The Chris Barnard Division is a small Division within the UCT Department of Surgery, comparable to other highly specialised disciplines such as Neurosurgery; it almost exclusively treats indigent patients who have no medical aid and as such are dependent on public hospitals. When the government shifted tertiary resources to primary health care in the mid 1990s Cardiothoracic surgery suffered significantly more drastic cuts in its staff and operating capacity than other disciplines. Viewed as an archetypical tertiary specialty that benefits few patients at significant cost, adult cardiothoracic operating lists at Groote Schuur Hospital were reduced to one third of the Division’s pre-1994 level in the course of the second half of the 1990s. Fearing a public backlash, authorities left the Division’s paediatric operating capacity as it was. However ...