NHI input ‘swept aside’, Bill likely to be challenged

While the portfolio committee on health decided to go ahead with the National Health Insurance (NHI) Bill, medical aid scheme Discovery Health says the Bill will “highly and likely” be legally challenged on various constitutional grounds.

Despite pushback and growing concern over some of its provisions, parliament said the committee considered and adopted the NHI Bill on Thursday, after the parliamentary legal advisor presented both the A-list and B-Bill to the committee.

“The A-list essentially listed all the amendments as agreed to by the committee. The B-Bill reflected all the proposed amendments and comments forming part of the new NHI Bill,” parliament said.

Amended draft of NHI Bill approved

The department of health said the NHI Bill aimed to provide universal access to healthcare in SA and would have to procure services from both the public and private sectors.

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Discovery Health noted the approval of the amended draft of the Bill by the portfolio committee, CEO Ryan Noach said.

“Following the passing of the Bill by the committee yesterday, it still requires the approval of parliament before being passed on to the National Council of Provinces (NCP) for consideration, prior to formal sign-off and presidential promulgation,” he said.

“We are surprised that the PPC approved the largely unchanged amended Bill, despite material concerns raised by almost all the opposition parties at the committee and, further to this, the significant constitutional concerns which were raised by the parliamentary legal advisor, which seem to have been ignored.”

Meaningful contributions ‘disregarded’

Noach said it was disappointing to note the meaningful contributions from multiple stakeholders to the draft Bill were effectively disregarded, with the amended version showing little variation from the original draft.

“The committee elected not to take the opportunity to make amendments to the Bill that would enhance both the feasibility and effectiveness of the NHI Fund, despite detailed and constructive inputs from multiple stakeholders, with the genuine intention of supporting expanded access to quality care for all South Africans,” he said.

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“It is particularly concerning that the inputs of the healthcare professionals, who are core and essential to the delivery of care, are not being given the appropriate weight and attention in the amendments to the Bill.”

Input not disclosed

Noach said the input from the National Treasury and the supporting of “Money Bill” had not been disclosed, nor debated, and the funding of this Bill remained unclear.

It was particularly concerning given the minister of finance’s recent comments relating to the financing challenges and nascent stage of the Treasury’s work on NHI funding, he said.

“It is absolutely critical to understand the affordability and economic strategy for supporting the Bill’s proposals, as well as the financial systems and controls required to ensure effective oversight of the monies in the fund,” Noach said.

Noach added that Discovery Health remained committed to supporting a national health insurance system, and universal healthcare coverage, that improves the equity and access to healthcare for all South Africans.

“However, we do not endorse the single-funder model as proposed in the Bill and believe that sustainability can only be achieved through collaborative work between the private and public sector, built on the strength of the Covid partnerships that served South Africa so well,” he said.

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