Evaluating support service co-operation in the Netcare-Settlers public private partnership, Grahamstown, South Africa
- Authors: Mahote, Tulisa
- Date: 2015
- Subjects: Settlers Hospital , Netcare 911 , Public-private sector cooperation -- South Africa -- Grahamstown , Privatization -- South Africa , Medical care -- Privatization -- South Africa , Health services accessibility -- South Africa , Contracting out -- South Africa
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3408 , http://hdl.handle.net/10962/d1020834
- Description: The neo-liberal restructuring of state assets and facilities, which has taken place internationally over the past three decades, as well as in South Africa, has been a matter of great controversy. Privatisation, in particular, has been a polarising issue, especially when applied to fields like healthcare. Supporters of privatisation view it as cutting costs, mobilising funding, expertise and innovation, resulting in improved delivery, and opening possibilities for a spread of ownership. Critics claim the process involves retrenchments, declining services for the (poorer) majority of people, and a focus on the elites as citizens become transformed into customers, and with any economic empowerment going to the already prosperous. This thesis examines these issues by looking at the privatisation of hospitals in South Africa, with a case study of the Netcare-Settlers Public Private Partnership (PPP) (also known as the Settlers Private Hospital) in Grahamstown, South Africa. Netcare is South Africa’s largest private hospital company, and also has substantial operations in the United Kingdom. The thesis sets out the context: a highly inequitable healthcare system in the country, the rise of privatisation in the apartheid and post-apartheid eras, and healthcare privatisation. In terms of the Netcare-Settlers PPP, the thesis examines how the PPP was structured and developed, focusing on the impact of the PPP on non-clinical operations. The thesis argues that the results of the PPP are mixed, that it has greatly improved areas like facilities, maintenance, cleaning and catering, performed less well in increasing the doctor/ patient ratio or in attracting specialists, and is associated with the widespread and problematic use of outsourcing of service workers like cleaners and security. Overall, the PPP has improved healthcare, with some effective sharing of resources between the public and private parts of the hospital, but also relies on a pool of relatively low waged, under-unionised, labour. In terms of the general debate over privatisation, the Netcare-Settlers PPP shows that both supporters and critics have some valid points, and that privatisation in practice is not an either/ or, black/ white, good/ bad proposition, but something more complex. The success and failure of PPPs depend on the details of the contracts, and these can be used to maximise the performance of both the public and private partners. Better contracts may help avoid the uneven results seen at institutions like the Netcare-Settlers PPP.
- Full Text:
- Date Issued: 2015
- Authors: Mahote, Tulisa
- Date: 2015
- Subjects: Settlers Hospital , Netcare 911 , Public-private sector cooperation -- South Africa -- Grahamstown , Privatization -- South Africa , Medical care -- Privatization -- South Africa , Health services accessibility -- South Africa , Contracting out -- South Africa
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3408 , http://hdl.handle.net/10962/d1020834
- Description: The neo-liberal restructuring of state assets and facilities, which has taken place internationally over the past three decades, as well as in South Africa, has been a matter of great controversy. Privatisation, in particular, has been a polarising issue, especially when applied to fields like healthcare. Supporters of privatisation view it as cutting costs, mobilising funding, expertise and innovation, resulting in improved delivery, and opening possibilities for a spread of ownership. Critics claim the process involves retrenchments, declining services for the (poorer) majority of people, and a focus on the elites as citizens become transformed into customers, and with any economic empowerment going to the already prosperous. This thesis examines these issues by looking at the privatisation of hospitals in South Africa, with a case study of the Netcare-Settlers Public Private Partnership (PPP) (also known as the Settlers Private Hospital) in Grahamstown, South Africa. Netcare is South Africa’s largest private hospital company, and also has substantial operations in the United Kingdom. The thesis sets out the context: a highly inequitable healthcare system in the country, the rise of privatisation in the apartheid and post-apartheid eras, and healthcare privatisation. In terms of the Netcare-Settlers PPP, the thesis examines how the PPP was structured and developed, focusing on the impact of the PPP on non-clinical operations. The thesis argues that the results of the PPP are mixed, that it has greatly improved areas like facilities, maintenance, cleaning and catering, performed less well in increasing the doctor/ patient ratio or in attracting specialists, and is associated with the widespread and problematic use of outsourcing of service workers like cleaners and security. Overall, the PPP has improved healthcare, with some effective sharing of resources between the public and private parts of the hospital, but also relies on a pool of relatively low waged, under-unionised, labour. In terms of the general debate over privatisation, the Netcare-Settlers PPP shows that both supporters and critics have some valid points, and that privatisation in practice is not an either/ or, black/ white, good/ bad proposition, but something more complex. The success and failure of PPPs depend on the details of the contracts, and these can be used to maximise the performance of both the public and private partners. Better contracts may help avoid the uneven results seen at institutions like the Netcare-Settlers PPP.
- Full Text:
- Date Issued: 2015
The effect of commercialisation, privatisation and liberalisation on universal access in South Africa
- Gardner, Sean Patrick Newell
- Authors: Gardner, Sean Patrick Newell
- Date: 2004
- Subjects: Telkom (Firm : South Africa) , Telecommunication , Telecommunication -- South Africa , Privatization -- South Africa , Trade regulation -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3431 , http://hdl.handle.net/10962/d1002885 , Telkom (Firm : South Africa) , Telecommunication , Telecommunication -- South Africa , Privatization -- South Africa , Trade regulation -- South Africa
- Description: From the 1990s onwards, significant developments have occurred in the international telecommunications sector that have affected the South African telecommunications industry and peoples’ access to the network. Rapid developments in Information and Communication Technologies and the reorganisation of telecommunications operators through commercialisation, privatisation and the effects of market liberalisation have resulted in monopoly operators moving away from their public service mandates. Globalisation and adherence to World Trade Organisation rules are causing operators to rebalance their tariffs closer to cost. Long-distance rates are decreasing while the cost of local calls is increasing. High-end users of telecommunications services are benefiting while low-end, largely residential users are being priced off the network. The end result is a negative effect on universal access to telecommunications services. This study examines the extent to which commercialisation, privatisation and liberalization are affecting the provision of telecommunications services and the government’s goal of achieving universal access in South Africa. Qualitative research methods were utilised to establish that the state owned operator, Telkom, has transformed itself from a public service operator to one that is fully commercialised and prepared for an Initial Public Offering and competition. Telkom no longer attempts to ensure that its tariffs are affordable for all people. However, positive developments presented themselves in the form of an increasingly competent regulator, a reorganised and dedicated Universal Service Agency, and the popularity of cellular telephony. The primary discovery of this study is that the liberalisation of the South African telecommunications sector cannot be assumed to have a negative effect on the provision of service. This study finds that liberalisation will most likely benefit the country through the role out of new infrastructure, the provision of new services and ultimately the reduction of those services themselves. In order for universal access to be achieved in this country the study recommends that the resources of the Independent Communications Authority of South Africa be enhanced to enable the regulator oversee the industry effectively. Secondly, the Universal Service Agency must provide clear definitions of universal access and universal service as well as manage the Universal Service Fund with greater efficiency. Lastly, the two bodies mentioned above must ensure that services are affordable for all people of this country.
- Full Text:
- Date Issued: 2004
- Authors: Gardner, Sean Patrick Newell
- Date: 2004
- Subjects: Telkom (Firm : South Africa) , Telecommunication , Telecommunication -- South Africa , Privatization -- South Africa , Trade regulation -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3431 , http://hdl.handle.net/10962/d1002885 , Telkom (Firm : South Africa) , Telecommunication , Telecommunication -- South Africa , Privatization -- South Africa , Trade regulation -- South Africa
- Description: From the 1990s onwards, significant developments have occurred in the international telecommunications sector that have affected the South African telecommunications industry and peoples’ access to the network. Rapid developments in Information and Communication Technologies and the reorganisation of telecommunications operators through commercialisation, privatisation and the effects of market liberalisation have resulted in monopoly operators moving away from their public service mandates. Globalisation and adherence to World Trade Organisation rules are causing operators to rebalance their tariffs closer to cost. Long-distance rates are decreasing while the cost of local calls is increasing. High-end users of telecommunications services are benefiting while low-end, largely residential users are being priced off the network. The end result is a negative effect on universal access to telecommunications services. This study examines the extent to which commercialisation, privatisation and liberalization are affecting the provision of telecommunications services and the government’s goal of achieving universal access in South Africa. Qualitative research methods were utilised to establish that the state owned operator, Telkom, has transformed itself from a public service operator to one that is fully commercialised and prepared for an Initial Public Offering and competition. Telkom no longer attempts to ensure that its tariffs are affordable for all people. However, positive developments presented themselves in the form of an increasingly competent regulator, a reorganised and dedicated Universal Service Agency, and the popularity of cellular telephony. The primary discovery of this study is that the liberalisation of the South African telecommunications sector cannot be assumed to have a negative effect on the provision of service. This study finds that liberalisation will most likely benefit the country through the role out of new infrastructure, the provision of new services and ultimately the reduction of those services themselves. In order for universal access to be achieved in this country the study recommends that the resources of the Independent Communications Authority of South Africa be enhanced to enable the regulator oversee the industry effectively. Secondly, the Universal Service Agency must provide clear definitions of universal access and universal service as well as manage the Universal Service Fund with greater efficiency. Lastly, the two bodies mentioned above must ensure that services are affordable for all people of this country.
- Full Text:
- Date Issued: 2004
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