By Cyril Ramaphosa

Last week, surgeons at Mankweng Hospital in Limpopo completed a remarkable operation.

A team of doctors, nurses and other health workers successfully separated conjoined twins in a complex operation that demanded extraordinary skill and precision.

We owe the medical teams that performed the operation, that helped deliver the twins and that are now caring for them our deepest admiration and gratitude.
 
This achievement is more than a medical milestone. It is proof of what our public health system is capable of. It is a reminder that South Africa possesses world-class medical expertise, not only in the private hospitals in our cities, but also in public facilities serving communities that have historically been neglected and underserved.
 
It is also the visible outcome of sustained national investment in cultivating medical excellence. This includes heavily subsidising the country’s medical schools, providing study bursaries for needy medical students, and providing on-the-job training through the Internship and Community Services Programme.
 
And yet, for every story of excellence like Mankweng, we know there are too many South Africans who cannot access the quality healthcare they need and deserve.
 
Our Constitution guarantees every person the right of access to healthcare services. That right cannot depend on where you were born, how much you earn or where you live. A child in rural Limpopo has the same right to quality healthcare as a child in the suburbs of Johannesburg or Cape Town. 
 
Closing the gap between the constitutional promise of healthcare and the daily lived reality is precisely what motivates the National Health Insurance (NHI).

The NHI is more than a funding mechanism. It is a commitment, grounded in our constitutional values, that every South African will have access to quality health services without suffering financial hardship. It is the instrument through which we will ensure that the skills and dedication on display at Mankweng are available to all our people, regardless of their ability to pay.
 
To realise this vision, we need genuine and sustained partnerships between the public and private health sectors, as well as academic institutions, medical professionals, pharmaceutical companies, non-governmental organisations and communities. 
 
South Africa has a well-equipped and well-funded private healthcare sector, with some of the finest hospitals, specialists and medical technology on the continent.

Yet only around 16% of South Africans have access to these facilities.

By contrast, the majority of the population, some 84%, uses public health facilities. On average, the amount of money spent each year on a person who uses private health care is around five times what is spent on someone in the public sector.
 
These two parts of our healthcare system cannot continue to operate in parallel, as if serving two separate nations. They must work together in service of one nation.
 
There are few people in South Africa who can disagree with this view, and there are a great many role-players who are eager for collaboration.

They recognise that there is both a great need and much opportunity to build stronger partnerships in health care. 
 
We should be doing more to share skills and knowledge across the public-private divide, as happens when private specialists contribute time to public hospitals.

It means investing in the training and retention of healthcare workers so that public facilities do not continue to lose their best people to private employers or to opportunities abroad. 
 
As we prepare to implement the NHI, we are already making significant investments to strengthen our public health infrastructure.

We are building and refurbishing clinics and hospitals, expanding our community health worker programme, working to ensure the availability of essential medicines, introducing digital systems and improving the management of facilities.
 
At the heart of all of this are the women and men who dedicate their lives to healing others. The surgeons at Mankweng did not separate the conjoined twins for recognition or reward, but because they understood their responsibility as health professionals.

We owe it to every healthcare worker to give them the support, tools and working conditions they need to do their vital work.
 
The great achievement at Mankweng Hospital has shown us what is possible. It has also reminded us of what is necessary: a health system that serves every South African with excellence, compassion and dedication.

Equal access to quality health care must be the standard we set and the constitutional promise that we keep.

Cyril Ramaphosa is President of Soth Africa.

INSIDE POLITICS

By Akani Nkuna

The administrator of the Services Sector Education and Training Authority (SETA), Lehlogonolo Masoga, has condemned what he described as a culture of intimidation and victimisation of whistleblowers, warning that it undermines governance and cripples the entity’s performance.

Masoga said the climate discourages employees from speaking out against wrongdoing, allowing corruption and maladministration to persist unchecked.

“You can imagine that if employees are aware that there is a culture of intimidation in the organisation, it suppresses open engagement,” he said on Friday.

“Even when people see wrongdoing, they keep quiet because they fear severe punishment.”

He added that addressing these challenges is central to the administration’s mandate.

“These are some of the issues the administration seeks to address. Administration has been brought in as an instrument to respond to the challenges identified, including improving performance,” he said.

Masoga was speaking to the media at the Government Communication and Information System (GCIS) in Pretoria, following a mid-term progress report by the Higher Education Minister on three SETAs placed under administration — Services SETA, Construction SETA and Local Government SETA.

His remarks come amid scrutiny over the dismissal of three senior Services SETA employees between 2017 and 2020, who were accused at the time of enabling irregularities.

Masoga rejected that characterisation, saying the employees were, in fact, whistleblowers who had raised concerns about alleged corruption and maladministration within the entity.

Lehloma Ramajoe, a former senior manager for special projects who later moved to chamber operations, was suspended on 20 July 2019 and subsequently charged following an investigation by a firm of attorneys.

According to Masoga, Ramajoe had made protected disclosures relating to alleged maladministration involving several individuals.

A review of records corroborated his account, and it was determined that he suffered “occupational detriment” as a result.

He is now eligible for remedial action in terms of Section 193.

Similarly, Thandi Mkhize, who served as a senior manager for quality assurance from 2002 until her dismissal in 2017, was found to have been unfairly targeted.

She had been charged with misconduct, including allegedly sharing information with union members and inciting resistance to performance management changes.

“Based on the facts before me, it has been concluded that Mkhize was deliberately targeted,” Masoga said, adding that she will be compensated.

The third case involves Tshepiso Mofokeng, a chamber manager since 2008, who was dismissed in August 2019 for allegedly failing to perform her duties.

However, a review found that she had been unfairly victimised after raising concerns about irregularities within the entity. She will also receive compensation.

Masoga said these decisions form part of a broader effort to restore governance and accountability at Services SETA.

“Restorative justice incorporates, among other elements, active participation by affected parties, taking responsibility and a commitment to repairing harm, as well as a victim-centred approach,” he said.

“It is for this reason that, on behalf of Services SETA, I take full responsibility for the actions and inactions of my predecessors and commit to dispensing justice to the victims of our previous decisions.”

He added that disciplinary and legal action against individuals implicated in corruption and financial mismanagement is under way, with investigations being conducted by the Public Protector and the Hawks.

While some suspects have been identified, Masoga said names would not be disclosed until cases are finalised.

“Until someone is found guilty, it would be inappropriate to publicly name individuals. We will wait for the appropriate time,” he said.

INSIDE EDUCATION