Lack of access to equal public health care and the locality rule in South Africa : a comparative study

Abstract

In South Africa a large divide exists within the health care sector. Health care provided in the private sector cannot be equated to that of the public sector, as the resources, quality and access in the public sector is a pipeline dream, not a reality. This dissertation aims to address this inequality of health care by acknowledging the stark realities the government seek to avoid when it comes to public health care. The only way to address the quality of health care is to admit to the lack of resources, and to deal with the situation according to these realities, instead of living in utopia. The link between the Locality Rule, access to equal public health care and medical negligence must be clear from the outset. It must be noted that the dissertation does not suggest that the Locality Rule will ensure the quality of health care to be equalised in the two sectors, but rather that it will be used as a tool to ensure that cognisance is taken of the differences that exists, and that medical negligence will be assessed based on these differences in the respective sectors. It needs to be mentioned that the sources used in this dissertation is updated until May 2016. The Locality Rule is therefore suggested as an interim solution to the standard of health care South Africans are faced with, until such a time that a proper solution (the complete implementation of the proposed National Health Insurance) can be implemented. The dissertation acknowledges the need for physicians practising in the public sector to be held to a compromised standard of care and skill than physicians practising in the private sector. The link between the Locality Rule and medical negligence can be found in that medical negligence cannot merely be assessed as a rule of circumstance - which is in itself extremely vague. The use of the Locality Rule will ensure that these surrounding circumstances are taken into account by the judiciary, every single time they are faced with a medical negligence claim.