ProfNet Medical supports the National Department of Health's vision of affordable and accessible healthcare for all South African, as encompassed in the NHI White Paper, and have been involved in the stakeholder engagements. We will also be making a substantiated written submission to the Director General of Health relating to the White Paper, which is currently open for comment, until the 31st May 2016. It is however always interesting (and important) to look at other points of view. One such view is the interesting view of Charles Molteno. I have included the article below from Fin24 - some food for thought...
Eradicate NHI need – Initiate school feeding scheme: Stuart Lowman: Fin24
A National Health Insurance Fund
In the United States of America their National Health Scheme called Obama Care has not proved a success notwithstanding the wealth of talent in that country. Despite this example the South African government has published a white paper on a National Health Insurance fund to which all taxpayers will have to contribute.
The comment from Leon Louw the head of the Free Market Foundation was that this would destroy the medical aid industry as well as lead to the departure of most of the skilled medical profession.
A Possible Solution
The French have a saying “Tell me what you eat and I will tell you what you are”. Judging by the Matric results at the poorest schools in the Eastern Cape, KwaZulu Natal and Limpopo, it seems that those poor scholars have very little protein to eat every day if any at all. On a diet of refined mealie meal with a little fat it is a wonder that they can learn anything at all.
A solution in the form of a School Feeding Scheme would cost as little as R10 billion a year, whereby those children would be well fed and not need much if any medical treatment.
As the children grow up over a decade or two there will be less and less need for medical treatment or a special Medical Health Insurance Fund. Tim Noakes and adherents to the Banting diet believe it is protein which can make the difference.
To run a successful School Feeding Scheme It would help if Bookkeeping, Agriculture/Horticulture and Cooking were taught at all schools.
The assistance of the leading supermarket chains such as Woolworths (It has a My School Scheme), Pick n’Pay, Shoprite Checkers and Spar would be a great advantage as when ordering food for their stores they could at the same time, and at the same advantageous prices, order for the schools in their areas.
They would be invited to do this at no profit but for the favourable publicity and in order to create a more prosperous country. The bookkeeping teacher would be responsible for the payment for the food and check the prices and quantities. The cooking teacher would choose the food and take delivery as per invoices and naturally check the quality and quantity.
The bookkeeping teacher would record daily purchases comprising quantity, price and quality in conjunction with the cooking teacher. The bookkeeping teacher would then explain to the class what had been bought, at what prices, what was consumed the previous day and what stocks were left over.
The class would then be able to check the prices at their local supermarket on the way home to ensure that the required volume discounts had been obtained and to report any discrepancies to the Provincial Finance department which would also monitor purchases against reported market prices.
The diet could be constituted as follows; breakfast served at 7-30 a.m of two cooked eggs, a cooked beef sausage or two, a piece of fruit and a glass of milk or yogurt. Lunch at 12-30 could comprise a portion of protein such as a quarter of a cooked chicken or other protein such as meat or fish plus at least two non starch vegetables, the objective being to increase the protein intake.
Sugar and starch should be forbidden at the school except for a two and a half kg packet of unrefined mealie meal such as “braai pap” or healthier version, to be given to each pupil each month to take home to supplement their evening meal. Refined mealie meal is not recommended as the most essential vitamins are removed in the refining process to discourage weavils and other insects from eating it.
So why must humans eat this deficient food?
If classes ended at say 3-15 p.m. compulsory practical vegetable and fruit production should be undertaken by each pupil for a half hour each day organised by the agriculture teacher, followed by compulsory physical exercise or energetic sport in order to build the pupils into strong, healthy and intelligent human beings.
Corpus sanus corpus mentis is the latin phrase implying strong in body means strong in mind. With such a regime, and other things being equal, this should lead to healthier pupils and better examination results. Furthermore the theoretical knowledge and practical experience should enable all pupils to feed themselves on farming land made available by willing farmers for whom tax concessions could be made available subject to sufficient contribution to feeding of pupils and the nation. It has been forecast that 50% of the children on leaving school will never have a permanent job.
Those without jobs will just have to be food producers for their own well being, or chefs, or restaurant owners or just traders or shop keepers. To be able to do this they need to study agriculture/horticulture, bookkeeping and cooking. Cooking is usually done by women, but in France, the home of fine cuisine, it is difficult to find a man born there who is not a good cook and an expert on food. Tourists flock to France and Italy for the fine food so why should they not flock to South Africa for the same reason?
Growing fruit and vegetables is demanding, digging the soil, planting the crops, weeding the fields and reaping the crops is hard work but very rewarding. Why make do with “pap and worse” when the alternative could be cauliflower au gratin, creamed spinach and pumpkin fritters? Let’s do something about this!
Besides the cost of the food each school would need trained bookkeepers/accountants, agriculture teachers, cooking teachers and physical fitness instructors. They would also need a secure cool room, a kitchen and dining room as well as the use of a piece of ground with water, seeds and fertilizer as well as implements for cooking and for growing food. The ideal would be for food deliveries to take place nearly each day in order to minimise shrinkage.
Paying for the cost
In the Sunday Independent of 8 February 2016 the DA leader proposed cutting the number of cabinet ministries to 15 from 35 thereby saving R4,7 billion a year. In addition to fewer cabinet ministers the head office civil servants should be also drastically reduced. The United States of America has 10 cabinet ministers with most countries having between 10 and 20.
The country needs teachers, health care workers etc. and does not need many “Gratte papiers” the French word for an unnecessary civil servant who scratches on paper. The annual cost of South Africa’s diplomatic service is R3.5 billion which it has been suggested could be cut by half. We do not need diplomatic representation in countries run by tyrants do we?
Consequences of having a school feeding scheme
Such an initiative would lead to a healthier youth and in the long run lead to vastly reduced medical expenditure and obviate the need for a National Medical insurance Fund which is in either event beyond the financing capability of a poor country such as South Africa. It should also lead to better examination results and produce a large number of accountants/bookkeepers, chefs and producers of food.
The unemployed would also have more options when it came to earning a living even if it is only as a self reliant entrepreneur. Being an entrepreneur should be their first choice not the last resort of the unemployed. This is a long term project and in keeping with the Xhosa advice “One who tries is never unlucky”.
Charles Molteno grew up on a large apple farm at Elgin in the Cape. The farm was owned by his great uncles and run by his father who played a leading role in farming, serving as Chairman of the Deciduous Fruit Board. The farm is today owned by an Educational Trust created by his great uncle Dr. H.A.Molteno.
After completing a Comm. degree in accountancy at Stellenbosch university he studied French and Economics at the Sorbonne, Alliance Francaise and the University of Paris. Charles has been a portfolio manager for most of the past fifty five years except for a stint in the entrepreneurial mining industry which prompted him to do a part time MBA degree at the Wits Business School.
The mining venture failed due to falling commodity prices as did his father’s brief stint in the mining of alluvial gold in the late nineteen thirties on the Lupa gold fields in then Tanganyika, now Zaire. Charles and his wife Anne-Marie, a superb chef, run the De Kuilen Country House guest house in Douglasdale where they have lived for the past fifty years. He currently works for Momentum but these are his personal views and may not be the same as those of Momentum.