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01 July 2021 | Story Dr Nitha Ramnath and André Damons
Discussing local government elections. Panellists in the University of the Free State Thought-Leader webinar hosted on 29 June 2021.

Elections are supposed to bring better, more accountable governments into place, but at local government level this has not happened so far. No real change should be expected with new local governments. The elections are not necessarily the answer.

This is according to Prof Susan Booysen, Director of Research at the Mapungubwe Institute for Strategic Reflection (MISTRA), who was one of the panellists at the University of the Free State (UFS) Thought-Leader webinar on Tuesday (29 June 2021). The webinar with the theme South African politics and the local government elections: scene setter for a capable state? is part of the Free State Literature Festival’s online initiative, VrySpraak-digitaal


Mr Ebrahim Fakir
, Director of Programmes at the Auwal Socio-Economic Research Institute (ASRI), and Prof Sethulego Matebesi, Associate Professor and Academic Head of the Department of Sociology at the UFS, were the other two panellists who discussed politics and local government elections – which is only four months away. 

Not much progress in local government

“We've seen minor changes, more coalition governments that have been coming into power – at least in the metro cities.  In the last few elections, there have been in the region of 30 or so local and major municipalities with coalition governments in South Africa,” said Prof Booysen.

According to her, she does not believe that we can go without elections; however, elections are not necessarily the answer, as there has not been much progress at local government elections as well as on other levels.

Prof Matebesi is in agreement with Prof Booysen, saying that the forthcoming elections would not bring about any change. Said Prof Matebesi: “If we agree that problems in local government – which leads to poor performance – are caused by political and not administrative leaders, if we agree that the local government system is not geared for power-sharing, and if we agree that the challenges of political leaders can partly be ascribed to the dominance of internal party politics, particularly the immense power vested in the office of the mayor – where there is sometimes a complete disregard for council resolutions – then I believe that the 2021 local government elections will not affect the changes, and produce a strong local government, capable of fulfilling its constitutional mandate.”

Decent government can withstand bad politics 

Mr Fakir said it is not possible to talk about a capable state or governance or effective government if we do not talk about politics. Axiomatically, it would mean that if politics precedes government, the type of politics prevalent in society would determine the nature of government thereafter. 

“Even if there is bad politics – with robust institutions, processes, and procedures according to which decisions are made and resources are allocated, society will be able to withstand a period of bad politics. The US and the UK have had bad politics for some time, with robust institutions. However, in South Africa, only 20 years into transition, our institutions are not robust enough and have therefore been available for the malevolent acts of state capture due to corruption,” says Fakir. 


 

He outlined five markers for a capable state:

1. A strong regulatory capacity – the ability to make laws and policies that are prudent, appropriate, and that fit the circumstances of the society.
2. A technical capacity – the engineering works, the ability to technically maintain and build the infrastructure and carry out the necessary activities required to make a society functional and facilitate its social and economic activity.
3. An administrative capacity – the ability to execute and implement strong oversight, serious ways of extracting accountability. 
4. An extractive capacity – the ability to raise taxes, revenues, rates, so that there is funding for the kind of things that need to happen at local government level.
5. A coercive capacity – the ability to ensure compliance with rules.

“I would argue that if one had to take each of these five measures, you would find that local government – and government in general – are lacking. So, if you have bad and malevolent politics, if you have bad ethics in society, then the ability for these five functional areas of capability in state suddenly starts to wither away, and you have a weak state,” Fakir said. 

 

South Africa is going through transformation and transition fatigue in the local government area. “At each local level of the state, there is a cadreship of representatives who are more powerful and can exercise power over the PR system. This type of dysfunction filters through the system of accountability and oversight, and as such, people who are responsible for coalface delivery collapse because the oversight is not there.” 

According to him, we have bad politics, and because of this our institutions are easily manipulated, our processes are easily undermined, and people are put in those positions because they can be easily manipulated. 

“Because of that, you have poor accountability, laxity, a poor attitude of working with a sense of ‘all will do as they please’ – the one takes licence from the other, and people feed off each other’s desire for lack of compliance, giving rise to a predatory state.” 

Prof Francis Petersen, who was the facilitator, said the challenges relating to local government will persist.  
“Ultimately, it is about the culture of service, the trust that needs to be developed between the citizens and local government. It is not only about the technical competency, but also about the ethical and value systems,” said Prof Petersen.

According to him, the role of universities in this should never be underestimated.  Platforms should be open to debate and discussion to offer potential solutions to politicians and to bring across that ethical and critical analysis. 

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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