“Accountability” essential for a successful nation!

“Accountability” as defined in the Merriam-Webster dictionary is “the quality or state of being accountable i.e. an obligation or willingness to accept responsibility or to account for one’s actions”. My professional training as a doctor made me aware of my accountability for my actions as a health professional. Accountability directly to my patient, a child in my case as a paediatrician, their parents and extended family. Accountability to the professional body with which I was registered to practice as well as to my employer, a public sector health department and university. Later when I moved into health management in 1995, I became legally accountable in terms of the Public Finance Management Act as an Accounting Officer for the effective and correct management of public funds to provide health services to the public. I took this accountability very seriously which on occasion placed me in conflict with those to whom I was accountable when it was expected of me to bend the rules to accommodate their wishes.

In the environment into which I moved in 1995 accountability was often viewed very differently from that defined above. As 1995 became more distant, the desire for accountability amongst some became increasingly less prominent. People with whom I interacted and who on face value seemed to be pleasant, committed and honest individuals turned out to be otherwise. Honesty and integrity, the basis of accountability and surely an absolute requirement for high office at times proved to be lacking. This may seem a harsh judgement but an analysis of the ills that have befallen the South African public health sector over the last two decades bear stark testimony to my assertion.

I have no doubt that the legislative framework set out in the South African Constitution and the laws and regulations that flow from it, provides a robust framework as long as that legislative framework is respected by all concerned. A pervasive culture of entitlement has developed that has made the work of honest public servants, and there are many, even more challenging. I am aware of senior public servants who have resisted efforts to subvert the systems of government and suffered negative personal and financial consequences as a result.

The response of legislators has been to develop an increasingly rigid regulatory framework that has in fact made the work of honest public officials to get things done more difficult. In my view, the key to a successful South African society is a return to an ethical leadership culture characterised by honesty and accountability. It must be accepted that there is no entitlement to wealth related to government office. The rationale for my statement is that despite the most rigid and rigorous legislative framework, which makes the functioning of government increasingly difficult, with a lack of integrity, accountability and ethical behaviour, any system can be subverted by collusion between individuals in positions of authority and power.

Accountability crucially means that there is an acceptance of the consequences of one’s actions, a reality too often lacking in the South Africa of today. How is it that the public health system can be defrauded repeatedly but the perpetrators are seldom if ever held accountable for their actions? I could give many examples but I will refrain from doing so here. Why did the most recent reprehensible events surrounding the procurement of essential equipment required by health workers in the midst of the life and death struggle with the COVID-19 pandemic occur? While comments can be made about the need for South Africa to rediscover its moral compass, what is needed is that people are held accountable and that this accountability leads swiftly to consequences for those found guilty of malfeasance.

For South Africa to be a successful nation we must restore “accountability” for our actions as a central tenet of our society and further accept that once held accountable consequences will follow from these actions.