n South African Medical Journal - Driving innovation, leadership and change at Groote Schuur Hospital, Cape Town, South Africa : correspondence

Volume 105, Issue 1
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



Globally, cost-effective and equitable delivery of healthcare is becoming a challenge. In the South African (SA) context, balancing the burden of disease and the patient load within available resources, while still maintaining quality of care, is becoming unsustainable. Our public healthcare services need to support a growing population of uninsured citizens together with immigrants from elsewhere in Africa seeking care, and while the reasons for the problem are both economic and related to health service design and delivery, it is compounded by an ageing population, a rising burden of infectious and chronic diseases and the global shortage of adequately skilled healthcare workers. The leaders of today will need to do something different in order to avoid collapse of the system.

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