SA not ready for universal health care

Mondli Dube, Cape Town

The drive for all countries in the world to implement universal health care coverage by 2030 is good in principle but is it achievable?

Even before Covid-19, the ideal of equal access to health care for all, noble as it is, was not always going to be easy to achieve for many countries.

The few developed countries that offer universal health care coverage succeeded at the expense of poor countries, using their ability to pay better salaries and offer better working conditions to lure health professionals away from their original countries.

The National Health Service of the UK, for instance, has been sustained by the thousands of expatriates recruited from many countries. It also continues to train adequate numbers of its own health-care workers because it knows it is important to maintain ideal doctor-to-patient and nurse-to-patient ratios to deliver quality patient care.

SA has allowed the emigration of skilled categories of health professionals to the UK, the Middle East, the US, Australia and Canada for years, which has crippled our health services. The training of nurses has been sluggish since nursing colleges were closed down in the 1990s. The overcrowding at Gauteng hospitals was caused in part by the closure of Kempton Park, Hillbrow and Lenasia South hospitals at about the same time as the nursing colleges. These events sparked the exodus of health professionals to overseas countries.

Rampant immigration of legal and illegal immigrants has worsened the situation, strangling our scarce resources and affecting our care standards negatively.

NHI (National Health Insurance), which is a financing tool for universal health care coverage, will be derived from all workers and companies through taxation. Yet SA has a youth unemployment rate of 55.75% and general unemployment of 32.50%.

Medical negligence claims are rife, with some incidents so horrifying it is hard to imagine how we got here. Overcrowding in health facilities and staff shortages are largely to blame, as is an inadequate health budget. In trying to implement universal health care coverage, without overcoming all the hurdles, we will be asking for the collapse of our health system.