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Health Minister Joe Phaahla on Wednesday said that the National Health Insurance (NHI) will not be crippled by corruption and maladministration.
On Tuesday, Parliament passed the NHI Bill. The government hopes the bill will provide universal access to quality healthcare for all South Africans.
The NHI Bill proposes for comprehensive medical aid schemes to fall away. It also intends for most healthcare services – such as visits to the doctor and medicines – will be free for all South Africans.
Private medical aids will only be able to cover complementary services that are not included in the NHI fund.
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The bill will now need to be passed in the National Council of Provinces (NCOP), and then be sent to President Cyril Ramaphosa for approval.
Despite fears that it will fall prey to corruption and maladministration, as well as the public health system not being able to adequately provide quality healthcare, Phaahla said he had faith that the NHI would be a success.
“There are a number of examples of well-functioning [government health] institutions, despite the pressure under which they function but are managing to the best of their ability,” he said.
Phaahla also said he was aware of the potential pitfalls.
“There are a number of clear examples where there has been mismanagement in some areas, in the extreme, elements of corruption have also been unearthed. Those issues must be dealt with.”
Discovery Health CEO Ryan Noach, however, disagreed with the minister. He said the current NHI model is not feasible.
He has concerns that the NHI will be the only funder of health services and is calling for a model that has multiple sources of funding.
“If you look around at the global healthcare systems, we can’t find an exclusive model of this nature anywhere else in the world, even in the United Kingdom (UK) where the famed NHS is successful,” Noach said in an interview with eNCA.
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Noach had previously said it was disappointing that meaningful contributions from multiple stakeholders to the draft bill were effectively ignored.
“Our worry is that the country does not have the resources for the single [funding] system that is envisaged,” he said.
He added that it is estimated that the NHI will cost between R500 billion and R750 billion a year.
Noach said without South Africa investing in improving its health system, the NHI will not work.
SA Medical Association (Sama) chairperson Dr Mvuyisi Mzukwa said the bill is being used for “electioneering” purposes.
Mzukwa is concerned that South Africa’s current public health system could not employ enough doctors. A lack of funding also means there is a shortage of nurses in the country.
“We have a lot of [qualified doctors] but they are not employed. If the Treasury says it does not have money, hospitals won’t have any funded posts to absorb such doctors,” he told Newzroom Afrika.
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He also highlighted the country’s “dilapidated” hospitals.
“[Healthcare workers] are moving out of the system because of poor working conditions.”
Mzukwa added that the NHI Bill is looking at the healthcare system in an ideal world, rather than what is actually happening on the ground.
“You can’t be talking about equitable healthcare access when you have dire shortages, when you cannot at the moment even attempt to capacitate the healthcare sector.”
Trade union Solidarity said on Wednesday that it is getting ready for a “major court case” against the NHI Bill.
“We realised from the outset that the NHI would probably be tested in court. The government’s plans to capture healthcare are unaffordable and unimplementable. It will lead to a mass exodus of health practitioners from the country,” Solidarity Chief Executive Dirk Hermann said.
The trade union added that its Solidarity Research Institute (SRI) has done research that it claims shows the NHI will lead to a “huge exodus of medical professionals” from South Africa.
“The government has already failed with the public healthcare system, and it now wants to fail on an even bigger scale. It has a history of failure when it comes to state enterprises, and there is no reason to believe the proposed NHI would not be to the serious detriment of South Africans.”
The Institute of Race Relations (IRR) also said it will oppose the Bill, saying South Africans should be alarmed by its approval.
“The NCOP must oppose the implementation of the NHI Bill. It is inconsistent with Section 27 of the Constitution, which requires the state to take ‘reasonable’ measures, within its ‘available’ resources, to make healthcare ‘progressively’ more available to all. The NHI is neither ‘reasonable’ nor ‘affordable’,” said IRR campaign manager Mlondi Mdluli.
The IRR said it will oppose the NHI with all the resources at its disposal.
“The government should rather focus on fixing what is broken instead of breaking what works,” said Mdluli.
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