South Africa has great sights, such as Table Mountain, but medical care is deeply divided along state and private lines The gap in standards between private and public medical care sectors is as wide in South Africa as any country in the world. Like other nations in Africa, the public sector is under-resourced and over-subscribed. Diagnostic facilities in state hospitals are lacking; wards are crowded.

The private sector shines by comparison. No other African nation comes near to offering these standards of care. They also exceed those in many European centres. Some hospitals in Johannesburg and on the coast are centres of medical excellence, and attract health tourists from outside the continent.

But they are beyond the reach of 80 per cent of the population. In effect, South Africa epitomises the medical care dilemmas evident in many parts of the world, namely

* The private sector has better pay, infinitely better working conditions and enough hi-tech equipment to satisfy doctors’ professional needs. Consequently, it has attracted doctors and some nursing staff away from state hospitals – where, arguably, they are more needed.

* At the same time, the cost of private care in South Africa – still reasonable by international standards – is accelerating. Some reports put yearly medical inflation as high as 25 per cent.

* The government wants to get more people to take out private medical cover – not necessarily for ideological reasons, but to ease the burden on the state. The medium to long-term aim is for a social insurance plan, requiring all employees to have cover. This is a key ambition, along with a much-needed drive against HIV/Aids and TB.