sector skills plan for the health sector in south africa

According to the Development Bank of South Africa (DBSA), South Africa’s public health expenditure is
slightly below that of comparable middle-income countries, but its per capita expenditure is above the
median level. However, when health outcomes are compared with those of peer countries, South
Africans are worse off. It could therefore be said that the health system is under-performing in relation
to its financing levels. 57 Reasons for this under-performance are, in part, related to the quality of health
care management, which in turn is related to the managerial skills available in the sector.
3.3 THE DEMAND FOR HEALTH SERVICES
3.3.1 THE PUBLIC-PRIVATE DIVIDE
More than 41 million people rely on the public health system and 7.9 million people are covered by
medical insurance. 58 Table 3-2 shows the use of public and private facilities as measured by the General
Household Survey of 2007. Of those without medical scheme coverage, an estimated 28 % use private
facilities and practitioners, but use public hospital services. 59 An estimated 64% to 68% of the
population is entirely dependent on public sector care. 60 About 6% of medical scheme beneficiaries use
public sector facilities. 61
57 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System.
58 National Treasury. Budget Review 2010; Council of Medical Schemes. 2010. Comparison of data in Annual Reports. Published
at http://www.medicalschemes.com (Accessed August 2010); Statistics South Africa. 2010. Mid-year population estimates.
Published at http://www.statssa.gov.za/publications/P0302. (Accessed August 2010); Van der Berg, S., Burger, R., Theron, N. et
al. 2010. Financial Implications of a National Health Insurance Plan for South Africa.
59 Day, C. and Gray, A. 2008. “Health and Related Indicators”. South African Health Review: Published at
http://www.hst.org.za/uploads/files/chap16_08.pdf. (Accessed August 2010); Van der Berg, S., Burger, R., Theron, N. et al.
2010. Financial Implications of a National Health Insurance Plan for South Africa.
60 HEU Information Sheet 3. 2009. “The public-private health sector mix in South Africa”. Health Economics Unit, University of
Cape Town. Published at http://www.heu-uct.org.za (Accessed August 2010); Coovadia, H., Jewkes, R., Barron, P. et al. 2009.
“The health and health system of South Africa: historical roots of current public health challenges”. Lancet. September 2009.
Vol. 374. Published at http://thelancet.com. (Accessed August 2010).
61 Day, C. and Gray, A. 2008. “Health and Related Indicators”. South African Health Review: Published at
http://www.hst.org.za/uploads/files/chap16_08.pdf. (Accessed August 2010).
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