Many large public hospitals underperform because their boards, managements and staff have little control even over something as small as buying toilet paper. There have been incidents of patients mistreated by staff, critical medicine shortages and maintenance failures.

Such incidents have to be reported by hospital CEOs to layers of authority in provincial health departments, or to an authority that does not have the power to act independently. Public hospitals are the pillars of SA’s public health system. The large provincial public hospitals should be repositioned as standalone entities, reporting to the national health department and the National Treasury, and with independent boards...

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