“We have no doubt that enemies of NHI will do everything possible to try to stop NHI from becoming a reality, failing which, they will try to cast doubt and aspersions on the integrity of the process,” according to the ministry statement issued this afternoon (28 November).

“We wish to reassure the nation that no law is being breached nor any illegality or irregularity committed in the manner in which the legislative process towards realisation of NHI is being conducted between the Department of Health, its officials, the Treasury, The Presidency and the rest of government.”

This follows a week of media reports about apparent breeches in protocol in the development of the latest version of the Bill, which was submitted to Cabinet’s social development sub-committee yesterday.

Leaked letter

Last week,  a letter written by acting Director General of Treasury, Ismail Momoniat, to NHI Presidential advisor Dr Olive Shisana was leaked to the media. In it, Momoniat said that Treasury could not support the latest version of the Bill as it had been “very substantively amended in October”, removing various agreements reached between the Ministers of Finance and Health.

After the publication of the leaked letter, Treasury said “we have reached agreement on most of the major issues,” and “we are confident that we will soon publish this important Bill for tabling in Parliament.”

The Ministry described as “sinister” the “leaking of such letters to the media by some unscrupulous officials and then pretending that they uncovered some hidden evil lurking in government departmental exchanges”.

On Monday, civil society organisations said that the three-month comment period on the Bill had been too short, and called on Cabinet to “send the NHI Bill back to the Department of Health and to require a proper and thorough consultation process and consideration of options available for improvement of access to and quality of health care services in the country”.

The Treatment Action Campaign (TAC), SECTION27, Rural Health Advocacy Project (RHAP), People’s Health Movement (PHM) and Lawyers for Human Rights (LHR) also said that the current Bill “risks damage to the functional elements of the health system – public and private” and that “government needs to focus on fixing the crises in private and public health rather than on hastily passing legislation that, in its current state, takes the country in the wrong direction”.

Public hearings

But the Ministry said that the Health Minister had already explained that “whatever outstanding issue that could not be raised through public participation within that period of three months will still be achieved when Parliament conducts public hearings throughout the length and breadth of our country. Such public hearings are still coming.”

It also explained that the Presidency was driving the NHI at the request of the health minister because “NHI is a huge seismic event which will need the guidance of the Head of State”.

“NHI is not just an ordinary government programme. It is a flagship programme of the state which is designed to ensure that we deliver on our constitutional mandate of Health as a right of all citizens regardless of their station in life,” said the Ministry.

“Ever since the United Nations adopted the concept of Universal Health Coverage (UHC) as one of the 17 world’s sustainable development goals, in all major democracies of the world, Heads of State have taken over the responsibility of being the major advocates and drivers of the process towards the achievement of Universal Health Coverage which in our country is NHI.  It will be remiss for our Presidency to stay aloof from such a major world endeavour.” – Health-e News.