The recent high profile signing of the National Health Insurance Act set me thinking about the public perceptions of healthcare in South Africa. In a South African context one hears much about problems experienced in the public health sector but less about those in the private health sector. In the public health sector issues relate to the poor quality of healthcare while in the private sector the issue most frequently is the high cost of services. I have had the advantage of having worked for forty years in the South African public health sector and subsequent to my retirement being part of, or having undertaken, various investigations into public health…
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Healthcare … a victim of a self-inflicted government funding malady?
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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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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Livingstone Hospital … a case study worth analysing
A recent media report revealed that some patients admitted to Livingstone Hospital a large provincial hospital located in Gqeberha, Eastern Cape are apparently given a letter which reads as follows: You have been admitted to Livingstone Hospital because you require emergency/urgent treatment for an orthopaedic condition. Unfortunately, the implants (metal devices used to fix broken/deformed bones) needed to best treat you are not currently available in the hospital. Depending on your injury and the delay the implant unavailability causes, you might not be able to be treated surgically and have a poor result/outcome. Your doctors have not been informed when implants will again be available nor given any alternative hospitals…
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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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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…
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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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Successful healthcare delivery … a missing link could be Logistics
The term “Logistics”is defined in the Merriam-Webster Collegiate Dictionary as “the aspect of military science dealing with procurement, maintenance and transport of materiel, facilities and personnel” or stated otherwise “the handling of the details of the operation”. While the term was initially used in a military sense, the term is now used widely in commerce, to refer to how resources are handled and moved along the supply chain. A brief scan of the internet reveals a multitude of universities offering under-graduate and post-graduate degrees in logistics and logistics management. Promoting these courses universities encourage prospective students that embarking on the these courses will prepare them for a successful career in…