Taking from the 'rich'.

Bit of a moral dilemma in clinic today. Followed up a patient that we had done a thumb resection on last month (very gangrenous looking, foul-smelling digit). Histology came back showing an invasive melanoma. Had organised for staging scans and re-resection early next week but when I told him this he said he couldn't come down until Wednesday "if" the bus was running (it hasn't come for the last two weeks). His other option is to get a mini-bus taxi but he couldn't afford the £2.50 that this would cost.
Obviously the answer to this is that SA needs to sort out it's healthcare provision to include transport for it's most rural patients. But faced with an individual where no transport could have a big impact on his outcomes, I reached in to my purse.
I'm aware that this isn't a long term solution; I can't do this for all the patients. It may not even be a short-term one as he may spend the money on something else, like food, that he feels has an even greater short-term benefit. But it felt like the right thing to do.