My first post on my health blog on 13th July 2020 had the title. “Winter of discontent”. I am again posting a piece with the same title as on that date.
The country has since emerged from the COVID-19 pandemic, which in July 2020 was still new to our experiences but dragged on with questionable measures taken by government over the subsequent almost two years with disastrous consequences for the lives of so many South Africans.
At that time the country had experienced euphemistically termed “load shedding” but more aptly the failure of a vital state entity ESCOM to provide enough electricity to keep the wheels of industry turning and the lights on during cold dark winter nights. As I write this the steady thud of a generator in the background highlights the challenge that South Africans face.
While government was quick to implement a national state of disaster with advent of COVID-19, even mobilising the army to deprive citizens of many of their rights under the Constitution, the silence had been deafening when the country is now without reliable electricity in many areas up to eight hours out of twenty four. The President graced us with so-called “family meetings” on national television at various times during the pandemic but while the country faced Stage 4 to Stage 6 “load shedding” saw fit to leave the country and as one tongue-in-cheek commentator quipped, “attend a G7 summit to charge his cellphone!”
If the challenges of ESCOM were a new phenomenon cause by a particular unforeseen incident, a “force majeure”, there could be some understanding that the government could not be held accountable but it is far from that. In March 2006, for the first time South Africa experienced power outages conveniently blamed, prior to local government elections, by the then Minister of Public Enterprises, Alec Irwin, on a loose bolt in the Koeberg Nuclear Reactor suggesting sabotage. This claim later proved to be false.
Subsequently over the next 16 years with varying but increasing frequency, South Africa has experienced the inability of ESCOM to maintain a constant supply of electricity to the country. Intermittently, the challenges at ESCOM have been again blamed on sabotage although more recently State Capture and mismanagement are mooted as the causes. Most recently ESCOM’s woes have been attributed to a loss of essential skills and labour unrest. As South Africans we are told how many units are out of service and how much diesel is being consumed to prevent a total collapse of the power grid but little of how the situation can be rescued.
Whatever the reasons and it is evident that these are multiple, the fact is that ESCOM is unable to ensure that the country can depend on a stable electricity network. What is also evident that the government, which is the sole shareholder of this State owned entity (SoE) and for the period in question, formed by a single political party, must bear responsibility for the consequences for South Africa. It cannot be, that as was recently stated by the cabinet minister responsible for Public Enterprises of which ESCOM is one, at an address at the University of Witwatersrand that those responsible for State Capture must be held accountable but that he although a member of the cabinet, in various portfolios, during what the President terms the “nine wasted years” seemed to abdicate that responsibility or as the Minister responsible for Minerals and Energy claimed when pressed on this issue that he cannot be held accountable for the problems experienced by ESCOM. If not the government as the sole shareholder, who else is accountable?
It is patently obvious to all but politically blinded apparatchiks that government must assume accountability and must be held accountable by ordinary citizens for what has occurred. In a healthy democracy it would be expected that a change of government would be the consequence at the next general election. Whether that will occur in the complex political environment of South Africa and what the alternative would be, is an open question. What is not an open question, is that to continue as we are, will lead to a South Africa that no-one would wish to contemplate.
You may ask why I would write on this topic in what is primarily a health blog? In my view, the effective functioning of the State is essential platform for an effective healthcare system. With legislation pending that seeks to implement a State controlled and centralised health system through the introduction of National Health Insurance (NHI), however well intentioned, it is inconceivable that this should occur in an environment that has allowed an essential SoE such as ESCOM, to falter again and again over the last 16 years and longer.
I recall the crisis that occurred in the health services in 2006 when ESCOM faltered for the first time and the urgent investment required to ensure alternative sources of power at health facilities. Now 16 years later these generators are required to provide power for prolonged periods for which they were not initially designed. Despite emergency generation, routine procedures will be negatively impacted as routine surgery should not be commenced while a hospital is supplied with back-up power alone as if this fails the consequences can be dire.
It is interesting that the solution to the inability of Escom to provide the country with sufficient power, is to increasingly engage the private sector. Yet with NHI the intention is to do exactly the reverse and effectively remove the private sector from the provision of health care and centralise this within a SoE, the National Health Insurance Fund.
I would hope that sense will prevail although the history of this country over the last two decades does not inspire confidence. Hope however springs eternal and one can only hope that those with insight and wisdom will urgently come to the fore both in the case of ESCOM and health care in South Africa.
