LETTER: No health service without enough specialist nurses

That bureaucracy and regulatory confusion are stifling the training of specialist nurses in SA bodes ill for the planned National Health Insurance (NHI) scheme (“Red tape chokes off supply of specialist nurses”, January 16).

If implemented, the NHI will in effect monopolise management of all health care in the country. And, despite the best wishes of promoting a “developmental state” in SA, the last 10 years especially have shown glaring deficiencies across public sector administration and management.

The pure pragmatic case against the NHI is that the skills capacity does not exist to “manage” everyone’s varied health-care needs. The risk such a concentrated scheme of ministerial power poses to health-care professionals, in terms of state control and possible abuse of power, is great.

Wits professor of nursing Judith Bruce paints the outlook in stark terms: “We have a shortage of up to 62,000 nurses in all categories, and 50% of these shortages are in the professional nursing category. If the capacity to train is not increased, we will produce less than half the shortfall by 2030.”

These basic problems cannot be fixed by adding yet more layers of bureaucracy and state control, as the NHI will do. The solution lies in focusing on what can be (with limited resources) in the public sector, letting the private sector function and reducing the forest of regulations that make it harder for private sector players to innovate and lower costs.

Chris Hattingh
Centre for Risk Analysis

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