The Fall and Rise of the South African Health Care System – Kayla Gilbert

Selected picture: Sun Set over Cape Town

Personal Review

I have chosen a sunset as a metaphor to depict the South African Health Care System, because similar to a sunset, the South African Health Care System has many contrasting colours and complex meanings that accompany it.

The different colours in the sunset seem to be in a battle, fighting to be seen. This in turn illustrates the constant struggle that patients go through within the public health care sector. For many South Africans, having access to healthcare facilities and services pose a major difficulty. Every day patients are faced with hardships, such as, waking up in the early parts of the morning and standing in endless lines waiting to be seen by a health care professional (e.g. medical doctor, physiotherapist, dentist, etc.). The vast majority of the South African population unfortunately fall underneath the breadline, and consequently are not able to afford healthcare. Patients have no choice but rely on the government to provide these services. From speaking to a patient that experiences the public health system, one can conclude that going to a public hospital is a great battle. The patient describes it as a task that requires strength and patience, which they do not have. He further explains that they want to be helped or treated in an understanding and caring manner, however most of the time they are only seen as a number and often feel “neglected” (Naidoo, 2019) by the hospital staff.

The dark clouds in the sky signify flaws and defects within the health care system. Some of the problematic areas in the public sectors are greatly due the lack of sufficient funding. Funding for facilities and services are provided predominately by the government unless the institution is an NGO, in which they function independently without assistance from the government. The government has an annual budget, where funds are allocated accordingly to each sector within the country (i.e. schools, healthcare etc.). Although specific funds are designated to the healthcare sector, funds may be misallocated and more often than not go missing due to high corruption levels within government.

Due to this, the sector is unable to run effectively and smoothly to ensure that everyone receives optimal health care. Patients are treated as quickly as possible, so that the next person standing in line can be assisted. The concept of quantity over quality plays a role here, because there are so many patients. Clinics and day hospitals have no choice but to help everyone in a short period of time and are unable to provide focused and adequate healthcare services to cater for individual patients.

Like a sunset evolving from day into night, we should remind ourselves that the public healthcare system is constantly evolving into better institutions, with innovative technology and equipment to ensure that all South Africans can receive equal health care benefits. Health care professionals dedicate their time and effort to ensure that patients are given efficient and adequate health care. Around the clock treatment is provided to the best of their ability regardless of the challenges and uphill battles they face, as well as the necessary tools and resources to ensure that their patients’ needs are met. From a patient’s perspective, these institutions help improve their quality of life and save the lives of their loved ones. Without the healthcare system, families would remain untreated and in great suffering. To many South African people public hospitals serve a sanctuary, to help relieve them from illness and disease and without the public healthcare system the country would have a major health crisis.

The role that government plays in the South African Health Care System.

The sun is setting on the government sectors of the health care system, similarly as the sun descends and the darkness of night approaches. The looming night portrays the government as degrading the health system, as it does not meet the demands of the people in the country. The government has minimal interest in trying to improve South Africa’s health care system and the ongoing corruption is a major factor that inhibits the health sectors, not only the health sector but in the country as a whole. From a holistic approach, each sector does not communicate effectively with each other as well as the government, thus leading to a non-beneficial, inadequate and fragile South African Health Care System.

“The sky takes on shades of orange during sunrise and sunset, the colour that gives you hope that the sun will set only to rise again”, a quote by Ram Charan. As the sun sets it gives promise of a new day and new possibilities, our goals and aspirations that were not achieved can be confronted and pursued the following day. The light areas in the sky symbolise hope that the health system will improve and become more efficient. This gives the South African Health Care System a chance to improve on aspects that they were not able to achieve. Aspects can include further research into new technology and new methods that can progress the medical care quality. The government can start taking responsibility for their corrupt actions and can set past wrongs, right. This can be achieved by providing the necessary and adequate funding to the public health care sector, which is needed due the vast majority of the country falling under this sector and having access, to basic health care is one of our constitutional rights. These are only a few examples of how the South African Health Care System can see the sunset as an opportunity to rectify their mistakes and establish entities to improve on the health care system.

Academic Review

According to Eddie Rakabe from Business Day Newspaper majority of South African citizens are forced to make use of the public health care sector as they are unable to afford private health insurance. (Rakabe, 2017). The South African Health care authorities have policies in place that supposed to address certain issues within the system however many of these policies are written down but are never initiated to its full potential.

Despite ongoing negative outcomes with the system, one has to look at positive outcomes to see that there are changes that are taking place but on a minute scale. “public healthcare interventions are at the centre of improved TB treatment and a cure rate that has improved from 54% in 2000 to 80% in 2016” (Rakabe, 2017)

If we consider the Health Departments point of view, one can understand that the government sector also face challenges. Some of these challenges include high levels of unemployment may reduce possible tax revenue and therefore limit funding for public healthcare. And as well as separations in society in terms of access to quality healthcare. There is a distinct division between the rich and the poor, in most scenarios the more economically stable citizens have access to the private sector whilst less fortunate people are forced to make use of the public sector, in terms of equality in the country, this is one of the major challenges the government faces because it is “morally and politically unacceptable” (Broomberg, 2011)


Broomberg, J., 2011. [Online] 
Available at: [Accessed 2 May 2019].

Naidoo, M. (2019). Patient died with maggots in mouth. Sunday Tribune, 1. Rakabe, E., 2017. 

Business Day. [Online] 
Available at:
[Accessed 3 May 2019]

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One thought on “The Fall and Rise of the South African Health Care System – Kayla Gilbert

  1. Hi Kayla. Thank you for a comprehensive overview of the topic and for the effort you clearly put into this post. First of all, I really like your title; it’s a nice version of the popular phrase, which made me want to read more. I also appreciated your insight that the system is complex and multifaceted, and like a sunset, is constantly changing. I’m not sure that I agree that there is a battle between the private and public health sectors. I think they’re both working for patients – maybe different groups of patients – but they’re not working against each other. You highlight the lack of funding in the public health sector but don’t go into any detail. Where is this money currently being spent? Are there sufficient funds that are misallocated, for example? As you said in the beginning, this is a complex topic so I wouldn’t expect you to cover it in a lot of depth. However, a bit more insight would be helpful here. Related to this, I think you try to cover too much in the piece. Comparing the public and private health system is a tough job. Maybe it would be useful to choose one aspect and look at that in more depth? Also, is this piece really from a patient’s point of view, or is it your point of view? I wonder if it would be useful to consider the view of a patient who spends a day in the public health system, versus one who spends a day in a private facility? It might be one way to simplify what you want to write about. Anyway, those are just a few ideas you may find useful. Good luck for your revision.

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