Healthcare varies from the most basic primary healthcare, offered free by the state, to highly specialised technical health services available in the both the public healthcare and private healthcare sector. Both the public and private healthcare sectors have their advantages and disadvantages.
The public healthcare sector is stretched and under-resourced in places, while the mushrooming private healthcare sector, run largely on commercial lines, caters to middle- and high-income earners who tend to be members of medical schemes, and to foreigners looking for top-quality surgical procedures at relatively affordable prices. The general consensus of private healthcare, although it serves its customers efficiently, tends to be priced at such amounts so as to ensure that only a minority of the South African population can afford some sort of coverage. The private healthcare sector also attracts most of South Africa’s health professionals.
The Department of Health has an overall responsibility for healthcare in the country, with a specific responsibility for public healthcare. High levels of poverty and unemployment mean healthcare is largely the burden of the state. The public healthcare system is, however, well on its way to being reformed as a real increase in funding for public hospitals has taken place.
Basically, South Africans that live in rural areas, who are earning a lower income are highly dependent on the public healthcare system. Their state of health is questionable in comparison to the racially mixed segment of urban South Africans with adequate access to private healthcare facilities, or relatively higher quality public health care facilities.
The public healthcare system in South Africa is large, complicated and fragmented. It is being reformed in terms of strategy, infrastructure and service delivery. In order to reform the public healthcare sector, the staff compliment has been increased by over 17 000 new employees for the year 2015/16. This number will soon rise again as a total of R157 billion of the 2015 South African budget was allocated to the Department of Health. While government’s spending on health matches that of the private healthcare sector, it should be noted that almost 81.2 per cent of the population relies on the public healthcare services and only about 18.4 per cent on health services is paid for by medical schemes.
With less resources and more poor people, cash-strapped provinces such as the Eastern Cape face greater health challenges than wealthier provinces such as Gauteng and the Western Cape. The Department of Health will invest R19.5 billion in the maintenance and refurbishment of state facilities within the public healthcare sector.
To address some of the resource and service delivery problems facing the public healthcare sector, partnerships between the public and private healthcare sectors are being forged. Some private hospitals are now offering beds and providing medical care to public sector patients.
They are also beginning to offer post-graduate teaching facilities to university medical faculties in an effort to stop the flow of doctors out of the country. To make progress towards equal access to quality healthcare in South Africa, the strategic use of all current resources of both the private and public healthcare sectors is necessary. The extension of the capacity and reach of the private healthcare sector is essential in order to help reform the state of the public healthcare sector.
Do you have medical aid or do you rely on the public healthcare system?
What do you think needs to happen to improve access to basic healthcare in South Africa?