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…
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Is the state of South African public health a budgetary or a delivery problem?
I was struck recently when according to a news report the National Minister of Health had appealed to his cabinet colleague the Minister of Finance to “stop cutting health budgets” and in doing do “alleviate the pressure on frontline health services”. He indicated that he had requested that there be no budget cuts in the coming year as had been indicated previously, so there would be no further reduction in frontline services. As an illustration the Minister reported a large number of vacant posts in the Free State Health Department of which the province had indicated nearly 900 were termed as “critical frontline posts” which he attributed to a lack…
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A reflection on “Echoes of Austerity” … the truth should be told!
I recently, completely by chance, came across a paper published in 2019 in a peer-reviewed journal, Focaal – Journal of Global and Historical Anthropology, authored by a United States based, South African academic, Theodore (Ted) Powers entitled, “Echoes of Austerity”. (https://www.berghahnjournals.com/view/journals/focaal/2019/83/fcl830102.xml?rskey=kneG81&result=1) It was disconcerting to find that I featured as a less than flattering central point of this anthropological discourse on, “Policy, temporality and public health in South Africa”. Further investigation revealed that Powers is an Associate Professor at the University of Iowa having previously been affiliated to the University of Pretoria. In the abstract of the paper he indicates that his intention was “to explore how policy principles associated with…
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Effective people make quality healthcare affordable
Healthcare is people intensive exercise and the cost of employment is the largest component of the budget of every provincial health department in South Africa and elsewhere. It follows that only staff who are skilled and essential at all levels of the organisation to the delivery of quality and affordable healthcare should be employed. Unfortunately, in my experience, the South African Public Health Service has too many people who lack the required skills or are wrongly placed in the organisation resulting in poor performance. It follows also that a person unable to effectively perform his or her allocated tasks, for whatever reason, or who is not essential to the delivery…