President Ramaphosa speaking at the 5th South African Investment Conference on 13th April 2023 made the following statements; “We are now confronted with the consequences of years of under-investment, mismanagement and corruption in our electricity, rail and logistics sector.” and that, “We are on a long journey to rebuild our country and recover ground we have lost. Our recovery is a mission and will take time to accomplish”. He continued that, “The lack of reliability in electricity supply weakens business and consumer confidence, taints international perceptions about our country and affects investment sentiment and decisions” concluding that, “If the focus of our struggle for liberation to end apartheid and achieve political freedom, the focus of our efforts must be to address inequality…
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Some thoughts on health service management
I am often asked what are the requirements to manage public health services or a public health facility? What qualifications are ideal? Is a health background essential? What about a health related MBA? I wrote on this topic in a post dated 21st December 2021 and if these are questions that still entertain you that post is worth another read. Previously my recommendations in that post were: Time spent in the health services either as a health professional or employed in another capacity within the health services is essential. Particularly, if one is not a health professional a postgraduate qualification in public health to provide an understanding of the field…
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When is enough, enough?
As a health professional and health manager, it is understandable that most of what I write about is health related. But I am also a citizen of this country and live some of the realities that South Africans experience, albeit not fully experiencing what my less fortunate fellow South Africans experience. For this reason I reflect here, accepting that I am a privileged citizen of this country, on the general state in which South Africans find themselves. Whilst the abolition of apartheid removed discrimination on the basis of race, we are still a country divided along racial lines between those who have and those who have not. South Africans are…
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Gauteng Health Department woes are not new
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…
