Following my last post describing an analogy between the space shuttle disasters and the possibility of a system failure following the envisaged implementation of National Health Insurance (NHI) in South Africa my thoughts have returned to what I wrote in March 2022. This post reflected on the alternatives to what is proposed in the South African model of NHI. As I wrote then since 1994 the divide between those who have the ability to afford what in South Africa is termed private healthcare and those dependent on the State operated Public Health Service for the provision of healthcare has regrettably grown. The widening gap cannot be laid at the door…
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Elected politicians and appointed public servants … at times a fraught relationship!
Mr Dominic Raab, the United Kingdom Deputy Prime Minister and Secretary of State for Justice resigned recently. The reasons for his resignation highlight the at times fraught relationship between an elected politician and appointed public (civil) servants. Mr Raab was alleged to have bullied and humiliated officials in various ministries. Bullying was defined for the purpose of this inquiry as follows: (1) Offensive, intimidating, malicious or insulting behaviour; or (2) Abuse or misuse of power in ways that undermine, humiliate, denigrate or injure the recipient . The inquiry, conducted by a senior British advocate, Adam Tolley KC, tested the allegations against the 2019 version of what in the United Kingdom…
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Politics, policy and implementation … there is a vast difference!
President Ramaphosa speaking at the 5th South African Investment Conference on 13th April 2023 made the following statements; “We are now confronted with the consequences of years of under-investment, mismanagement and corruption in our electricity, rail and logistics sector.” and that, “We are on a long journey to rebuild our country and recover ground we have lost. Our recovery is a mission and will take time to accomplish”. He continued that, “The lack of reliability in electricity supply weakens business and consumer confidence, taints international perceptions about our country and affects investment sentiment and decisions” concluding that, “If the focus of our struggle for liberation to end apartheid and achieve political freedom, the focus of our efforts must be to address inequality…
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2022 …the year that was!
As we enter the last days of 2022, it is worthwhile to reflect on some of the events impacting on the health sector in the year that was. It was an eventful year with both the good and bad. Those who have read my posts during 2022 may feel that I concentrate too frequently on the negative and rarely focus on the positive. That may be true but I only reflect the world around me as I see it. I accept that there are amongst us many good people doing great things who are rarely acknowledged and I also accept that maybe I have failed to focus enough on them.…
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National Health Insurance … noble in intent but is it a bridge too far?
In the summer of 1944 during the Second World War the Allies launched an airborne operation, named Market Garden, aimed at securing a crossing over the Rhine River and thus an advance into the heart of Northern Germany. The aim of the operation was to seize key bridges with airborne troops allowing ground troops to advance over 100 kilometres to the Dutch town of Arnhem and by so doing outflank the German frontier defences. The plan which was backed by the British General Montgomery and Prime Minister Churchill despite concerns expressed by others in the Allied High Command lead by General Eisenhower. The operation despite the heroic efforts of allied…
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Management decisions right or wrong must have consequences.
Recent experience with almost month-long power cuts in South Africa due to inadequate generation capacity have highlighted a State-owned entity has been unable to ensure a reliable source of electricity to the country for over a decade. When this first occurred in 2008, I was heading the Western Cape Department of Health and as management we had urgent meetings with officials from the power utility to decide how to manage what was envisaged then to be a short-term problem. At that time many health facilities had inadequate or no back-up generators and a decision was taken and actioned urgently to acquire and install generators at as many facilities as fast…
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Gift of the Givers and a Vaccine Task Force … lessons to be learnt … revisited.
It is worth reading my post of December 2021 again and then watching the link below to a recent Twitter post featuring a short input from Dr Imitiaz Sooliman. Well said Dr Sooliman! What we need is action and deeds by capable people as the answer to the challenges faced in South Africa today! https://twitter.com/nosh15/status/1550421503489019906?s=20&t=9PBoHEZ7i_MO8KdrdlWVJw
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Refuse … a marker of government failure
In March 2021 I wrote a post entitled, “Piles of refuse are a public health problem”, and reflected on the causes and consequences of this phenomenon. 18th July 2022 was the annual Mandela Day, a commemoration that is intended to be a “global call to action that celebrates the idea that each individual has the ability to make an impact”. Using the fact that Nelson Mandela fought for social justice for 67 years, people were urged this year to spend 67 minutes according the Mandela Day 2022 slogan to “Do what you can, With what you have, Where you are.” A video was posted on Twitter by the South Africa…
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Liberal, socialist or neoliberal?
A recent read of Francis Fukayama’s Liberalism and its Discontents set me thinking. For someone who is not a social scientist despite being a short book of 174 pages, it is a tightly written, challenging but stimulating read, which I can recommend. I have in fact read the book twice and continue to delve into various chapters in the book. Having in the past been taken to task for my application of the so-called neoliberal policies of budgetary austerity faced with a limited health budget, the book made me think whether I am indeed a liberal with socialist leanings, which I had always considered myself to be, or whether over…
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Winter of discontent … again!
My first post on my health blog on 13th July 2020 had the title. “Winter of discontent”. I am again posting a piece with the same title as on that date. The country has since emerged from the COVID-19 pandemic, which in July 2020 was still new to our experiences but dragged on with questionable measures taken by government over the subsequent almost two years with disastrous consequences for the lives of so many South Africans. At that time the country had experienced euphemistically termed “load shedding” but more aptly the failure of a vital state entity ESCOM to provide enough electricity to keep the wheels of industry turning and…