We need a social compact

Readers of this blog will see me talking increasingly of the need for a social compact, especially with reference to the Department of Health’s 10-point plan, and NHI in particular.

So what is a social compact?

It is basically an agreement that members of society, ‘the people’, make with the government about the terms under which they agree to be governed. In other words, the powers of government are derived from the consent of the governed.

So how does this apply to health?

In the Mail and Guardian on December 14, 2012, Popo Maja, spokesperson for the Department of Health explained that “The department can succeed working together in partnership and inspired by the collective commitment to build a health system that provides quality healthcare to all the South African citizens – rich and poor, urban and rural as well as across all the other many divides that characterise the nation”.

Minister of Health Dr Aaron Motsoaledi was quoted as saying “nothing brings out the best in us as South Africans than when we put our differences aside, focus on what we share and rise to the challenges confronting us. This has been the hallmark of our country. There is no doubt that looking ahead that we will continue to register significant victories in this fight.”

That is all very laudable, but what is missing is a written compact that clearly outlines the expectations of the people at all levels. Building a health system for all citizens requires input and buy-in from these citizens.

I know that there are many collaborative efforts, and that the lines of communication are mostly open, but I still believe that we need a Codesa-style meeting to draft a social compact for health that we can all believe in.


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