Athol Williams’ Deep Collusion was a recent read. The book outlines the role of the international consultancy Bain & Company in the “capture” of state entities such as Telkom and the South African Revenue Services (SARS) during the Zuma presidency years. Of particular interest to me was the author’s conceptualisation of the process of state capture. He compares the differences between corruption and state capture. The different degrees and influence and control (decision making) that “illegitimate and unelected parties” have over the functions of the state determines the differences. In what he categorises as a “just democratic state” there is no influence or control by illegitimate parties over state resources. With…
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National Health Insurance … what is government saying?
I have written on several occasions about the proposed National Health Insurance Bill (NHI) that is currently before the South African parliament. I have proposed a rational debate and have raised my concerns about what is proposed in the draft legislation. I was thus interested in an interview with Dr Nicholas Crisp, the deputy director-general tasked with National Health Insurance in the National Department of Health published in the Sunday Times on 3rd April 2023. Dr Crisp, who is one of the most senior officials in the National Department of Health, was posed a series of questions by Chris Barron and his responses, if he was correctly quoted, I found…
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Walking the Road of Healthcare in South Africa now available on Amazon
I am glad to inform readers and subscribers to this page that my book published last year by Quickfox Publishers is now available on Amazon Books in either Kindle ebook or hard copy versions. In recent posts on this site I have referred to the book and I feel that what I have chronicled in the book remains relevant to the discourse on the future of healthcare in South Africa and elsewhere. I can also recommend the book to those who are either embarking on a career in health management or already in the thick of the challenges that such positions bring. I am glad that the book now has…
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National Health Insurance … what are alternatives?
I have in recent posts referred to my concerns related to the National Health Insurance (NHI) draft bill and it is only reasonable to ask, “So if you are concerned what alternatives would you recommend or consider? It is easy to criticise but if it is accepted that the current status quo for the majority of South Africans is unacceptable, rather than carping on the sidelines offer alternatives!” So much has been written in the last few years on this topic that I am hesitant that I can add anything of value to the debate but for what is worth here are my views! Since 1994 the divide between those…
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The more things change the more they stay the same …
The more things change the more they stay the same Ah, is it just me or does anybody see The new improved tomorrow isn’t what it used to be Yesterday keeps comin’ ’round, it’s just reality … The words of a song by Bon Jovi echo in my mind as I reflect on the state of South African healthcare. The song itself echoes the words of the French writer Jean-Baptiste Alphonse Karr from the 1800’s who wrote that “plus ça change, plus c’est la même chose” – the more things change, the more they stay the same – indicating that turbulent changes do not affect reality on a deeper level…
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From policy pronouncements to implementation … a seemingly difficult path!
I was struck that many of the pronouncements by President Ramaphosa in the 2022 State of the Nation Address (SoNA 2022) are noble in intent but fail to address the mechanism by which policy pronouncements become a reality. While it is correct, as the President did, to allude to the consequences of State Capture and the COVID-19 pandemic that have set the country back, these alone cannot be the reasons why South Africa finds itself in the perilous position that it does today. In fact, from the Constitution down this country has some of the most progressive policies and legislation in the world but has failed in many areas to…
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The argument for meaningful debate.
In my book, “Walking the Road of Healthcare in South Africa”, I reflect on my experiences as a senior bureaucrat and what I term the “argument for meaningful debate”. A parliament is defined as a “formal conference for the discussion of public affairs” while a legislature is defined as “body of persons having the power to legislate or make laws”. My expectation of the deliberations in such a body or a committee of such a structure, was that there should be a meaningful debate with the exchange of logical and consequent ideas. However in my experience, meaningful debate is often a scarce commodity in the chambers of the South African…
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Life after the COVID-19 pandemic
The advent of the Omicron variant initially worrisome, and in various ways very damaging to the South African hospitality industry, has proved to be less serious than expected in terms of the health impact. Nevertheless there seems to be a reluctance on the part of health experts, to whom I referred in my last post, to now let go of their prime position in the media that they had occupied at the height of the pandemic and return to the less glamorous aspects of health care. A negative aspect of the pandemic aside from the direct consequences of the virus, has been the disruption of the wider ambit of health…
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COVID-19 … is there another approach?
A recent weekly press briefing by the Western Cape Premier Alan Winde to update the province on the COVID pandemic set me thinking and asking myself some difficult questions. With the advent of the Omicron COVID variant, countries around the world have reacted with further restrictions placed on their citizens. International travel for the average citizen has ground almost to a halt with disastrous consequences for the hospitality industry and the many other commercial entities dependent on this sector. Despite these new and draconian restrictions, almost impulsively implemented, the numbers of Omicron infections across the globe continue to rise. In South Africa where the Omicron variant was first identified, the…
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Health management … what do I need to be a health manager?
I was asked by a reader of one of my recent posts, what I regarded as the ideal preparation to become a manager of health services? The question was posed by a medical student about to graduate as a doctor and it set me thinking what is the best preparation for entering the field of health management? Given my background and experience I will focus primarily on a management career in the public health service. So here are my thoughts … I do not think that management of health services is the province of medical practitioners alone although for many years it was the case as evidenced by those who…