The Healthcare Sector in South Africa 2024

The healthcare sector in South Africa report includes hospitals and other services such as blood banks, pathology laboratories and emergency medical services. There is comprehensive information on the number and distribution of hospitals, healthcare expenditure, capacity, practitioners, notable players, regulation, the state of public and private healthcare and NHI developments.

There are profiles of 50 companies including major hospital groups Mediclinic, Life Healthcare and Netcare, pathology services such as AC Mauff and Partners and Ampath, specialist hospitals such as Bay Eye Hospital and emergency services including ER24 EMS and Cape Medical Response.

Introduction

• South Africa spent an estimated R547bn on healthcare in the financial year to end-March 2023, compared to around R529bn in the previous fiscal year.
• Although total healthcare spending as a percentage of GDP declined, it compares favourably with the global average for middle-income countries.
• The performance of the private healthcare sector has largely normalised since the pandemic.
• The public health sector is in crisis, with crippling staff shortages, funding constraints, corruption and maladministration.

Key Market Trends

• A shift towards wellness services and preventative healthcare.
• Competition for the services of healthcare professionals.
• Focus on preventative healthcare and the delivery of primary health services.
• Greater willingness of the health department to collaborate with the private sector, notably in the distribution of chronic medication and facilities management.
• Growing demand for mental health services and facilities.
• Healthcare practitioners and service providers continue to be negatively affected by medical schemes that restrict their members to preferred provider networks.
• Private hospitals and healthcare practitioners remain under pressure to make healthcare more affordable.
• Strong demand for mental health services and facilities.
• Strong focus on technologies that can improve efficiency.
• Surgical procedures are increasingly being performed in day theatres.
• Telemedicine and virtual consultations have become mainstream.
• The medical and dental tourism market, is supported by strong demand from expatriates.
• There are less patients due to stagnant medical scheme membership growth.

Opportunities

• Local and regional research and development interventions including health apps.
• The development and training of healthcare practitioners.
• The implementation of National Health Insurance offers opportunities for private-public collaboration.
• The medical tourism market (including dentistry) offers high growth potential.
• The provision of public and private mental health facilities and services.

Challenges

• Concerns about NHI’s affordability, the state’s ability to implement the NHI and the impact it will have on the private healthcare sector.
• Disparities in the provision of healthcare services, particularly in rural areas.
• Inequity in healthcare.
• Public healthcare management is generally inefficient and corruption is pervasive. Critical staff shortages, challenging working conditions and low morale.
• Service delivery in the public health sector is constrained by inadequate funding allocations.
• Spiralling private healthcare costs.

Market Outlook

• With the NHI Bill on the cusp of being signed into law, the healthcare sector is facing an uncertain future.
• The enactment of the proposed legislation will require the amendment of other legislation, which will delay the rollout of the new health system.
• Although the private healthcare sector is unlikely to be overhauled over the short and medium term, investment in the sector is expected to be muted.
• Human resource challenges are likely to increase.
• Surveys on the bill suggest a high risk of an exodus of healthcare professionals from South Africa is extremely high.