South African Medical Association says health system is not ready for NHI

The South African health system is not ready for National Health Insurance (NHI), the South African Medical Association (Sama) told Health Minister Dr Joe Phaahla in Limpopo last week.

It said NHI is a funding model and does not address various challenges such as a shortage of staff in the public health system.  

Sama chair Dr Mvuyisi Mzukwa said its Limpopo branch had invited the minister and the health department to discuss the branch’s concerns about NHI.

System is not ready

“We support the objectives of NHI, but the system is not ready for implementation. There’s a human resources shortage and as a funding model, NHI does not have sufficient funding for staff.”

Former health ombud Prof Malegapuru Makgoba said at the meeting that the department did not have competent leaders and managers to lead NHI.

Mzukwa said this was important because besides money, NHI also needed good governance.

“If NHI does not address these issues, it will just be a big medical aid. NHI will not build infrastructure and address staff shortages, shortages of information technology and the many other issues in health,” he said.

He said government must first capacitate the department before it could get the funds for the NHI. “Only then can government render the private sector optional, but the system is not ready.”

Sama is also perturbed that the department did not consider its submissions on the NHI although the association has been part of the NHI journey from the time it was described in a green paper.

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No politics

Sama has also tried to stay out of politics and Mzukwa said this was why it had refused to join political parties when they had marched against the NHI.

Sama also raised the issue of unemployed young doctors.

“We told the minister we are not pleased that our South African children, our trainees, cannot be absorbed into the public health system although we have a dire shortage of doctors, but instead push them into the private sector or to leave the country.”

Mzukwa said government should prioritise employing doctors who had completed their community service last year.

“Then government says young doctors are crazy to leave the country and go work in other countries that also have NHI. But in those countries, working conditions are so much better and there are no security issues.”

Mzukwa said Phaahla had said at the meeting that he would meet the provincial health departments this month to find out where they are in absorbing the unemployed doctors. But Mzukwa said these promises are just electioneering.

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