Realising the right to healthcare: the legislative frameworks pertaining to private health establishments and private healthcare funding models in South Africa

dc.contributor.authorLabuschagne-Kom, Lindsie
dc.contributor.supervisorMahery, Prinslean
dc.contributor.supervisorMartin, Blake
dc.date.accessioned2025-06-12T13:04:43Z
dc.date.issued2024
dc.descriptionA research report submitted in fulfillment of the requirements for the Master of Laws, In the Faculty of Faculty of Commerce, Law and Management, School of Law, University of the Witwatersrand, Johannesburg, 2024
dc.description.abstractThe 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.
dc.description.submitterMM2025
dc.facultyFaculty of Commerce, Law and Management
dc.identifier.citationLabuschagne-Kom, Lindsie . (2024). Realising the right to healthcare: the legislative frameworks pertaining to private health establishments and private healthcare funding models in South Africa [Master`s dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/45128
dc.identifier.urihttps://hdl.handle.net/10539/45128
dc.language.isoen
dc.publisherUniversity of the Witwatersrand, Johannesburg
dc.rights© 2024 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.
dc.rights.holderUniversity of the Witwatersrand, Johannesburg
dc.schoolSchool of Law
dc.subjectUCTD
dc.subjectAccess
dc.subjecthealthcare
dc.subjectprivate healthcare
dc.subjectUniversal Healthcare
dc.subjectConstitution
dc.subjectfragmentation
dc.subjectinequitable
dc.subjectprivate healthcare establishments
dc.subjectinefficiencies
dc.subjectrealisation
dc.subjectNational Health Insurance Bill
dc.subjecthealthcare service delivery
dc.subject.primarysdgSDG-3: Good health and well-being
dc.subject.secondarysdgSDG-8: Decent work and economic growth
dc.titleRealising the right to healthcare: the legislative frameworks pertaining to private health establishments and private healthcare funding models in South Africa
dc.typeDissertation

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