Shamed by our public hospitals

Shamed by our public hospitals

Douglas Gibson, 5 October 2016,

Harsh truths about SA education and health

Do we as country care about the health and education of our people?  If we do, why do we – a middle-income country, the most developed in Africa, with the biggest economy – tolerate our disgraceful world ranking?

The latest Global Competitiveness Index by the World Economic Forum ranks South Africa as 123rd out of 138 countries in the health and primary education category.

I make no apology for again referring to our basic education. I wrote recently about the shameful South African truth: if you are poor and black, your children will have inferior education equipping them for a lifetime of servitude or unemployment. If you are middle class, you will pay a lot and your children will enjoy the advantage of a good education.  If you are well off, your children will probably attend private schools comparable with the best in the world.

Although we are doing reasonably well in school enrolment at primary level, being 44th in the world, we are doing shockingly when it comes to the quality of primary education: 125th out of 138 countries.

By way of comparison, we are doing even worse when it comes to the quality of our higher education system: 134th in the world.  Our maths and science education ranks 138: the worst in the world.  Guess whose children get this education?

Looking at South Africa’s health services, the facts are also shameful: 123 out of 138.  Those who can afford it have a world-class health service.  The rich and the middle classes have medical aid entitling them to the very best care. The poor, mostly black people, but also many older and some younger whites, have to rely on state services.  The care they get is often poor.

We have many dedicated doctors and nurses who do their best, but the standard of service, the overcrowding, the inhumane waiting times for operations and the often-uncaring treatment meted out to many patients are a blot on our national life.  A government loudly espousing “pro-poor” policies has not improved the lot of patients in a generation.  If anything, many of our public hospitals are worse – some far worse – than they were under the apartheid government twenty-five or thirty years ago.

South Africa’s minister of Health, Dr Aaron Motsoaledi, scores an “A” for aspiration but an “F” for execution.  He wants to introduce a national medical scheme that would not be out of place in Scandinavia, but he and the MECs for Health seem incapable of making the backbone of such a scheme – our hospitals and clinics – function at a reasonably good standard. Failures at that level make the introduction of the Motsoaledi scheme so much “pie-in-the-sky.”

A friend of ours received a hip replacement a few months ago and the second is to follow soon.  The problem is that because she is black and is a cashier in a department store, with no medical aid, she has had to wait in considerable pain for nearly three years for her operation.  Admittedly, her operation was successful and the treatment she received at Helen Joseph Hospital was adequate if uncompassionate at times.

I am to have a shoulder operation this week on a date of my choosing because I have a good medical aid, enabling me to be operated on by a top surgeon of my choice in a private hospital. If I were black and /or poor, I would have to wait, in pain, for up to three years for a similar operation. That is simply not good enough.

Can you believe that a middle-income country like ours is satisfied with 33.6 infant mortality deaths per 1000 live births, placing us at number 107 out of 138 countries?  The babies who die are almost all born to poor black mothers.

We rank 130th in the world in respect of life expectancy.  This in a country that has one of the finest climates in the world. Life expectancy here is 57.2 years. Those who die young, often much younger than 57, are mainly black and poor.  People in the white community and many in the black middle class have a life expectancy equal to the people in Europe, some twenty-five years more than our average in this country.

Our government formulates plans that succeed each other rapidly.  None of them gains much traction before being phased out and replaced with another with a catchy acronym that garners public support but gets nowhere.

Instead of a new plan, it would be refreshing if the cabinet went off on a weekend indaba and focused on nothing other than the Global Competitiveness Index.  All the ministers would address the ranking given to their area of operation and table a one or two page document detailing the concrete steps they commit themselves to that will lead to an improved rating over one year and over five years.

The Global Index is not all negative; in fact, we have improved overall from 49th to 47th in the world, but we are still below where we were ten years ago.  Our areas of excellence such as banking soundness (2nd), financing through local equity markets (1st), strength of auditing and reporting (1st) and efficacy of corporate boards (3rd), to name a few, are hugely satisfying. We are entitled to be proud of being 11th in the world in financial market development and even 30th for market sophistication.

These rankings prove that we have the talent and the ability.  If we develop the will to extend good government to those most in need of it and focus on health and education, we will move dramatically up the rankings, proving that we really do care about improving the lives of all our people, especially the poor.

A former Opposition chief whip and former ambassador to Thailand, Douglas Gibson is a public speaker and writer. Follow him on Twitter @dhmgibson

This article first appeared in The Star.


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