EDITOR – Without fail, a week is not complete if no mention of the so called crisis in the public health sector is raised in various forums. These reports or comments are generally about the lack of medical specialists, nurses and doctors and obviously for the opposition parties this unacceptable situation inspires them into action.
Yet another reason to knock down the Ministry of National and Provincial Health. I’ve yet to see a realistic and tangible solution put on the table. The public heath industry debate has provided the opposition parties with a reason to attack the ANC led government – they are however not blameless.
What are the facts – annually 30,000 aspirant matriculants will apply to study medicine in SA of whom somewhere between 1200 and 1500 will gain admission. Access to medical training remains a privilege in SA specifically and globally generally. We are all aware that SA is faced with an absolute shortage of health professionals which is compounded by the maldistribution of health human resources between the public and private sectors and between the urban and rural areas.
Over 70 per cent of medical practitioners, 40 per cent of nurses, 90 per cent of dentists and 85 per cent of pharmacists service the private sector largely in urban areas – this translates to 9,5 million people who have access to private medical care. An extrapolation of these figures says that 30 per cent of medical practitioners, 60 per cent of nurses, 10 per cent of dentists and 15 per cent of pharmacists service 45.5 million people who use the public health sector. The overall shortage of health professionals in the public sector is estimated at 80,000.
In 1976 when the population of SA was sitting at 22 million we had seven medical universities of which five were intended to produce doctors for even a smaller white population. The 8th medical school was established in 1986 and the 9th in 2015. The population of SA sits at 55 million as at 2016 while the collective production of medical practitioners during the 23 years since the 1994 democratic dispensation has been steady at between 1200 to 1500 doctors per annum.
The population of SA in 1994 was 40,56 million reflecting an increase of 15 million in 23 years. This statistical data is crucial in that during these past 23 years only one new medical school was established. However we must note that the government opted to outsource the training of doctors to its old struggle ally, Cuba, at an excessively high cost to the taxpayer.
A systematic overhauling of the public health sector must be done to analyse the urban-rural and private-public maldistribution. In the final analysis we need to train more health professionals, improve doctor-to-population ratios in the public health sector and distribute doctors more efficiently so that the country can address the healthcare needs of the marginalised communities. After this has been achieved the government can focus on their purported resolve to implement a National Health Insurance Scheme (NHI). Up until then the NHI is just pie in the sky and can never be realised as the ANC legacy.
Attempting to build a world class NHI on a foundation of jelly is bound to flop and the ANC government is all to well aware of this, but to appease the masses the NHI has been thrown into the quagmire of unfulfilled and unattainable promises.
Sicario
Durban
Letter shortened – Editor
