NHI is a step forward in revolutionising healthcare – Makhura

NHI is a step forward in revolutionising healthcare – Makhura

Sebokeng Surgical Clinical Manager Oupa Mashele, left, Gauteng Premier David Makhura and Gauteng Member of the Executive Committee (MEC) for Health Dr Bandile Masuku look at X-ray files at Sebokeng Hospital south of Johannesburg, 17 July 2019, during a surprise visit to the hospital. Picture: Nigel Sibanda

After running NHI pilot projects in Tshwane, specific clinics had subsequently become the best-performing in the country, he said.

Gauteng premier David Makhura says while there is a debate around how best to implement national health insurance (NHI), it is a fallacy that the system must be put aside to fix the current healthcare system.

Responding to a question from Democratic Alliance (DA) member of the provincial legislature Refiloe Nt’sekhe yesterday, Makhura said the pilot projects of the NHI had helped to leverage capacity and enhanced service delivery where there was a large concentration of resources.

He said those calling for the current problems in public health delivery to be resolved before the new system was implemented were, in fact, arguing against it.

Makhura cited successes in the NHI pilot projects in Tshwane.

Specific clinics in Tshwane had subsequently become the best-performing in the country, he said.

Makhura publicly asked both former Tshwane mayors, Kgosientso Ramokgopa of the ANC and Solly Msimanga of the DA, to confirm this, which they did.

“This shows we can introduce NHI while we are fixing the [public health] system. In fact the NHI has helped to revolutionise the system,” he said.

The NHI was introduced on the basis of the belief that equity was the foundation of freedom and that no one should be sidelined whether they had money or not. The system was meant to give equitable access to healthcare to all South Africans, regardless of their financial status or class.

“Equitable access to education and healthcare is one of the defining features of human civilisation in the 21st century.

“It’s not based on level of income but on the service you need,” he said.

Answering a question from the DA shadow health MEC Jack Bloom, Makhura said the NHI was a health financing system designed to pool funds together to give access to quality and affordable personal health services to all South Africans, based on their health needs, irrespective of their socioeconomic status.

“It is a fund that will pay for healthcare for all South Africans. There will be no fees charged at the health facility because the NHI fund will cover the cost of your care. This is exactly what the medical aids schemes are doing,” he said.

The difference between NHI and medical aid was that the NHI would cover every South African regardless of income level. Thus the socioeconomic status of members of the public would not influence the type of healthcare they received.

“The health insurance will cover all whether employed or not, and … people will be treated equally.

“The NHI will pay both public and private healthcare providers, it will treat human beings as equal whether they are rich or poor,” Makhura said.

The premier said the province’s central hospitals – Chris Hani Baragwanath and Charlotte Maxeke hospitals in Johannesburg and Steve Biko and George Mukhari hospitals in Tshwane – would have to revert to getting national funding in full.

Makhura said that due to the drastic decline in funding for health in general, which was down by 30%, national funding for the central hospitals had also dropped. This had forced the Gauteng government to cross-subsidise the facilities to cover the shortfall at the expense of focusing on primary healthcare.


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