In February 2017 after the release of the damning report by the Health Ombud Professor Makgoba on what happened subsequent to the disastrous transfer of mental health patients from Life Esidemeni to ill-prepared NPO’s, the then Minister of Health Dr. Aaron Motsoaledi and the then Premier of Gauteng David Makhura announced the appointment of a high-level task team to address what were termed “critical inadequacies in the capacities and capabilities and competencies to run the system and the management and incapacities exposed by the Life Esidimeni tragedy.” I was a member of that five-person task team for four months working in Gauteng. Ultimately I resigned in frustration as the team’s work…
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Being a patient provides another perspective!
For most of February 2023 I was a patient in hospital requiring two laparotomies, a spell on a ventilator, two weeks in intensive care discharged home after just over three weeks. Somewhat chastened by the experience I am now 10kg lighter than when admitted and recuperating at home. Certainly an experience of this nature brought me face to face with my own mortality but also emphasised the impact that sudden severe illness has on those close and dear to one. I am grateful that the pathology that required surgery was not malignancy and could be rectified by the surgical interventions. However, the experience brought home to me the crucial importance…
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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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What lessons were learned from the COVID-19 pandemic?
I often read, and at times hear, that many lessons were learned during the COVID-19 pandemic. It has been said by some that these can be used to determine the future direction of health care. I have been reflecting on whether there were lessons to be learned and, if so, to what extent they provide insights into the future of healthcare in South Africa. From the position now as an outsider to the mainstream of healthcare policy and management I am aware that the efforts of many in the health sector across the globe went far beyond what was normally in their job descriptions. Health professionals faced with the uncertainties…
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Does quality healthcare depend on money alone?
Recently I met with the management of a health department as part of my work in the healthcare field. I arrived early at the venue located in a large hospital and as the meeting also commenced later than scheduled, I had time to walk around the hospital. I encountered various staff members and patients and was cordially greeted although none asked whether they could assist me or what I was doing in the hospital. What was striking was the dilapidated state of many areas of the facility. Paint peeled from the walls and there were signs of water damage to the ceilings in various places. A pane of glass was…
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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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Healthcare … how should the priorities be determined?
I read with interest a recent report of the proceedings from a recent conference held in Cape Town. The conference, it was reported, brought together healthcare workers, researchers and community activists from 11 African countries. The focus of the conference was the unequal provision of surgical procedures to those living in rural areas and those without a medical aid or medical insurance. At the conference it was stated that before the COVID-19 pandemic the lack of access to surgical procedures was a challenge for public health services but that this had been exacerbated by restrictions on surgical procedures during the pandemic with an estimated 175 000 people now waiting for…
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Is a fixed retirement age a sensible option?
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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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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Gift of the Givers and a Vaccine Task Force … lessons to be learnt
Recently it was reported that Gift of the Givers, a charitable organisation, has been distributing food to hospitals in the Eastern Cape. This was reportedly due to the provincial health department being unable to ensure adequate food supplies to patients due to what was termed a “budget shortfall”. If even partially true it is an iniquitous situation for State hospitals to find themselves and begs the question, why has it come to this? I have written on many occasions that we should expect greater accountability from those responsible for the management of health departments in this country. This is not the first time the unacceptable conditions in Eastern cape Hospitals…