Much has been written about the age at which employees should retire and whether with increasing longevity, the retirement age should increase commensurately. In countries with ageing populations resulting in many living over two decades after retirement, an increasing burden on pension funds has increased the urgency of this debate. A survey from the United States indicated that while there are many factors supporting an increase in the age at which citizens become eligible for Social Security payments that a proposal of this nature is unpopular with voters. It must be stressed however that retirement is a luxury reserved for those with permanent employment and employment is a luxury which…
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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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A personal reflection …
I have not posted anything since July 2022. This is not because there has been nothing worthy of comment in the health sector but rather that I have felt a deep sense of despair with what has transpired in the preceding months and years. Since my retirement in 2015 I have been involved in various initiatives to address challenges in the South African public health service as a member of nationally appointed task teams and most recently as a consultant requested to address financial management in a South African provincial health service. Whilst I accept that as an outsider and consultant not directly responsible for the management of health services,…
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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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The end of life … assisted dying … a vexed question
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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…
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Reflections on life in my seventies …
With the onset of winter in South Africa, the time of the “sere and yellow leaf”, I am in a reflective mood as my 74th birthday looms later in the year. I retired from a full-time career as a specialist paediatrician and then a senior government bureaucrat in 2015 having headed a university department of paediatrics and managed two provincial departments of heath in South Africa. Subsequently I have remained busy as a consultant and on the boards of various entities. 2023 marks 50 years since I qualified as a doctor in 1973 and the world around me has changed dramatically since that milestone and as befits that anniversary a…
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COVID-19 Lockdowns … can we learn the lessons?
A recent study published in the South African Journal of Science by Bradshaw et al provides interesting reflections on the number of reported COVID-19 deaths in the four waves of coronavirus infections compared against the total number of excess “natural” deaths during the same periods. While in one province, Western Cape, the ratio between reported COVID-19 deaths and the excess natural deaths was 69% in some other provinces, Mpumalanga and Limpopo respectively, the ratios were as low as 10 and 13%. From this it appears that quality of the provincial data systems varies markedly. The data also indicates that the quality of official COVID-19 reporting may be worsening over time. The…