South African health care in change

Abstract

Abstract This article presents an overview of the nature, direction and depth of change in the South African health care system since the European settlement in 1652 up to the present The main argument is that in reality there were, despite much dynamics and slight changes, no fundamental changes at all; rather a structural drift of the health care system in the same direction throughout As a result a typical pluralistic system was eventually established, and with it the numerous structural problems characteristic of this type of health care system. Despite this dominant structural drift, significant markers of fundamental change presented itself, including the Gluckman Report, the Freedom Charter and more recently pleas for fundamental restructuring of the current system. All these markers distinctly point in the same direction, and that is towards increasing socialisation of South Mrican health care. However, a precondition for any fundamental change in South African health care remains fundamental change in South African society, especially its political economy. Depending on the direction in which the political economy proceeds in future, it seems inevitable that either a national health service or a socialist health system will be the only possibility for future South African health care.