct. It is not acceptable that in some hospitals, something in the region of 80% of all babies delivered are to mothers who have crossed into South Africa to take advantage, without paying a cent, of our vastly superior medical services.

Nor are all these patients necessarily indigent foreigners. Nurses and doctors on the frontline, as well as the local patients they displace, are aware that many who could afford to pay, are free-riding on the South African public health system.

Hence the public anger. This offers a political opportunity that is being shamelessly exploited by the likes of Patriotic Alliance leader Gayton McKenzie, who this week said he would personally switch off the oxygen machines of foreign nationals, if it were necessary to save South African lives.

The SA Medical Association’s response, which is representative of the many organisations and individuals that self-define as “progressive”, is that health care is an absolute, fundamental human right. “Discrimination of any kind in the health-care sector is unacceptable,” Sama states.

It is, of course, a human right. But it is not an absolute right. As our Constitutional Court has ruled, it’s a right qualified by the constraints of budgets and resources, and the competing demands of others in need of medical attention.

That’s a universally recognised reality. No country in the world allows untrammelled access to its medical resources for foreigners, especially not to the detriment of the local population. To do so is to invite popular revolt, since access to medical care is a life or death issue. And the angry dispute about illegal foreigners is just the beginning of it.

This is an issue that is soon going to be even more the focus of political scrambling for advantage.

South Africa is about to embark on a madly ambitious, ideologically driven plan, which will see the robust private health sector phased out in favour of a “free” National Health Insurance. It’s unaffordable and will be disastrous for the 9 million who belong to medical schemes, of whom about a million are public servants, and who currently can shield themselves from the foreign free-riders flooding state hospitals.

In the near NHI future, the disenchantment of the disadvantaged will become more difficult for progressives to deprecate and dismiss. The middle-class members of medical schemes are going to become very, very voluble when they have to compete with masses of illegals clamouring for care.

And the progressives? Well, they’ll have to join the ANC leadership in seeking their medical care in Russia, China and Cuba.