Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study traces the development of the welfare state in Mauritius and South Africa from the early 1900s until the present, with specific reference made to the non-contributory old-age pension scheme. It seeks to understand the intersections between big capital, the state and broad-based social forces in heralding different welfare outcomes in the two countries. Mauritius has retained its long-standing traditions as a social democratic welfare state stretching back to the late 1950s. In contrast, the current welfare model of South Africa continues to be the embodiment of the liberal welfare state, similar to that of the ancien regime set up in 1928, even though it has maintained a generous social grants system since the advent of democracy in 1994. As a result it is important to unravel patterns of historical evolution that are responsible for different welfare outcomes in seemingly identical socio-political contexts. Similarly, it is important to scratch below the surface of these historical patterns of evolution to account for these disparate welfare frameworks which, nonetheless, exhibit identical outcomes in the social security sector in terms of their unfaltering commitment to old-age pensions. To this end the dissertation employs the comparative historical analysis approach in a bid to draw cross-national parallels between the social processes that unfolded and consequently underpinned development paradigms over time. This study suggests that accounting for the divergent policy outcomes is the disproportionate powers being wielded by neoliberal market forces within the main arteries of the South African economy, which hindered the state from defining the policy direction of its welfare framework to dovetail with expansive social reforms. This restraint was compounded by the left as a 'labour aristocracy', whose alliance with the political ruling class compromised their ability to champion the pro-poor agenda with as much vigour as they would have if they had pursued an independent course. This is a far cry from the welfare trajectory of Mauritius, in which a mutual understanding between the state, cross-class movements and capitalist market forces bridged contesting class interests by reconciling market economics with social fundamentals. Unlike in South Africa, the independence of the working classes in Mauritius – whose mobilising traditions cut across the class spectrum – has added special impetus to the social reform movement, having served as the bulwark against welfare retrenchments and/or less egalitarian reforms in the past. That the universal pension scheme and the state’s commitment to the pro-poor cause remain intact in Mauritius is a result of these pro-active class contestations. On the other hand, the absence of the balance of power struck between social actors and the economic élite in South Africa propelled a class compromise that allowed for the dominance of pensions to come at the cost of extensive social reforms. Such outcomes would not have come into effect in South Africa had the playing field for all relevant stakeholders been level, as in Mauritius. / AFRIKAANSE OPSOMMING: Hierdie studie volg die ontwikkeling van die welsynstaat in Mauritius en in Suid-Afrika vanaf die vroeë 1900’s tot op hede, met spesifieke verwysing na die nie-bydraende ouderdomspensioenskema. Dit poog om die snypunte tussen groot kapitaal, die staat en breë-basis maatskaplike kragte wat gelei het tot verskillende welsynuitkomstes in die twee lande te begryp. Mauritius het sy langdurige tradisie as ’n sosiale demokratiese welsynstaat, wat sedert die 1950’s bestaan, behou. In kontras gaan die huidige welsynmodel in Suid-Afrika voort as die beliggaming van die liberale welsynstaat, soortgelyk aan die ancien regime wat in 1928 ingestel is, selfs al het dit ’n vrygewige stelsel van maatskaplike toelae sedert die vestiging van demokrasie in 1994 onderhou. As gevolg hiervan is dit belangrik om die patrone van historiese evolusie te ontsyfer wat verantwoordelik is vir verskillende welsynuitkomstes in blykbaar identiese sosiaal-politiese kontekste. Eweneens is dit belangrik om onder die oppervlak van hierdie historiese patrone van evolusie te krap om hierdie uiteenlopende welsynraamwerke te verklaar wat nietemin identiese uitkomstes in die maatskaplike sekuriteitsektor vertoon in terme van hulle onwrikbare verbondenheid tot ouderdomspensioene. Ten einde dit te bereik gebruik hierdie proefskrif die benadering van vergelykende historiese analise in ’n poging om dwarsliggende nasionale ooreenstemmings te vind tussen die maatskaplike prosesse wat gelei het tot die skep van ontwikkelingsparadigmas oor tyd en hulle gevolglik onderskraag het. Hierdie studie stel voor dat die verklaring vir die uiteenlopende beleidsuitkomstes berus in die ongelyke magte wat binne die belangrikste kanale van die Suid-Afrikaanse ekonomie deur neoliberale markkragte beheer word, wat die staat daarvan weerhou het om ’n beleidsrigting vir sy welsynraamwerk te definieer wat by die breedvoerige maatskaplike hervormings pas. Hierdie remming word vererger deur die linkersy as ’n ‘arbeidsadelstand’, wie se alliansie met die politieke regerende klas hulle vermoë gekompromitteer het om die pro-arm agenda met soveel lewenskrag voor te staan as wat dit moontlik sou gewees het as hulle ’n onafhanklike koers ingeslaan het. Hierdie verskil hemelsbreed van die welsyntrajek in Mauritius, waar ’n wedersydse begrip tussen die staat, bewegings wat klas oorskry, en kapitalistiese markkragte kompeterende klasbelange oorbrug het deur die markekonomie met maatskaplike grondbeginsels te rekonsilieer. Anders as in Suid-Afrika het die onafhanklikheid van die werkersklas in Mauritius – wat se mobiliserende tradisies oor die klasspektrum heen sny – besondere impetus gevoeg by die maatskaplike hervormingsbeweging, aangesien dit gedien het as verskansing teen welsyninkortings en/of minder gelykmakende hervormings in die verlede. Dat die universele pensioenskema en die staat se verbondenheid tot die pro-arm saak in Mauritius onaangetas bly, is as gevolg van hierdie proaktiewe klasstryd. Andersins het die afwesigheid van ’n magsbalans tussen maatskaplike akteurs en die ekonomiese elite in Suid-Afrika gelei tot ’n klaskompromis, wat toegelaat het dat die oorheersing van pensioene gekom het ten koste van breedvoerige maatskaplike hervormings. Sulke uitkomstes sou nie in Suid-Afrika ingetree het nie as die speelveld vir al die relevante belanghebbers gelyk was, soos in Mauritius.

This dissertation analyses public health service delivery at the Sir Seewoosagur Ramgoolam National Hospital (S.S.R.N.H.) in Mauritius. Particular emphasis is laid on the historical development of public health service delivery at S.S.R.N.H. Public health service delivery has been approached from the view points of its nature and scope. The core components of the research survey have been on some major obstacles and flaws in effective public health service delivery at S.S.R.N.H. The measuring instrument used for the research survey was a self­ administered questionnaire. The main findings were discussed especially absenteeism, personnel turnover, stress, burnout, morale, sexual harassment, lethargy and disobedience, nepotism, shirking responsibility, alcohol and drug abuse, active political interference, bribery and corruption, dishonesty and retaliation and neglect of duty. Attention was also devoted on the current national health policy for improving public health service delivery at S.S.R.N.H., inter-alia, the National Policy for Public Heath Act 17 of 2000 and the White Paper on Health Sector Development and Reform of December 2003. The public health environment is constantly altering. Therefore, it is essential to adjust to the changing health environment. This dissertation has addressed the future challenges in the micro health environment and macro health environment of S.S.R.N.H. Ultimately, a holistic instead of a parochial approach to addressing shortcomings identified in public health service delivery at S.S.R.N.H. has been advocated in this dissertation. / Public Administration / M.Admin. (Public Admin)

This dissertation analyses public health service delivery at the Sir Seewoosagur Ramgoolam National Hospital (S.S.R.N.H.) in Mauritius. Particular emphasis is laid on the historical development of public health service delivery at S.S.R.N.H. Public health service delivery has been approached from the view points of its nature and scope. The core components of the research survey have been on some major obstacles and flaws in effective public health service delivery at S.S.R.N.H. The measuring instrument used for the research survey was a self­ administered questionnaire. The main findings were discussed especially absenteeism, personnel turnover, stress, burnout, morale, sexual harassment, lethargy and disobedience, nepotism, shirking responsibility, alcohol and drug abuse, active political interference, bribery and corruption, dishonesty and retaliation and neglect of duty. Attention was also devoted on the current national health policy for improving public health service delivery at S.S.R.N.H., inter-alia, the National Policy for Public Heath Act 17 of 2000 and the White Paper on Health Sector Development and Reform of December 2003. The public health environment is constantly altering. Therefore, it is essential to adjust to the changing health environment. This dissertation has addressed the future challenges in the micro health environment and macro health environment of S.S.R.N.H. Ultimately, a holistic instead of a parochial approach to addressing shortcomings identified in public health service delivery at S.S.R.N.H. has been advocated in this dissertation. / Public Administration and Management / M.Admin. (Public Admin)