Access to free medical treatment is a constitutional right in South Africa, but though the government has devoted at least 12% of its budget to health care annually since 2010, the Department of Health (DoH) itself has characterised the system as “inequitable, with the privileged few having disproportionate access to health services”. Expenditure is split fairly evenly between the public and private sectors, but 84% of South Africans rely on state health care services, while the private facilities serve just 16% of the population. South African health care is poised for a huge overhaul. The question is whether the roll-out of the NHI programme is feasible, given the human resource, technical and financial constraints of the existing public health system.
Ample resources are invested in South Africa’s education sector, which ranks among the best on the continent. The state spends approximately one-fifth of its budget annually on education and training and has nearly achieved the goal of universal primary school enrolment that has proved so elusive elsewhere in sub-Saharan Africa. Some 14% of government expenditure is invested in basic education, according to UNICEF, though quality remains an issue, and low pass rates are especially prevalent in disadvantaged schools. With 10 globally recognised higher education and research institutions in the country, the tertiary education sector is the best in sub-Saharan Africa, and ranks 33rd in the world in terms of scientific research output. Now that black South Africans have been given access to the continent's best primary and tertiary education system, the government will have to focus on improving outcomes to create a pipeline of skilled youth that meets the needs of the labour market. The challenge will be cultivating the academic and financial capital to meet this goal.
This chapter contains interviews with Stephen Saad, Group Chief Executive, Aspen; and Jonathan Jansen, Vice-Chancellor and Rector, University of the Free State.