SA’ health care crisis: EFF calls for radical reform

The EFF places health care at the centre of the struggle for economic justice and human dignity, as highlighted in our third National People’s Assembly discussion documents.

South Africa’s health care system is collapsing, leaving the most vulnerable in society – workers and the poor – without access to adequate medical care.

Despite the constitutional guarantee of health care services for all, the current state of public health care is a betrayal of this fundamental right.

South Africa’s public health care infrastructure consists of 5 505 facilities, of which 57% are clinics. Yet, only 1 507 out of 3 152 clinics meet the standards of an “ideal clinic,” leaving nearly half unable to deliver essential services due to poor infrastructure, inadequate staffing and lack of support services.

Public hospitals fare no better – of the 696 facilities inspected in 2017, only five met the required norms and standards.

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The challenges extend beyond infrastructure. There are over 41 300 vacancies in public health care facilities, leaving patients to endure long waiting times and insufficient care.

A misguided policy in the 1990s that shut down vocational training nursing colleges has led to a dire shortage of trained nurses, exacerbating the crisis.

Only 16% of South Africans can afford medical aid, leaving the majority dependent on an underfunded and dysfunctional public health care system.

The Competition Commission’s investigation revealed stark inequalities, with 42.5 million South Africans relying on the public sector while 8.7 million benefit from private health care. This unequal distribution of resources perpetuates a system where quality health care is a privilege for the wealthy.

Over 500 facilities still contain asbestos, a known health hazard. Hygiene and patient safety are compromised and the conditions not only endanger patients, but also demoralise overburdened workers.

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This brings us to the National Health Insurance (NHI) Bill, which seeks to provide equal access to quality health care for all.

The EFF believes that NHI has significant gaps that must be addressed to ensure its effectiveness and alignment with the realities of South Africa’s socioeconomic and health care challenges.

While the NHI aims to integrate public and private health care sectors to eliminate inequality, its current model does not address the root causes of disparities in health care access and outcomes.

Collapsing the public and private health care sectors without building a robust and well-resourced public system risks overwhelming the existing infrastructure.

The NHI does not sufficiently consider the unique spatial and social dynamics of South Africa, such as the difficulty of accessing health care in rural areas and informal settlements, or the needs of marginalised groups, including the LGBTQI+ community, women and children.

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This is why the EFF has always envisioned a health care system that is universal, equitable and people-centred.

Our approach emphasises prevention, promotion and education as pillars for improving health outcomes.

To achieve this, the EFF advocates for strengthening primary health care as the foundation of the system.

There needs to be clinics and polyclinics in every ward, ensuring that they operate 24 hours a day and are adequately staffed with permanent health care professionals.

The EFF suggests the implementation of a 12-month refurbishment and maintenance plan to upgrade clinics and hospitals.

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Training of health care professionals needs to be prioritised by establishing health sciences training facilities in every province.

Health science curriculums will need to emphasise human rights, equity and cultural competence to prepare practitioners to address South Africa’s diverse health care needs.

Health care services have to be accessible and inclusive, particularly for vulnerable populations like women, children, persons with disabilities and LGBTQI+ individuals.

Special attention need to be paid to mental health, domestic abuse, sexual violence and other socioeconomic determinants of health.

Traditional health care practices need to be integrated with modern medicine to provide culturally relevant solutions.

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Health care reform must be underpinned by equity, innovation and a people-centred approach that leaves no-one behind. Health is a fundamental human right and the EFF will continue to fight for a health care system that guarantees dignity, quality and opportunity for all South Africans.

– Thembekwayo is an EFF member of parliament