government,  Health commentary,  Political commentary

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 party with just under 22% of the votes but also included a number of smaller political parties all with single figure percentage representation which resulted in the formation of what was a termed a Government of National Unity (GNU). Notably two political parties, uMkhonto we Zizwe (MK) and Economic Freedom Fighters (EFF) elected to become the opposition with collective representation of just over 24% of the vote tally. So if that is the current situation in South Africa, is what has transpired truly a government of national unity?

A national unity government or government of national unity is defined as a broad coalition government consisting of all parties represented in the legislature and is usually formed during a time of war or national emergency. In such a government, based on the basis of “consensus democracy,” there are not opposition parties or these parties are small or negligible. Since neither the MK or EFF could be termed as small or negligible given that the MK party was the majority party in one province and received the third largest number of votes in the national election it is probably more appropriate to term the new South African government a coalition between the two largest political parties. A number of smaller parties were added to provide the illusion of a government of national unity but what has transpired is rather a multi-party coalition. The aim of the GNU (sic) seems to have been to prevent both the MK and EFF with their radical populist policies from participating in government. The policies of the two largest parties in the new government considering their respective manifestos are far apart not the least related to health and basic education and yet these differences have to date been papered over in the speeches and comments delivered by politicians from both the parties.

It could be said that justification for a GNU is that South Africa is facing a national emergency related to unemployment and poverty reflected by rampant unemployment reported most recently at 32.9% and a Gini-coefficient of 0.67 which is deemed to be the highest in the world indicating a gross maldistribution of wealth in the country’s population. Similarly the levels of fraud and corruption as reflected by various assessments, not the least of which was the costly Zondo Commission, are a further indication of the need for drastic action. The call by the President in his address at the recent opening of the 7th parliament on 18th July 2024 was for “strategic alignment of priorities, greater efficiencies, focus and optimal usage of resources”. He continued that the aim of the GNU was “inclusive growth and job creation, reducing poverty and tackling the high cost of living and building a capable, ethical and developmental state”. Similar sentiments that have been echoed by the President in previous speeches at the opening of parliament. The challenge facing the President is how credible are his statements given that he and the ANC alone formed the governments of the 5th and 6th administrations which were characterised by the inefficiency and wastage of resources he now seeks to address.

While the enthusiasm of the new members of the national cabinet is understandable and their pronouncements may be well-meaning, the implementation of the “new” policies will be the responsibility of the bureaucrats who remain unchanged from the previous administration. Bureaucrats who albeit influenced or instructed by politicians in the previous administrations, failed to ensure the “greater efficiencies, focus and optimal usage of resources” that the President now seeks. South Africa differs from some other countries in that the appointment of heads of departments while on fixed term contracts is not linked directly to the political term of a minister or MEC. Officials below this level, once beyond a short probationary period, are appointed permanently and unless guilty of gross misconduct or proven incapacity cannot be replaced. This severely limits the ability of a new government to rapidly influence the composition of this cadre of employees. Further many of the Ministers and deputy ministers in the new and somewhat bloated cabinet were the very people under whose watch the “building of a capable, ethical and developmental state” could be said to have failed.

Health departments both national and provincial across the country, with the possible exception of the Western Cape, have failed to deliver the quality health services that the citizens sought. I would emphasise that this in no way detracts from the efforts of the many committed people in these departments but rather reflects a lack of effective management and leadership at various levels within these departments. The National Health Insurance (NHI) Act was hurriedly signed into law by the President in the weeks before the election. In the view of many this was a desperate ploy to bolster the declining popularity of his party. In his speech at the opening of parliament  he referred to the implementation of National Health Insurance and that the focus would be “on strengthening health care infrastructure, improving training of health care personnel and using technology to improve health care management”. Laudable goals but unchanged national and provincial administrations will be expected to miraculously address the multitude of well documented challenges faced by health services in many provinces that had not been successfully addressed over the last decades under similar leadership.

The President acknowledged that “there is much contestation around the NHI ” but stated that “there is broad agreement that we must draw on the resources and capabilities of both the public and private sectors to meet the health care needs of all South Africans equally”. He concluded hopefully that “in implementing the NHI, we are confident that we will be able to bring stakeholders together, and that we will be able to resolve differences and clarify misunderstandings.”  Nevertheless the “new” Minister of Health, who was in the same position from 2009 to 2019 during previous administrations, in his most recent speech to parliament espoused the necessity for and the benefits of the implementation of NHI not reflecting the willingness, alluded to by the President, to accept that there may be aspects of the Act that are not acceptable to many, including members of the GNU of which he is a member. It could be said that listening to alternate views is not necessarily one of the ANC, Minister Motsoaledi or some members of his senior management team strongest assets as evidenced by the failure to respond meaningfully to the constructive criticism of the NHI Bill in the past. Those criticising NHI were categorised as reactionary and anti-poor by members of the ruling party during the long legislative path leading up to the final approval of the NHI Act by the President on 15th May 2024.

If the GNU, or more correctly the multi-party coalition, is indeed a necessity brought about by the “emergency” of poverty and unemployment it will require all parties involved to adopt a different approach. This would include the members of the ANC who have been in power for the last 30 years and used to making policy decisions alone being prepared to listen to alternative views and make compromises to reach the consensus demanded by a Government of National Unity. Similarly the major partner in the coalition, the DA, which has spent many years in opposition will have to adapt rapidly to the realities of implementation versus policy pronouncements. If the approach to the implementation of NHI to date is used as a litmus test of that altered approach, then the jury is out on whether that will indeed occur. It is early days and in fairness to the members of the GNU, particularly those who are new to cabinet positions, they have yet to find each other and a workable modus operandi. However, what is clear is that the business of government cannot be done as it was in the past if the 7th administration is to succeed and be the “new way” that the citizens of this country seek.

 

 

A health professional with over 40 years of experience both as a clinician and a senior health manager in South Africa