The Healthcare Sector in South Africa 2022

Introduction

Healthcare expenditure in South Africa, amounting to more than R500bn a year, is roughly evenly split between public and private healthcare, despite the former providing care for 85% of South Africans. Private healthcare bounced back in 2021 and 2022 to pre-COVID performance levels. Public healthcare, already under strain from lack of resources and sub-quality care, struggled to cope with service provision during the pandemic. Healthcare funding concerns are increasing and public healthcare budget cuts are expected. Rising private healthcare costs are causing a reduction in the already small pool of medically-insured people.

Government expects National Health Insurance to fund over 90% of all healthcare, but there are huge concerns.

Opportunities

Local and regional research and development interventions including the development of health apps.

The development and training of healthcare practitioners. The implementation of National Health Insurance offers opportunities for lower healthcare costs, greater universal health coverage and more public-private collaboration. The provision of public and private mental health facilities and services.

Outlook

South Africa’s healthcare system has not achieved the outcomes expected with the level of expenditure it receives.

The high costs associated with private healthcare are making it difficult for some people to continue to use it. The impact of the pandemic is likely to exacerbate healthcare funding concerns. National Health Insurance is its current form has come under some scrutiny, including its funding and the ability of the state to implement it. The design of the solution with have a fundamental bearing on the outlook of the South African healthcare system.

Report Coverage

This report focuses on the public and private healthcare sector in South Africa, including hospitals and other medical facilities, medical practitioners, emergency services and pathology services.

It includes comprehensive information on the state of the sector, statistics, the performance of notable players, corporate actions and other major developments. There are profiles of 47 companies including hospital groups such as Netcare, Mediclinic, Life Healthcare, Lenmed and RH Bophelo, pathology practices such as Ampath, ambulance services such as ER24 and optometry groups including Torga Optical and Neovision.

Strengths

Enhancing the quality of public healthcare and improving the management of public healthcare facilities have been identified as imperatives.

Government is committed to the sustainable development goal of universal health coverage. The healthcare system weathered the COVID-19 storms of 2020 and 2021, displaying capacity and resilience. The public healthcare system has made considerable gains in the battle against HIV/AIDS reducing mortality and raising South Africa’s population lifespan. The quality of healthcare in the private sector, and at some public sector academic hospitals, is of a high standard. The standard of medical research is high.

Threats

Climate change and the high environmental burden of disease could result in substantial increases in the number of people requiring treatment for illnesses and injuries.

Economic pressures could result in funding constraints for both public and private sectors. Industrial action and protests, which cripple the delivery of essential services. The continued impact of waves of COVID-19 infection amidst low vaccination rates. The possibility that National Health Insurance will not be able to meet the needs of the population and will impose an unsustainable tax burden on South Africans. The threat of cyber security breaches is increasing with the development of digitised health systems.

Weaknesses

Inadequate infrastructure, poor maintenance and a lack of basic services, such as waste removal. Private healthcare costs are high and escalating ahead of inflation. Progress towards universal health coverage has slowed in recent years. Public healthcare management is generally inefficient, there is excessive bureaucracy and service delivery is poor. South Africa’s healthcare system is characterised by extreme inequality of access. 85% of the population have no form of medical insurance and cannot afford private hospital care. The private hospital market is highly concentrated and dominated by three players. There are critical staff shortages across all disciplines in the public health system, where conditions are challenging, morale is low and working hours are long. The retention of healthcare practitioners is a challenge.