Faculty of Commerce, Law and Management (ETDs)

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    Realising the right to healthcare: the legislative frameworks pertaining to private health establishments and private healthcare funding models in South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Labuschagne-Kom, Lindsie; Mahery, Prinslean; Martin, Blake
    The Universal Declaration of Human Rights recognises access to healthcare as a fundamental human right and is guaranteed by the South African Constitution. An analysis of this right reveals that it comprises of two main components, namely financing and delivery of healthcare services. These are fulfilled by the government in the public sector and by private healthcare funders and private health establishments in the private sector. However, an analysis reveals that access to healthcare is substantively inequitable due to the fragmentation of the health system and unveils significant inefficiencies in the private sector that impeded realisation of this right. This dissertation examines the cause of this fragmentation and the inefficiencies within the private healthcare funders and private health establishments market. It investigates how these issues can be resolved to realise the right to healthcare. This study applied a qualitative desktop review of governmental policies, direct and incidental legislation, and multidisciplinary fields of academic reviews such as competition, healthcare, constitutional law and international policies to evaluate the effect of historical, contemporary and prospective policies and legislation, on access to healthcare. This analysis reveals that access to healthcare was historically manipulated to achieve political ideology through a legislative framework that provided the foundation for private funding models and private health establishments to flourish. This occurred at the expense of the public sector and embedded the fragmentation and inefficiencies in the health system. Notwithstanding the enactment of the Constitution, which envisioned a transformed and equal society, access to healthcare remains substantively inequitable. This is due to governmental failings to regulate these stakeholders. Given this state of affairs, the government intends to enact legislative reform through the National Health Insurance Bill to meet its constitutional mandate to realise the right to healthcare. An analysis of the Bill’s framework, however, reveals that it will have a cascading effect with the collapse of the private healthcare funders and private health establishment markets. This will ultimately cause a regression in access to healthcare and impede the practical realisation of this right. An investigation into alternative mechanisms to fulfil the right to healthcare reveals that incorporation and collaboration with private healthcare funders and private health establishments is a pragmatic alternative to the National Health Insurance Bill that will aid with the practical realisation and vindication of this right. These findings indicate the need for government to improve its stewardship of the health system and provide pragmatic solutions to reform the legislative and regulatory frameworks governing these stakeholders to resolve inefficiencies and to foster collaboration to fulfil the right to healthcare.
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    Misalignment between government planning and budgeting in Limpopo department of economic development, environment and tourism
    (University of the Witwatersrand, Johannesburg, 2022) Mahlatji, Elizabeth Sarona; Malindini, Kholiswa
    Prior to 1994 in South Africa, strategic planning and budgeting processes were fragmented. However, in the post-1994 democratic dispensation, the South African government introduced certain strategic planning and budgeting reforms. The aim of these reforms was to ensure alignment between government planning and budgeting processes to enhance service delivery, as well as the effective and efficient utilisation of resources. These reforms included the introduction of various policy frameworks, structures, and systems to guide planning and budgeting. The purpose of this research was to assess the factors contributing to misalignment between strategic planning and budgeting and challenges this presents in the execution of government programs in LEDET. The study employed the organisational alignment theory to guide the development of this empirical journey stressing the integration of various functional areas within an organisation to enhance performance. A qualitative research approach was employed and a total of 13 senior and middle management officials within the chosen case study participated in the study. Participants were purposefully sampled for semi-structured interviews so as to provide rich information relevant to the phenomenon under investigation due to the experience and knowledge they possess relating to the subject. A thematic data analysis method was used to analyse the primary data and formulate the themes. Some of the findings of this study indicate that, despite the government reforms to ensure alignment between planning and budgeting, misalignment still persists. This misalignment impacts negatively on effective and efficient utilisation of government resources in terms of budget and achievement of planned developmental programs and projects for improved organisational performance. The study further discovered that misalignment between government planning and budgeting is due to both internal and external factors. Internally, misalignment between planning and budgeting is as a result of parallel processes by planning and budgeting units with no efforts for synchronisation. There is duplication of functions that existed for a long time between the department and some state owned entities which has a bearing on allocation of limited resources. In addition, the study found that evaluations of departmental programs and projects to determine their impact on the plight of the poor people and also to inform future planning and budgeting are not conducted. Furthermore, a lack of strategic leadership contributes to the misalignment between planning and budget, as sometimes things are done just for compliance, rather than for improving the quality of the processes to ensure synchronisation. It may be necessary to deploy effective planning and budgeting processes to enhance alignment, support the evaluation of departmental programs and projects to inform future planning and budgeting
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    Implementation of the institutional plans in the Gauteng provincial legislature
    (University of the Witwatersrand, Johannesburg, 2023-02) Ngonini, Yolanda; Pillay, Pudy
    This research examined the implementation of institutional plans in the Gauteng Provincial Legislature (GPL). This research applied a qualitative design with the aid of a case study. Research respondents were chosen through a purposive selection. Semi- structured interviews were utilised in collecting data and thematic analysis is applied in the analysis of the data gathered. Institutional plan implementation was shown to be a critical part of the GPL and its effectiveness determined the extent to which the GPL could deliver its mandate as enshrined in the Constitution. The research further revealed that the plans were usually quarterly or annual, depending on the anticipated targets of the GPL. However, despite ensuring the effective implementation of the institutional plans, the research revealed that this process was undermined by several factors, chief amongst them being the inability of those in the top echelons of the GPL to include all key interested parties in the planning process. Failing to involve those with a high stake and influence in the GPL plans meant that the implementation was marred by bottlenecks. In light of these challenges, the research recommends the need to apply a multi-stakeholder approach in the planning and implementing of institutional plans in South African provincial legislatures. Effective communication was also identified as a missing link, hence there is a need to address this challenge by ensuring that implementing institutional plans within the GPL is a process that is inclusive and accommodating the needs stakeholders directly or indirectly involved
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    An examination of the treatment of fees received by directors for South African tax purposes
    (University of the Witwatersrand, Johannesburg, 2023) Letlabe, Obed
    The study is about the way non-executive directors are treated for tax purpose by SARS and its reasoning regarding the VAT and PAYE liability of resident and non-resident non-executive directors. This research then evaluates both statutory and common law to determine whether non-executive directors can be treated as independent contractors. The report further evaluates whether the SARS reasoning is consistent with international conventions and treaties. The research suggests that it was never the legislature’s intention to treat services rendered by office holders as ‘enterprise’ liable for VAT