EDITOR – Generally the KZN Department of Health is facing many hurdles and more specifically the two oncology centres – Durban and Pietermaritzburg – have come under the spotlight for numerous reasons.
The caveat to this debate is to recognise that government is not a business. The public sector is far less accountable to market conditions than it is to the amorphous but real incentives and vicissitudes of politics. However, the private sector’s main goal is maximisation of profits and the main goal of government is nothing less than “the good of mankind”. This should underline this debate.
A good point of departure in contestations such as these is to provide actual facts and not alternative facts that suit a particular political agenda. There is a tendency for letters sent to editors, to sensationalise very sensitive critical matters without providing more objective and analytical information. I therefore take the liberty to provide the unvarnished and uncontaminated facts.
It’s also very important that those who wish to attack the Department of Health should have served a reasonable time in the trenches of the system to be in a more qualified position to pass judgement on a system that has historical baggage and services the poorest of the poor. Sitting in your air-conditioned private sector chambers, while charging patients 500 per cent over the medical aid rates, does not give you any legitimate mandate.
According to the Institute of Race Relations, out of a population of over 54 million people only 17.4 per cent are covered by medical aid. This means that only 9.5 million South Africans have access to private medical care while more than 44 million don’t. This then means that 44 million people put increasing pressure on the public health system. A GHS survey has established that seven in every 10 households opted to go to a public hospital or clinic as their first point of access. It’s also interesting to note that public health uses almost 11 per cent of the government’s total budget.
The statistics also reflect that 73 per cent of all trained GPs work in the private sector. Just to add – there were 458,933 deaths in SA in 2013 of which 1835 died from complications of medical and surgical care and in 2015 out of 460,236 deaths, 1732 died from similar complications. These statistics need no further explanation but go far in considering that 44 million people use the public sector health care facilities.
Factual information points to two important observations: firstly that the public health industry is stretched to its limits and that if 73 per cent of all GPs are in private practice only 27 per cent are in the public sector (73 per cent serving nine million versus 27 per cent servicing 44 million) – herein lies the fundamental problem; and secondly, given the costs of litigation in the private sector the only conclusion one is forced to believe is that our specialists are not adequately trained or that they jump into private practice without serving sufficient time in the public sector, or maybe as they claim they are forced out of the public sector because of the fact that it’s dysfunctional.
The lesson that the “shadow”opposition need to take from this experience is that while they have every right to criticize, they need to be constructive in the how the crisis should be resolved. Just calling for the MEC to resign is “childish”. This is what the opposition would be remembered for – it would be their legacy given that the chance of the opposition would run the country is extremely slim if not impossible.
My final word to these medical specialists who abandoned their posts by resigning knowing that those patients needed them more now than ever before – you will need to search deep into your conscience to rationalise the real reason for you leaving the beleaguered Public Health Industry, that trained you at the taxpayers’ account.
Sicario
Durban
Letter shortened – Editor
