The Congress of South African Trade Unions fully agrees with Health Minister Aaron Motsoaledi that health is a fundamental human right, and that South Africa's private healthcare system is a “monster that will swallow the country whole”. It perpetuates the gross inequality in our two-tier, wasteful healthcare system, which consists of:
§ A public health service which treats health as a social need, yet is starved of adequate funding and resources. Less than 40% of total health care resources are in this sector, yet it serves 85% of the population, the majority of whom are black and poor.
§ A private sector, which treats private healthcare as a business. It accounts for more than 60% of the total healthcare resources, including majority of health professionals (other than nurses), yet it serves a minority of the population, the majority of whom are white and wealthy.
The federation also warmly welcomes the minister’s announcement of plans to solve the serious shortage of well-trained healthcare professionals, by building six new academic hospitals and medical schools in the next decade, revamping existing hospitals, and increasing the quota of medical students at universities each year.
This is a key component of the move towards the implementation of National Health Insurance system. COSATU totally agrees with the minister that although we are producing 1200 medical doctors a year the number needed to be at least tripled. As he said, "to train more people you need superior infrastructure. We are not only producing a human resources plan but equally producing a plan on infrastructure".
The minister rightly diagnosed that the shortages of medical staff is “self-created", caused by poor planning by the apartheid government, from which we are still suffering. COSATU supports his appeal to private practitioners to move back into public healthcare to improve the quality of medical care and education.
The case for the NHI is overwhelming. The health profile of the population has deteriorated. The life expectancy of South Africans dropped from 62 years in 1992 to 50 years in 2006. Although we rank 79th globally in terms of GDP per capita, we rank 178th in terms of life expectancy, 130th in terms of infant mortality, and 119th in terms of doctors per 1000 people.
South Africa has less than 1% of the world’s population, yet it still has 17% of people living with HIV/Aids, the highest incidence in the world. Life expectancy rates are falling and now stand at 56 for women and 51 for men. The death rate has doubled in nine years!
Yet spending on health care in South Africa is higher than in many countries with better health care provision. So it is not just money, but the misallocation of resources, with a private health sector making rocketing profits and an underfunded and mismanaged public sector.
That is why COSATU is campaigning for the urgent implementation of the National Health Insurance system to bring the quality of public health care up to the same and better standard as in the private sector.