When Health Minister Esperance Luvindao told Parliament yesterday that public hospitals must be good enough for senior officials, she cut through years of polite avoidance. Her message was direct: if the state runs a public health system, those who govern the state should use it. That declaration deserves recognition.
Namibia has lived with an uncomfortable duality in healthcare. The majority depend on public facilities that are chronically stretched. Meanwhile, a politically connected minority accesses private care through the Public Service Employees Medical Aid Scheme (PSEMAS). The result is a structural detachment between decision-makers and the daily experience of ordinary patients. The Minister’s proposal seeks to end that detachment.
By directing state employees and senior officials to use public healthcare facilities, beginning around April 2026, she is attempting to align political accountability with public service delivery. It is a bold move tied to the broader Universal Health Coverage reform agenda under the 8th National Assembly. It signals seriousness about dismantling a two-tier system that entrenches inequality.
For that courage, the government deserves praise. But courage alone will not repair a malfunctioning ambulance.
Affirmative Repositioning MP Frederick Shitana brought Parliament back to earth with a story that stripped the debate of abstraction. His brother died after a black mamba bite. The family reached a clinic at 10:00 in the morning. The ambulance arrived at 14:30. Four and a half hours later, a life was lost.
No policy framework can soften that reality.
Shitana’s intervention was not ideological resistance to Universal Health Coverage. It was a warning about sequencing. You cannot redirect thousands of additional patients into public facilities before ensuring that emergency response systems function. Healthcare reform is not a philosophical exercise. It is measured in minutes, supplies and management.
The Minister did not dismiss the criticism. To her credit, she acknowledged systemic failure and a culture of weak accountability within the ministry. She conceded that the system is “not yet ready.” That candour is refreshing in a political environment often allergic to self-critique.
But candour must now translate into operational reform.
Namibia allocates approximately N$12 billion to health. Billions more flow through PSEMAS into private providers. The issue is not solely funding; it is governance. Redirecting medical aid beneficiaries into public hospitals may create pressure for improvement, but without groundwork it could simply intensify dysfunction.
The fundamentals remain stubbornly basic:
Ambulances must be available, fuelled and dispatched without bureaucratic paralysis.
Clinics must have essential medicines in stock.
Equipment must work.
Maintenance must be routine rather than crisis-driven.
Professional negligence must carry consequences.
These are not revolutionary demands. They are the foundation of a functioning health system.
The Minister’s emphasis on “mindset” is partially correct. Complacency corrodes institutions. However, mindset reform must be reinforced by measurable targets. Rural ambulance response times should be publicly tracked. Medicine stock-out rates should be published monthly. Vacancy rates for nurses and doctors must be aggressively addressed. Accountability cannot remain rhetorical. April 2026 cannot be symbolic theatre.
If senior officials enter public hospitals before clear service improvements are visible, the move risks backfiring. Overcrowding, extended waiting times and strained staff morale would confirm public scepticism rather than rebuild confidence. Reform cannot be announced into existence. It must be engineered.
There is strategic logic in collapsing the distance between leaders and the public system. When decision-makers sit in public waiting rooms, inefficiencies become personal inconveniences rather than distant statistics. That proximity can accelerate reform in ways no committee report ever could.
But the order matters. Strengthen capacity first. Expand scope second. Enforce usage third.
The Universal Health Coverage Bill is a necessary instrument. Equity in healthcare is not negotiable in a constitutional democracy. Yet legislation cannot compensate for operational gaps. A law cannot substitute for an ambulance that fails to arrive within the golden hour. A policy directive cannot replace anti-venom in a rural clinic.
Public trust will hinge on visible progress. If response times shrink, if medicine availability stabilises, if patient complaints decline, the reform will gather legitimacy. If negligence cases are investigated transparently and sanctions applied consistently, confidence will grow. If digital systems reduce paperwork bottlenecks and improve patient tracking, efficiency will follow.
Without these gains, the reform will remain aspirational. Minister Luvindao’s “relay race” analogy is apt. Health system transformation is incremental. Each phase must leave the next stronger. The April milestone should represent demonstrable improvement, not political symbolism. The test is not whether elites are willing to use public hospitals; the test is whether those hospitals are demonstrably better by the time they do.
Compassion, too, must return to the centre. Infrastructure failures are damaging, but so is perceived indifference. Patients often speak less about broken machines and more about dismissive treatment. Leadership must enforce professional standards that restore dignity to care. Respect costs nothing and builds trust quickly.
The Windhoek Observer believes the Minister’s initiative contains genuine transformative potential. Aligning political incentives with public service performance is long overdue. It is politically risky, administratively complex and morally compelling.
Yet the reform’s success will depend on discipline, not declarations. Namibians do not demand miracles. They demand reliability. They want ambulances that arrive. They want medicines that are available. They want staff who are present and accountable. They want a system that functions predictably in moments of crisis.
The nobility of the vision is unquestioned. The execution will define its legacy. Leadership by example is powerful. Leadership by delivery is decisive.
If the government gets the basics right, this reform could mark a turning point in Namibia’s public health trajectory. If it rushes implementation without strengthening the foundation, it risks validating its harshest critics.
Healthcare reform is not about political symbolism. It is about life and death. The boldness of the idea has been established. Now the ministry must prove that the system can carry it.
