Towards a national health service for South Africa. A personal view.

Circumstances are propitious for a new look at the Gluckman Report of 1942-1944 with a view to introducing a national health service for South Africa, including the homelands and national states. The circumstances relate to the ethical question of the patient's medical care, without economic disadvantage, being paramount in a health care system. Other issues concern doctors in a salaried service; a burgeoning population; the high cost of health care to the individual patient and to the State as a result of a proliferation of health bureaucracies. The issues are compounded by economic decline, unemployment and adverse socio-economic factors, which militate against the privatization of health care.