The South African Constitution specifies that it is the right of every person to achieve optimal health. Thus the term “universal access” is when access to healthcare is secured for all in the population, at an affordable price. Universal coverage entails individuals and households sharing the financing of the total health costs and making healthcare attainable to all. Universal access is the key component in a future health system and is discussed from all angles (private, public and provider) in the congress programme below.

In its 2007 National conference the ANC took the following resolution on health:
• Education and health should be the two key priorities of the ANC for the next years.
• Reaffirm the implementation of the National Health nsurance System by further strengthening the public healthcare system and ensuring adequate provision of funding.
This is therefore the policy position that is widely regarded as the blueprint for South Africa’s future healthcare system. In the two years following the date of this resolution, it is critical for all relevant stakeholders to engage constructively with this policy affirmation. Dr Mkhize, as the head of the ANC’s Education and Health committee, will share some of the thinking behind this ANC policy position.

The South African Constitution, in its Bill of Rights, specifies the ‘Right to Health’ as an entitlement for all those that live in the country. Professor Dhai unpacks these issues and takes us through some of the implications of these rights, for both the policy makers and the recipient population.

Countries around the world are searching for the ideal method of funding their healthcare system. South Africa is no exception in this search for a more efficient system of funding. There are many lessons from other countries in this regard and Professor McIntyre, as a foremost researcher in this field, takes us through these global experiences

South Africa has been classified by the World Bank as a middle-income country. However, there is no denying that it is essentially a developing country, given the wealth distribution patterns of its population. Therefore the country has much to learn from the experiences of healthcare models that have been used in other developing countries. Professor Buch will provide his insights and analysis of the key lessons from these experiences of developing countries.

Health and healthcare delivery is part of the social security system and this is a key angle from which to view the entire health system in South Africa. Accordingly the South African social security system has been a subject of some of the most rigourous scrutiny and scientific research, thanks largely to the work of Professor Viviene Taylor through the acclaimed Taylor Report. Professor Taylor takes the social security angle to share her insights on the paths that has been covered since 1994; and provides her views on the most pertinent challenges the country is facing in this regard.

The general trend around the world has been that universal access was achieved through National Health Systems that have positioned the public health system as the primary provider. This seems like the most feasible option for South Africa. Professor Sanders brings his vast experience as a public health scientist as he examines the role of the public health system in providing universal access.

The fiscal challenges of competing societal needs have been well articulated in South Africa since the first democratic election in 1994. These challenges have been cited as the main reason for the inability of the current health system to meet the needs of the population for universal cover. National treasury is at the ‘coal face’ of weighing out these competing demands. Dr Blecher provides his own analysis of these dilemmas and advances some of the models that offer prospects for possible solutions to achieve universal access.

As South Africa has a dual health system the private health system is an important part of the country’s healthcare system. SAMA’s own policy position on universal access stipulates the retention of what is good about the current system. Dr Broomberg has vast experience of working on both sides of our dual system and offers his valuable expertise from that angle. From his position as a key player in the South African private health funding, he discusses the challenges of private healthcare funding arrangements in the context of universal access, and balances these with the opportunities available.

The South African private hospital industry is said to be world-class. The role of this industry in sharing the expertise to improve the standards of all hospitals in the country, has been widely debated. Dr Matlala, as a senior player in the private hospital industry, continues this debate and advances some of the practical solutions for private service providers - in positioning themselves to play a meaningful role in a future system of universal access.

The South African labour movement has been instrumental in shaping many of the national policies aimed at correcting societal ills. Accordingly, trade unions have prioritised healthcare as one the outstanding areas that require urgent reform. Mr Vavi has been one of the most prominent union leaders for many years. He gives a perspective from the entire labour movement on what the workers want to see in a future health system, and why they view this as a critical deliverable for South Africa.

More and more the debates on a universal system of healthcare have been emphasising the need to map out a pragmatic way forward. Where do we go from here? What is the first step and what are the next steps? These are some of the questions that transcend idealism and aspiration and connect to reality in the quest for healthcare system reform. Dr Shisana has been a senior leader and academic in the health sector for many years. She offers her thoughts on some of the most critical next steps that will move us towards the goal of a National Healthcare System based on universal access.

It is now thirty years since the Alma Ata declaration: Health for all by the year 2000. In 2008 the WHO revisited this elusive milestone and reaffirmed the key role of the doctor in the rendering of a primary healthcare service. This is a clear indication of the role that must be assumed by the doctor in the future healthcare system for South Africa. Professor Naidoo examines this centrality of the doctor and the implied responsibilities for the medical practitioners practising in South Africa