Charting a preferred future for healthcare in South Africa

Bosch, Rafeeq (2011-03)

Thesis (MPhil)--Stellenbosch University, 2011.


The objectives of this research report on a scenario planning exercise for the SA healthcare sector were to prepare the material that would feed into such a exercise, to document some ideas about how the planning workshops would run, and identify some possible role players in the process. Several items of research regarding the SA healthcare environment are presented, including economic research data and an environmental scan of recent developments in the healthcare arena. In addition, primer material on various futures studies techniques has been prepared. These are deemed to hold the potential to shift the prevalent thinking within the SA healthcare environment. The list of techniques includes scenario planning, systems thinking and causal layered analysis. The set of data presented confirms that there are several critical issues facing the SA healthcare environment. These need to be tackled in a unified way by all players in the industry if the prevailing dynamics that give rise to these issues are to change. Scenario planning is proposed because it creates a forum within which to do so. The effectiveness of futures studies problem solving techniques in addressing these challenges is demonstrated. This is achieved by recognising, for example, that the problems besetting the current industry are, in one sense, structural (from systems thinking) or that perceptions about the issues are seated in mental models which are not necessarily universally-held (from causal layered analysis). Scenario planning is a first step to imagining an alternative future for SA healthcare which is different from the one toward which it is heading by default. As a collaborative planning technique, it also starts to shift the mode of interaction of the various sectors that make up the SA healthcare environment. Instead of the de facto conflict-based adversarial modes of interaction designed to maximise individual interests (e.g. law suits and competitive dynamics), the scenario planning exercise creates a fresh space for co-operation and holistic thinking designed to optimise collective interests. The relationships formed in this safe space often survive well beyond the duration of the scenario planning workshop (as was the case with the Montfleur scenario exercise), thereby adding a new dimension to the systemic operation of the healthcare environment.

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