Our state hospitals are not known for the quality of the healthcare they provide, their short waiting times or excellent administration. A measure of their deficiencies is that the national Department of Health set aside R25-billion, about a sixth of its annual budget, for medical negligence claims last year. South Africa has one of the worst maternal mortality rates in the world, higher than that of Equatorial Guinea.We have a severe shortage of doctors and nurses - and a sick population.The health minister's cures for our struggling health system are training more doctors in Cuba and the oft-cited national health insurance.Both these plans are intended to improve the basic care of patients at their community clinics, which need nurses to function effectively. Clinics are run and staffed by nurses. They are the frontline of the health system, accounting for 70% of the health personnel on the ground despite the dire shortage of nurses.And the shortage will get worse - 43% of nurses are older than 50.But not only are there too few nurses, some are badly trained.Some "staff nurses" can do nothing more than make a bed, said one doctor yesterday.The decision to increase the length and quality of basic nursing training from two to three years is arguably a good idea. But as with many good ideas, it comes down to implementation.The old, shorter nursing courses have been phased out. But private nursing colleges cannot offer the new improved courses because the courses are not yet accredited by the SA Nursing Council.This means that hundreds or even thousands of junior staff nurses cannot be trained next year, unless they can afford a four-year university nursing degree.In short, having too few nurses kills patients.We need to train more nurses and the SA Nursing Council must explain why private colleges can't do that next year...