Currently there are according to reports several hundred unemployed young doctors in South Africa, a country that according to recommended doctor to population ratios requires more and not less doctors. It has been previously reported that some amongst other categories of health professionals are similarly finding it difficult to find employment in the South African public service leading to some even emigrating from this country to find work elsewhere. This situation has been attributed to the shortfall in funding for public health services. The current financial crisis in government departments largely results from a wage agreement with organised labour that increased the salaries of all public servants by 7%. These…
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National Health Insurance … potential for system failure?
I recently read about the two disasters affecting the American Space Shuttles. The Challenger exploded shortly after launch in 1985 while the Columbia was destroyed 20 years ago over Texas on its 2003 return to earth after a 16-day mission. In both cases an accident investigation board (AIB) was established to investigate the causes of the disasters and make recommendations to address what had occurred. In the case of Challenger, a faulty o-ring on one of the solid rocket booster rockets, due to the abnormally cold weather during the launch, lead to flames leaking from the rocket igniting a catastrophic explosion in the shuttle’s external fuel tank destroying of the space…
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Hospitals are key to an effective health service
Having recently been a patient requiring major surgery in a hospital, I have reflected on the vital nature of a fully functional hospital to the integrity of a health service. Despite spending half my professional life as a clinician working in a hospital, being a patient requiring complex care without which I may not have been here today to write this, provided me with another perspective. Hospitals, be they in the public or private health sector, are complex organisations focused on, and vital to the well being of the patients admitted to their wards. Hospitals are essential to provide a range of services that cannot be provided elsewhere which is…
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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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Health and Wellness go together but are very different challenges.
The World Health Organisation (WHO) defines Health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” and defines Wellness as “the act of practicing healthy habits on a daily basis to attain better physical and mental health outcomes, so that instead of just surviving, you’re thriving”. Both without a doubt important concepts but result in different challenges for those responsible for their achievement. “A new name, a new direction?” is the title of a recent article published in Daily Maverick . The authors draw attention, as so many have done in the past, to the work of Sydney and Emily Kark…
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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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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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Groupthink … in a COVID-19 world
Groupthink is a pattern of thought characterised by forced manufacture of consent and conformity to group values and ethics. The concept originates from the work of a social psychologist, Professor Irvin Janis, who coined the term in 1972. In groupthink groups of highly intelligent people at times make poor decisions when insulated from the divergent opinions of people outside the group. Under these circumstances a person within the group, although holding an alternative view, will withhold that view to appear to remain part of the group, while the group will reject an alternative view originating from outside the group. There are many examples of this and its negative consequences within…