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.…
-
-
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…
-
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…
-
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…
-
A personal reflection …
I have not posted anything since July 2022. This is not because there has been nothing worthy of comment in the health sector but rather that I have felt a deep sense of despair with what has transpired in the preceding months and years. Since my retirement in 2015 I have been involved in various initiatives to address challenges in the South African public health service as a member of nationally appointed task teams and most recently as a consultant requested to address financial management in a South African provincial health service. Whilst I accept that as an outsider and consultant not directly responsible for the management of health services,…
-
Liberal, socialist or neoliberal?
A recent read of Francis Fukayama’s Liberalism and its Discontents set me thinking. For someone who is not a social scientist despite being a short book of 174 pages, it is a tightly written, challenging but stimulating read, which I can recommend. I have in fact read the book twice and continue to delve into various chapters in the book. Having in the past been taken to task for my application of the so-called neoliberal policies of budgetary austerity faced with a limited health budget, the book made me think whether I am indeed a liberal with socialist leanings, which I had always considered myself to be, or whether over…
-
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…
-
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…
-
Walking the Road of Healthcare in South Africa … is now available!
As possibly the longest serving head of a Provincial Health Department in South Africa, Dr Craig Househam shares his autobiographical journey: From a youth growing up in apartheid, to a doctor, specialist paediatrician, and the extraordinary career in public service that followed. From the advent of democracy to the AIDS crisis, Dr Househam was at the coalface of South African healthcare. Journey with him as he regales the reader with analysis, anecdotes and insights into the people and decisions that have influenced healthcare in South Africa over the past 25 years. Walking the Road of Healthcare in South Africa: My 40-year Journey
-
The Road to Better Healthcare … we are at a crossroads.
Following my last post, I have been reflecting further on the failures in public health care in South Africa since 1994. In doing so I reread a book, “Yenza – a blueprint for transformation”, published in 1998 that has been on my bookshelf since then. I worked with the author, Dr. Piet Human, on several occasions during the early days of my time as Head of the Free State Department of Health. Read some twenty years later, the optimism, idealism and hope of the years immediately after 1994, reflected in the book, are poignant given what has transpired since. The opening sentences of his book read as follows: “The present…