June 2018

The June edition - South Africa’s state of health - provides an overview of major healthcare trends in South Africa against the background of the proposed National Health Insurance (NHI) scheme and amid growing concern at its implications.

Public health spending accounts for 12% of total government expenditure, up from 10.5% in 1994/95.  It also accounts for 4.1% of GDP, up from 3.1% in 1994/95. Data on private medical cover - an indicator of middle class status - shows that less than a fifth of South Africa’s population are beneficiaries of private schemes.

South Africa has more private than public hospitals - Gauteng has about four times as many private as public hospitals. A similar trend is seen in KwaZulu-Natal and the Western Cape, the more prosperous provinces. The number of general practitioners nearly doubled between 2000 and 2016, while the number of medical specialists increased by 22%. Nurses in the private sector outnumber those in the public sector - possibly an indicator of better working conditions in private hospitals and clinics.
On public sector healthcare performance, an average performance score based on seven domains is provided for each province according to which none of the nine provinces obtained a ‘compliant’ (70% and above) score. Ultimately, a major revamp of management efficiency is necessary to bring public healthcare to a state of optimum efficiency and it is unclear that the NHI proposal is geared to achieve that.

The Fast Stats pages, with financial and other statistics, are included.