Patients are forced to suffer because government is unable to address the multiple failures of the
South African public health system, including the lack of funding, poor staff morale and a low staff-to-
patient ratio. These failures are rooted in dereliction of the philosophy and ethics of ubuntu including
poor management in many instances due to cadre deployment.

The NHI will not be the alpha and omega quick fix to the myriad of problems faced in the public health
system. The health environment is on life support and needs urgent intervention in order to supply
quality universal health care to the citizens of this country.

The ANC has consistently stated that SA does not have universal health care (UHC).
It is ironic that the ANC has been in power since 1994, yet they openly acknowledge that they have
done very little to ensure that South Africans have quality UHC. It is appalling. Despite repeated
promises and plans to improve the public health system these past 3 decades, it has come close to
ruin under the ANC government. Hospitals and clinics are falling apart, and this government has done
nothing to ensure the citizens of this country’s Constitutional right to quality healthcare.

There is little to no consequence management for corruption and financial mismanagement. There
are severe staff constraints, facilities and equipment are not maintained or upgraded and are often
unsafe. For nearly 30 years, the ANC government have barely done the minimum to ensure health
care – of quality we do not even speak. How do they envision complying in terms of the required
regulations stipulated within the NHI Bill?

When maladministration, fraud and corruption eventually leads to investigations, recommendations
are never implemented and things continue to deteriorate, as seen recently with Rahima Moosa

Mother and Child Hospital in Gauteng. Pleas for help and intervention are simply ignored for years.
The public health sector is riddled with corruption – we have seen a Minister’s close friends and
families profiting from Covid-19 and PPE funding, whistle blowers are being intimidated, silenced and
killed.

In the budget realization, there are a number of targets and indicators relating to mother and child
mortality, but the efficacy of these programs needs to be better reported upon. Infant mortality rates
rose sharply from 2020 to 2021. The same increased trend can be seen for mortality in children under
5 years. These trends show that we might see an increase by the end of the year. This indicator in the
budget needs serious adjustment and re-alignment.

A recent question to the Minister revealed that 178 445 children aged 0 to 5 years died in public
hospitals the past decade, 12 582 from moderate and severe acute malnutrition.

Thousands of babies die in hospitals annually due to poor infection control, limited neo natal beds in
ICUs, delays on case management, hypothermia and staff that do not have the required training.

Diabetes has doubled in South Africans in the last decade. 4.2 million people have diabetes in our
country. Around 45% of people are undiagnosed according to the Diabetes Federation, so the number
could be as high as 9 million.

South Africa has one of the highest obesity rates in the world, which could lead to a range of other
diseases including hypertension and diabetes.According to a health study, 8.22 million South Africans dependent on public health care suffer from hypertension, which is a root cause of heart diseases, strokes and kidney diseases.

According to a question submitted to the Minister only half of the allocated R48 million of the Health
Promotion levy raised was spent, which begs the question; with lifestyle diseases on the rise, why was
the full amount not spent? This indicator was also very prevalent within the budget indicators.

Cancer is one of the leading cause of mortality in the country, accounting for 10% of the nation’s
deaths. There is an urgent need for the public health sector to implement and fund cancer prevention
strategies in order to reduce the burden on the health system.

Government has spent more than R2.3 billion rand on legal costs for medico-legal claims since 2018,
with reports that legal professionals sometimes collude with medical personal and doctors to obtain
patient files and also file fraudulent claims. A total of 15 148 claims were lodged.

Medico-legal claims and the massive accruals seen in our health care system has serious implications
on the Provincial hospitals’ budgets. The consequences is that government is not able to supply the
health care that is needed within state hospitals as their budgets are depleted due to this.

It is worth mentioning that the Department had an under expenditure of R771 334 000 and
underspent R82 million on health systems and human resources despite the significant staff shortages.

The department underspent R102 372 000 on hospital systems, which includes infrastructure.

Many hospitals lack basic ICT infrastructure, many do not have working telephones or computers,
never mind w-fi. The Department has put a plan in place to implement an e-system at the cost of R1.5
billion over five years. This indicator will be closely monitored to ensure this outcome is realized.

The severe nursing staff shortages in the country between 26 000 and 62 000 public and private nurses
is a major risk to the health system in South Africa. Yet, despite all these staff shortages, the

Department spent R30 million on just 44 posts for the NHI.

During the presidential health summit, the private sector mentioned they have capacity to train
specialized medical personal but is hampered by regulation. This was one of the health compacts
indicators that was not realized since 2018.

It is clear that almost no progress has been made on the Presidential Health compact since 2018. The
lack of progress on the compact is a clear indicator of what will happen within the NHI. Clear goals on
paper, but no political will or expertise to implement.

In conclusion, who has health has hope, and who has hope has everything. The citizens of this country
have no hope under the ANC government and very little to celebrate.