SA far from ready for NHI rollout

Failures in the National Health Insurance Phase 1 pilot project show that South Africa’s health system is nowhere near ready for universal health cover.

This was according to the Democratic Alliance’s Siviwe Gwarube who sits on the portfolio committee on health in parliament.

Yesterday Health Minister Zweli Mkhize and his delegation presented parliament with a report on the program’s progress over the past give years. The NHI piloting phase was based on piloting ten programmes, in all nine provinces and across 11 districts. It aims are re-engineering primary health care and strengthening the health system in preparation for the full roll-out of the NHI.

But according to Gwarube, government’s own findings on the pilots indicated the country was not ready for Phase 2, and far from ready to implement the NHI.

By government’s own admission in the report’s findings, it was difficult to assess the overall impact of the implementation of interventions placed at the various pilot sites, due to a lack of control groups and a lack of baseline data measures and variations.

“Effectively the authors of the report concluded that they can’t claim that the NHI Phase 1 was a success and they were saying there… there were some successes and some considerable failures and on that basis they cannot say that there was any success except for the one chronic medicine dispensing unit that had results, because they were essentially centralising pick up points for medications,” said Gwarube.

What the DA took issue with was the NHI’s Phase 1 outcomes could not inform how phase two would be rolled out because it had failed.

“Clearly there are massive challenges with the basic healthcare system as it stands. There are massive issues that require our attention like all the vacancies in posts and the huge service pressures. We still have a long way to go in terms of improving access to quality healthcare.”

According to the report, the first phase of the NHI pilot did not involve developing a new funding model for health care in South Africa, but was focused on piloting various health system strengthening interventions. The evaluation also did not provide district-specific findings in detail, although it was acknowledged that there were differences in implementation between the provinces and districts.

Last month President Cyril Ramaphosa urged the country to get behind government’s plans to universalise healthcare. The NHI Bill was published last year to much dissent from civil society organisations, political parties and industry players. Government’s plan was to implement it in an incremental fashion with an aim to cover the whole country by 2025.

Simnikiweh@citizen.co.za

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