I underwent knee surgery and found the whole experience decidedly
sombre. I know it is a truism to say hospitals are clinical and
sterile, but they are. They are dens of suffering and the environment
contains too much public discussion about bodily fluids for my liking.
again, I am one of the lucky ones. My operation went well, the treatment
was superb and the hospital room was comfortable, with couch, en
suite bathroom and 24-hour satellite television to dull the pain.
This is the benefit of private healthcare, whether in the UK or
most people in the world do not get this treatment. About 60% of
spending on healthcare in South Africa is in the private sector,
with less than 20% of the population benefiting from it. The State
spends R33-billion on healthcare for 38-million people; the private
sector spends some R43-billion on 7-million.
South African healthcare system is an either or arrangement.
Either you have medical aid and go privately, or you use public
facilities. The system in the UK is more of a hybrid. If I had braved
the waiting list the same consultant who performed my surgery would
have done it free, albeit in two years time. The long waiting
list meant I had little choice but to max-out my credit cards to
see the same consultant privately. Strangely, this concoction of
a system means that doctors, who are technically independent contractors
paid at a reasonable rate by the State, work in the public service
and the private system at the same time. This seems better than
in South Africa, where doctors migrate to the private sector the
day after graduation. Only 23% of specialists work in the public
sphere in South Africa.
the UK system is also hardly ideal. The best scenario would be to
get all doctors committed to the NHS, bringing waiting lists down.
When the public system works it is fantastic. As a South African
used to private care, it has been a real eye-opener to use a without
charge public system on other occasions. The free NHS maternity
care and GP services we have received so far have been first-rate.
the challenge of shorter waiting lists is fostering a general slide
towards more private care in the UK. In South Africa, the slide
has long since turned to a freefall. Four years ago, there were
161 private hospitals in South Africa; now there are 200, which
means ten new private hospitals a year. Who is winning? Private
healthcare fat cats, thats who. Profits in the private healthcare
business are astronomical. Medical aid premiums have consistently
outstripped inflation and the services they cover decrease each
year. It is all good and well if you have medical aid or are wealthy.
But no one is asking the bigger questions: when will the private
healthcare avalanche end and at what cost? The desire for private
healthcare in South Africa has become the norm, with everyone aspiring
to a job that provides it, rather than thinking about how to improve
public healthcare. Attempts to curb private care and bring doctors
back to the public system seem abandoned. What happens when the
premiums become even higher, the medical-insurance companies even
more powerful or when the State system collapses? We will probably
need a lot more than satellite television to dull the pain.
Hamber writes the column "Look South": an analysis
of trends in global political, social and cultural life and its
relevance to South Africa on Polity, see http://www.polity.co.za/pol/opinion/brandon/.
To get "Look South" by email each week click
"Look South" published by