Can parties provide adequate health care services if entrusted with power

THE right to health for thousands of South Africans is constantly under threat, and as the country prepares to embrace a new era post elections, the public is eagerly listening to parties outline their blueprint and pledge improvement for the next five years.

This as the majority of citizens use public health institutions, and from clinics to hospitals, to staff compliment and availability of medication, no less than 70% are subjected to a less than acceptable standard of service.

“Broken and non-functioning equipment is just the tip of the iceberg for the people of this country, many who depend on public institutions for the basic health system,” Pretoria’s Dr Mandisi Pulane said, adding that medication, service with a smile and comfort was lacking.

And not only was it the underprivileged who were hard done by the lack of a functioning system, she said, but so were patients who required treatment available only in these institutions.

“Cancer treatment and management, no matter how much money you have, is in the hands of government hospitals, and while private institutions can care for and treat, they will refer patients to these facilities as they have the best - and often world class, equipment required,” she explained.

This was because institutions which treated illnesses like cancer were attached to universities, and so benefited both from the finances and human resources thereof, Pulane said.

The failure to ensure equipment, facilities, lifts and even something as basic as air conditioning and food, was available, patients attending public hospitals are subjected to long queues, being turned away, dying as they waited for care, in a sector bogged down by severe medical staff shortages, added paramedic Zweli Hlatjwayo.

“This is in addition to acute drug shortages, ambulance and patient vehicles either sitting around waiting for repairs or staff, or being unable to access certain areas for crime and roads and a wide variety of reasons,” he said.

Hlatjawo said in the 20 years he has worked in Gauteng, there has never been a smooth running of services.

“In many instances it is due to the running - from the top, of institutions, clinics, hospitals and pharmacies, by people who are not in touch both with the constitution or the needs of people.”

In a 2022 review, the WHO Council on the Economics of Health forAll said some countries recognised health as a human right in their constitution but did not pass it and put into practice laws to ensure populations were properly serviced.

”They do not ensure everything is in place for those entitled to have access to health services,” the international body said, adding: “This underpins the fact that the majority of people are not fully covered by essential health services.”

They said, as the world observed World Health Day 2024 under the theme 'My health, my right’, that it was time to champion the right of everyone, everywhere, to have access to quality health services, education, and information, as well as safe drinking water, clean air, good nutrition, quality housing, decent working and environmental conditions, and freedom from discrimination.

“The right to health care is enshrined in South Africa’s constitution. The National Development Plan 2030 has several health priorities which have guided the National Health Strategic Plan 2015 - 2020, aimed at achieving a long and healthy life for all South Africans.”

The WHO said the government, and in turn public health, had the advantage of cooperation with international bodies, which not only funded but provided advice and resources.

“But, are people aware that as parties campaign for power they need to outline clearly how they will improve on the provision of health to the multitudes who so desperately need it,” Pulane asked.

When the EFF launched its manifesto, they spoke of seven cardinal pillars constituting their core approach to ‘genuine revolutionary’ transformation of society for the better, among them free quality education, health care, houses and sanitation.

They said: “South Africa’s health care system excludes a substantial number of South Africans, and the country is, sadly, still far from achieving universal health coverage.”

In addition to subsidising embedded electricity alternatives for public institutions, among them public health facilities and schools, the party promised to build primary healthcare facilities in each school.

“The EFF government will establish residential clinics to ensure easy access to primary healthcare for all students; renew the health system through the strengthening of Primary Health Care: universal coverage, people-centred care, with an emphasis on public health and evidence-based policies,” they said.

The ANC said they would, if they maintained their position as the ruling party, tackle the high cost of living, by taking steps to make everyday life more affordable for workers, unemployed persons, women-headed households and the middle class by addressing key needs like food, housing, health care, energy, transport and wages; strengthen health services and implement the National Health Insurance to make quality health care affordable and available to all.

New party on the block, uMkhonto Wesizwe, committed to transformative change across all sectors and said their policies were designed to address the most pressing challenges, among them economic inequality, inadequate access to quality education and healthcare.

Speaking of their health care policy, the party said they would ensure accessible and quality healthcare. “...ensure healthcare facilities are accessible, well-staffed, and well-resourced, including alternative medicine options.”

On infrastructure and staffing they promised to improve healthcare infrastructure and increase the number of healthcare professionals.

The DA said the country was besieged by staff shortages, long waiting times for patients, and long working hours for staff. “To rescue South Africans from a broken healthcare system, we need to remove politicians from the running of healthcare facilities and increase access to healthcare services. We need to reject the NHI in favour of the DA’s Universal Healthcare Coverage model, which aims to increase access to services in both the public and private health sectors, improve the existing healthcare system, and guarantee a basic level of care to all people.”

ActionSA said theirs was not a list of unattainable promises but a pragmatic plan aimed at addressing some of the country's most pressing issues. They would ensure safer communities, secure borders, ensure access to quality education and healthcare for all, while the UDM pledged greater access to specialised services like courts, legislatures, hospitals and healthcare specialists.

They said the standard of the quality of healthcare infrastructure and maintenance remained below par, the level of hygiene at many clinics unacceptable, and the distance that South Africans had to travel to reach the nearest clinic or hospital remained a sad fact. “Health infrastructure and services need to be brought closer to the poor.”

They promised proper and functioning referral mechanisms, said the identification and referral of patients in need of specialised care was important and had to be identified early so as to deal with their needs in order to prevent long queues and inadequate treatment.

“The UDM believes that nutrition guidance and family planning must form an integral part of primary healthcare, recognising that counselling and skills development in these areas will have a major impact on the general health and wellbeing of our people.”

They said traditional healing remained popular in South Africa and should be respected: “but, it should be regulated.”

ntando.makhubu@inl.co.za