The NHI must be more than a plaster on a festering sore

There is a worrying possibility that government mismanagement of the health sector will not be improved by NHI, but may even be made worse.


The ANC holds out the National Health Insurance (NHI) as the solution for healthcare in South Africa. It is intended that the scheme will eliminate the common failings of the public health service system to deliver quality services to its patients – failings like shortages of medical personnel and medicines, as well as long queues and waiting times. It seems as though little will really change in the future – save that those problems might be just spread around more evenly … to include the currently reasonably efficient (although hugely expensive) private health care sector. That’s the only conclusion we…

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The ANC holds out the National Health Insurance (NHI) as the solution for healthcare in South Africa.

It is intended that the scheme will eliminate the common failings of the public health service system to deliver quality services to its patients – failings like shortages of medical personnel and medicines, as well as long queues and waiting times.

It seems as though little will really change in the future – save that those problems might be just spread around more evenly … to include the currently reasonably efficient (although hugely expensive) private health care sector.

That’s the only conclusion we can come to after visiting one of the NHI’s pilot schemes in Mpumalanga.

The “shambolic” state of the project – intended to supply primary health care services – is confirmed by patients in the area, who dread going to the clinics in the Bethal area. These people – mostly poor – complain that there is a shortage of medical people, they are treated with rudeness by nurses and that there are long waiting periods. A lack of prescribed medicines is also a huge problem.

Some people put up with difficult, agonising or even dangerous medical conditions because they despair of ever getting helped by these NHI pilot projects.

The testimony of the long-suffering residents of the area raises a worrying possibility – ahead of the public hearings into the whole NHI project – that continual government mismanagement of the health sector will not be improved by NHI, but may even be made worse.

There is a real prospect of that misery being shared.

Having said that, we do recognise that there is need for an efficient, cost-effective national health service. Private health costs now border on the outrageous, as do the profits of the corporates who run medical aids.

NHI must be more than a sticking plaster on this grievous sore.

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