In the context of weak economic growth, lower-than-expected tax revenues, and the implementation of measures to reduce public spending, there is a “rising panic” ahead of this year’s Medium Term Budget Policy Statement. The concern for health care provision is palpable as anticipated budget cuts threaten the country’s already fragile and understaffed public healthcare system, write Matshidiso Lencoasa and Dominic Brown.
The National Treasury’s Cost Containment Letter sent to government departments instructing, among others, the freezing of posts was one of the big themes underlying talks about building South Africa’s healthcare worker capacity at the Public Health Association of South Africa’s conference held recently in Gqeberha. Luvuyo Mehlwana reports.
Though budget cuts impact the health system’s ability to provide quality services to the 85% of people in South Africa estimated to rely on public healthcare, women are doubly burdened by these cuts owing to their unequal reliance on public health services. Women have a disproportionate risk and prevalence of HIV/AIDS and more differentiated health needs, including those for reproductive and maternal health. This Women’s Month is an opportune moment to reflect on how much we spend on healthcare and the quality of that spending which can be powerful measures to help create a public healthcare system that narrows the gender gap, writes Matshidiso Lencoasa.
South Africa’s new National Strategic Plan for HIV, TB, and STIs 2023-2028 and the country’s TB Recovery Plan necessitate a sharp increase in TB testing and increased enrolment into care, which will require additional spending on testing and medicines. Sihle Mahonga Ndawonde argues that a joint committee should be set up to review and interrogate provincial departments’ resource allocation decisions for the next three years.
Investment in public health facilities is crucial as the country weathers storms on various fronts – from drought (water shortages) and flooding putting strain on health infrastructure to a harsh economic climate that makes private healthcare unaffordable to more and more people. Mbali Baduza and Matshidiso Lencoasa assess the investments in infrastructure in the budget and what it means for the planned National Health Insurance system.
Spending on public sector infrastructure over the 2023 medium-term expenditure framework (MTEF) is estimated at R903 billion and the health sector accounts for 5% of this. The well-documented poor maintenance and oversight of projects, also in the health sector, will require close monitoring of trends across the public sector, particularly where procurement and contracting is concerned, writes Zukiswa Kota.
Budgets, while important, are not the right mechanism to drive the structural change needed to improve the responsiveness of our public health system in meeting the needs of the population. But, argues Russel Rensburg, we can reorient the health system towards meeting the health needs of the population and then let the budget bolster the reforms. Here he provides some suggestions on how to go about it and contrasts that with the budget announced by Minister of Finance Enoch Godongwana this week.
Health budgets have the power to advance access to healthcare for millions of people in South Africa. This year, however, as the health sector and the economy recovered from the worst of the COVID-19 pandemic and a volatile global environment, the South African government missed opportunities to provide the financial resources to protect access to healthcare for the most vulnerable. Matshidiso Lencoasa unpacks how the past year’s budget choices will affect key public health services.
Surgical waiting lists are not unexpected in the context of the COVID-19 pandemic, but there are indications that the situation is particularly acute in the Free State, and possibly for reasons that are not directly related to the pandemic. Also, the department of health failed to offer any explanation or details of current surgery waiting lists and waiting times reported by healthcare workers and patients. Refilwe Mochoari reports.
Since the COVID-19 pandemic has stymied the progress of the tuberculosis response across the world, the call for increased investment is important. Although health programmes can always do with more financial assistance, in South Africa, for its TB Recovery Plan to work, the focus should be on the strategic use of existing resources, argues Russell Rensburg.
As we transition towards a different strategy in the management of the COVID-19 pandemic and look to build up better, there was an expectation that the budget tabled this week, would provide insight into the government’s response and strategy to address the gaps left by COVID. Russel Rensburg looks at some of the budget’s hits and misses as it relates to healthcare.
The South African Law Reform Commission recently published its discussion paper on medico-legal claims. Baone Twala unpacks the Commission’s proposals on law reform and what it may mean for claimants and the government.
