The Ray Alexander workers clinic--A model for worker-based health services in South Africa?

During the period of current political transition, concern for the future of South Africa's health services have led to increased interest in different models for the provision and financing of health care. These debates have included an examination of the concept of Managed Care and the ideas of Health Maintainance Organizations. Progressive trade unions, particularly, have been faced with the prospect of promoting private sector health care if they are directly to meet their members health needs, while at the same time seeking an equitable health care system for a future democratic South Africa. The Ray Alexander Workers Clinic is presented as a model of a worker-based health service which attempts to address this contradiction. Important lessons for a future National Health Service may be learnt. The role of worker control and cost containment are emphasized and implications for integration into State Services and relationships to social services for the broader community are explored. An argument is made that worker-based health services offer excellent possibilities for integration in a future National Health Service in South Africa that is centred on a Primary Health Care approach.