I am a health professional and healthcare is an issue very dear to my heart. But healthcare can so easily become the victim of issues beyond its control. The recent events surrounding the withdrawal of the funding of key health initiatives around the world by the United States is an example of this. I have recently written about the danger of dependency by a country on foreign aid, but the danger of what has transpired goes much further than that. America is a democracy and its president was elected by more than 50% of those who went to the polls in what most would accept was a fair democratic process…
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Inspired by Youth … anything is possible!
I was privileged recently to attend a performance of the Ndlovu Youth Choir. What a stunning show it was which entranced a full-house at the Artscape Theatre in Cape Town. All the the members of the choir, which was formed in 2009, come from a small village, Elandsdoorn, in the Moutse district of Limpopo South Africa. Achieving prominence after their participation in the America’s Got Talent (AGT) television show, they have performed across South Africa and in many countries around the world, most recently at New York’s famed, Carnegie Hall. The story of the choir is an inspirational and well documented one which I will not repeat, but their performance…
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The Consequences of Power and Privilege
I have not written anything on my website since September 2024. Call it writer’s block or a sense of disillusionment with the world that I see around me but I have lacked inspiration despite the many issues that have crossed my path. Conflicts abound across the globe some becoming newsworthy for a while only to be superseded by others in the relentless news cycles that occupy the news channels of the world media. Images of displaced people as a result of various conflicts or natural disasters fill our television screens. The poor remain poor across the world with even basic services to communities crumbling in many places. But amongst all…
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The Life Esidimeni tragedy … a lesson that must be learned
The Life Esidimeni tragedy happened in the early months of 2016 when a long-standing contract with the Life Healthcare Group was terminated by the Gauteng Department of Health. Thereafter despite warnings that this was unwise around 1500 vulnerable mentally retarded patients were transferred from Life Esidimeni facilities in Gauteng to Non Governmental Organisations (NGO’s) in what was known as the Marathon Project. Many of the NGO’s did not have the capacity or resources to manage patients of this nature and as a result at least 144 patients died of neglect and many more suffered inhuman and degrading conditions. This occurred less than a year after I had retired as Head…
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Government of National Unity (GNU) … illusion or reality?
The May 29th 2024 election delivered a parliament for the first time in the 30 years since 1994 in which no single party had a majority. During the past 30 years the African National Congress (ANC) had a significant majority at both national and provincial level with the exception of the Western Cape province where since 2009 the opposition Democratic Alliance had a majority which was maintained in the 2024 election. Clearly after the 2024 election the ANC which was the largest party with just over 40% of the votes had to seek coalition partners. After tough negotiations a coalition was formed with the Democratic Alliance as the second largest…
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National Health Insurance NHI … the “final countdown” … or not!
In May 2023 I wrote a post titled “National Health Insurance … will logic prevail?” Now a year later, in May 2024, it appears to me that emotion and political necessity rather than logic has prevailed certainly amongst the ruling party. I do not intend to repeat an analysis of what is contained in the now NHI Act signed by President Ramaphosa but rather to consider the consequences of his doing so 15 days prior to a general election in which the political party which he heads faces for the first time possible, but probably unlikely, election defeat. The President has defended his actions with the argument that the delay…
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2023 … some reflections on the year that was!
At this time last year I published a similar post reflecting on the happenings of 2022. It is interesting to reflect on what I said then in the light of what has transpired in 2023. In December of 2022, the echoes of COVID-19 still remained, something that has now almost vanished from the public consciousness despite reports of new variants, similar to the amnesia that may follow a very traumatic event. In Britain, however, the country continues to anguish over the consequences of what was and what was not done during the pandemic in the public hearings of a commission of inquiry into the actions of those in positions of…
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Thoughts after recent travel outside of South Africa …
I recently had the privilege to travel to Scotland, Austria and Germany and while this post is not directly health related the connection to good governance and government on which effective healthcare delivery depends is clear. In Scotland my wife and I visited my daughter, son-in-law and two grandsons on the croft in the Scottish Highlands that they purchased shortly after their arrival in Scotland over three years ago. In the last 18 months the family have constructed a barn on the property without outside assistance, something that they would have been unlikely to undertake in South Africa. Crofts which are a feature of the Scottish Highlands established in the…
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South Africa … how long are the shadows of apartheid?
In recent days both President Ramaphosa and a cabinet minister have attributed current issues in South Africa to the legacy of apartheid. Without doubt legacies of apartheid remain in this country almost thirty years after the birth of a democratic and non-racial South Africa. Glaring examples of this are the spatial distribution of South Africans and the significant differential of income and employment amongst South Africans which in large measure remains defined by race. However, can the tragic events of a fire in a “hijacked” Johannesburg building be attributed to apartheid as was done by a cabinet minister? Is the poor state of many municipalities across the country due to the…
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Healthcare … a victim of a self-inflicted government funding malady?
Various questions trouble me when I hear that a public sector health department has a major shortfall in the budget allocation that will result in people being unable to receive the healthcare that they need. Who is accountable? Who is responsible for the consequences? Is it immoral that the cost of healthcare should limit access? Who should decide which treatment should not be provided? What is an acceptable package of healthcare? What can be done to alleviate the problem? I could go on … I have great empathy with a doctor who although the treatment plan is clear must inform the patient that due to affordability constraints that either a particular…
