Equity, Rights and Regulation: Facing the Public/Private Health System Divide in South Africa

Equity, Rights and Regulation: Facing the Public/Private Health System Divide in South Africa

Marius Pieterse, Professor of Law, University of the Witwatersrand, South Africa

 Like elsewhere, the South African health system reflects severe inequalities in the extent and quality of access to health care services.  These inequalities are reflected and exacerbated by the gulf between the private (for profit) and public health sectors respectively.  Achieving the right to health and associated development goals requires that this gulf be urgently addressed.  This paper considers regulatory attempts to achieve greater equity between the public and private health sectors in South Africa.  It considers the different ways in which constitutional norms and human rights, especially the right of access to health care services, impact on regulatory efforts at health system reform.  In particular, the paper focuses on the extent to which reforms must respect existing rights of health care professionals relating to the practice of their profession, as well as the rights of patients to the continued availability and accessibility of care.  Over and above the limitation of private interests in the pursuit of an equitable health system, the paper pays attention to the question of the elaboration and enforcement of private obligations under health-related constitutional rights.