On the health front, parties agree on the importance of primary health care. While the ANC punts the National Health Insurance (NHI), opposition parties have either been silent on the issue or want it canned.
A few parties want clinics opened around the clock and traditional healers brought into the fold. While Cope wants the ambulance service jacked up in rural areas, the EFF is more ambitious – it wants ambulances built at a production plant it would set up. Even the medicinal use of cannabis gets a mention in the political manifestos.
The ruling party says it would improve hospitals and clinics, implement free NHI, fill critical vacant posts and “significantly expand training of doctors and nurses. It promises to “absorb” over 50000 community health-care workers into the public health system and double this over the next five years.
The DA calls the public health-care system “broken”, citing three provinces where health departments have been put under administration, and the Life Esidimeni tragedy which claimed the lives of mental health patients in Gauteng. The party said it would build at least 50 more primary health-care clinics in under-served areas.
The DA calls the NHI model “entirely unfeasible” and a risk to the Treasury. It has an alternative to the NHI, and would instead work with private health-care insurance industry to extend cover to lower- and middle-class earners.
The party would also remove racial quotas at medical schools.
New kid on the block, “Aunty Patty’s” Good party also wants to focus on primary health care in order to prevent diseases. “This will alleviate pressure on state hospitals so that specialist health-care services can focus more on emergencies and non-preventative diseases,” the party said. Although it does not say anything about the NHI, the Good Party supports quality basic national health care, which can work in conjunction with private health care. “Good recognises the right of every South African to procure additional health-care provision over and above the nationally provided health care,” it said.
In a detailed section of its manifesto, the party lists 51 points to overhaul health care. By 2024, it would have all people in the country immunised.
Like the ANC, it wants community health workers integrated as government employees. It wants to work with institutions in Cuba “to develop vaccines for identified preventable diseases in South Africa”, and invest in research on the use of cannabis for pharmaceutical and medical purposes.
The EFF said it would also build consulting rooms for traditional healers, employ more staff and send recruits to train as nurses across the world, including Cuba. It wants to have ambulances built locally and would invest in an ambulance production plant.
It would clamp down on those advertising illegal medical procedures, organ sales and health facilities.
Another new entry on the ballot paper, Loyiso Nkohla’s Land Party, refers to the Life Esidimeni tragedy as a failure in the health-care system.
The party would allow hospitals and clinics more autonomy and “convert the Department of Health into state-funded medical funds for all”.
“Once you reach your limit on your medical fund, you will be required to go to a medical training facility for treatment, for free,” the party said.
The party would focus resources to “provide health care closer to home”.
“We need an approach to dealing with our country’s mental health issues that incorporates both Western medicine and traditional healing,” the party said.
The party promises to re-establish nursing colleges linked to training hospitals. It would look at the feasibility of ordering medicine directly from suppliers at pre-approved prices to eliminate tender irregularities and abuse. It also wants clinics to remain open 24 hours a day. Cope says traditional health practitioners would be accredited and monitored.
The party says the biggest challenge in public health care is not a lack of money, but a lack of expertise.
It proposes that public facilities should first be upgraded before a NHI is considered. “The NHI cannot be used for these upgrades. In the short term, the planned NHI must be terminated at once,” it said.