Introduction
Corruption is the abuse of power entrusted to an individual or organization for undue financial, physical, or non-physical gains. Sadly, the healthcare sector is susceptible to misappropriation of resources, authority, trust, or power leading to dire consequences (Mackey et al., 2018). Developing countries such as South Africa have massive public fundsillegally pocketed by corrupt politicians, healthcare professionals, administrators, and suppliers (Pillay and Mantzaris, 2017). The impact of such dealings can lead to low quality of care, increased inequality, high levels of error, and the death of innocent patients. Although bribery and misuse of power are rampant in South African healthcare, strategies such as whistle-blowing, transparency and accountability in recruitment, and ethical governance can help curb corruption.
Ways through Which Corruption is perpetrated
Stealing of public funds directly or indirectly by top government officials is rampant. For instance, during the COVID-19 pandemic, there were multiple graft cases of substandard personal protective equipment (PPE), overpricing, and giving tenders to people with government connections (Muvunyi, 2020). A close associate of the president, Khusela Diko’s husband, was awarded a $7 million tender (Muvunyi, 2020). Thus, corruption is perpetrated by people using taxpayer money to enrich themselves at the expense of critical healthcare needs.
Bribes are common channels through which corruption is perpetrated and may lead to low healthcare standards. Unscrupulous healthcare professionals can illegal fees or bribes from patients in exchange for faster results or specialized services (Pillay and Mantzaris, 2017). In some cases, the recruitment team can select or promote professionals who give bribes leaving out those that are qualified (Kirya, 2020). Thus, greediness and ignorance of consequences make some people to participate in corrupt dealings.
Measures by South African Healthcare Sector
The South African government has established an ethics and anticorruption authority body which is independent and investigates. For instance, after the report on corrupt dealings in the purchase of PPE different anticorruption groups started to investigate 91 companies that got purchase orders from the ministry of health (Muvunyi, 2020). After the investigations, the listed companies are prosecuted in a court of law and sentenced. If there is justice in the courts it may deter other people from engaging in exhortation practices.
Policies and legislation is the other measure that South Africa can use to minimize the incidences of corruption. For example, in 2004 the legislatures provided the Prevention and Combating of Corrupt Activities Act (Pillay and Mantzaris, 2017). The laws help in coming up with strategies and standard measures for ending corruption. In addition, it outlines procedures to be followed by public hospitals to make it difficult to bribe. For instance, the policy may require the anonymity of applicants during recruitment, criminalize sexual relations at the workplace, and control instances of relatives working within the same companies. Thus, the avenues for engaging in corrupt dealings are limited even for the top officials.
Impact of Corruption on South African Healthcare
Inequality in accessibility and provision of care is an expected consequence of corruption. According to Hsiao et al. (2019), urban areas often attract experienced medics while poor people may be disadvantaged when seeking medical care because of discrimination and finances. The result is that the people in remote regions have a poor quality of care and are unable to get better services because of the geographical distance. Worse still, corrupt politicians may choose to distribute more resources in their home areas leaving other regions underdeveloped.
Loss of life due to avoidable errors and negligence is another consequence of corruption in South Africa. For instance, during the COVID-19 pandemic, many medics were exposed and died from coronavirus (Muvunyi, 2020). Yet, the few people who were given government tenders to supply the materials used the money for personal gains. Patients die in the hands of rogue doctors who bribed their way to get employment. If the physicians are greedy they can sell some vital organs of their poor patients to rich people locally and internationally. The motivation of the good professionals may be derailed and there is a lack of teamwork because of disagreements (Kirya, 2020). The poor work environment leads to poor health outcomes for citizens. Thus, different forms of corruption can be life-threatening to both the medics and their patients.
Effectiveness of Whistle Blowing in the Public Sector
The act of reporting any irregular, illegal, or dangerous practice omitted by a person or organization within the healthcare sector can aid in ending corruption. Whistle-blowing is intentionally providing information by a person who has substantial evidence (Nwoke, 2019). For the report to produce positive results it is essential to report to the right authority. Notably, where the police are corrupt and easily bribed whistle-blowing becomes ineffective. For instance, one woman was murdered after exposing corruption in PPE procurement in South Africa (Botha, 2021). The implication is that whistle-blowing can be dangerous and when there are no mechanisms for protecting the people their lives may be in danger. Therefore, whistle-blowing is only effective when the anti-corruption authority and law enforcers work together to ensure justice while protecting the informer.
Conclusion
Corruption in South African healthcare is rampant and may have life-threatening consequences. The perpetrators are greedy individuals and organizations seeking to gratify their gains. Yet, they cause a lot of harm including inequality, low quality of care, lack of motivation, and death resulting from avoidable errors. The anti-corruption groups have been trying to fight bribery and exhaustion but their progress is slow. The use of legislation may effectively curb corruption when there is justice. However, with the current trend where even the whistle-blowers are endangered corruption remains a puzzle to be solved to realize better healthcare.
Reference List
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Hsiao, A., Vogt, V., and Quentin, W. (2019) ‘Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa’, PLOS ONE, 14(8), pp.1-12.
Kirya, M. T. (2020) ‘Promoting anti-corruption, transparency and accountability in the recruitment and promotion of health workers to safeguard health outcomes’, Global Health Action, 13(1), pp. 1-7.
Mackey, T. K., Vian, T., and Kohler, J. (2018) ‘The sustainable development goals as a framework to combat health-sector corruption’, Bulletin of the World Health Organization, 96(9), pp.634-643.
Muvunyi, F. (2020) South Africa’s double blow: Corruption and the coronavirus. DW.COM. Web.
Nwoke, U. (2019) ‘Whistle-blowing as a corporate governance mechanism: South Africa and Nigeria in perspective’, Journal of Corporate Law Studies, 19(2), 421-450.
Pillay, P. and Mantzaris, E.A.(2017) ‘Corruption in the health sector in South Africa and India: some considerations and reflections’, African Journal of Public Affairs, 9(8), pp.48-62.