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The South African Constitution promises everyone the right to health care. Yet nearly 85% of the nation’s 62 million people have no medical insurance and rely on a decrepit public system with too few doctors, resulting in delayed or inadequate treatment. In 2007, the ruling party agreed to enact universal national health insurance, but its implementation stalled while funding and operational details were being ironed out. Now parliament has approved enabling legislation for the program, which will be phased in over several years. However, doubts remain about whether it will solve the country’s health-care woes.
The country’s poorest people have access to free treatment at 3,741 public clinics and hospitals, but these facilities are often plagued by broken equipment and shortages of medicine and beds. In its most recent report, covering 387 primary health care clinics, the Office of Health Standards Compliance found that only a fifth of them met the required performance criteria in areas such as drug availability and proper infection control. There’s also a shortage of medical personnel. In the public sector, the ratio of practitioners to population is 0.3 per 1,000, whereas in the private sector, it’s 1.75 per 1,000. Poor working conditions are the most common reason given by doctors for leaving the public sector.
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