Residents of O.R Tambo District Municipality braved the chilly weather conditions for their voices to be heard during the National Health Insurance Public (NHI) Hearings held recently in Mthatha Town Hall, Eastern Cape.

The province’s healthcare system is plagued with problems such as long queues caused by a shortage of staff or demotivated staff, unavailability of medicines, lack of infrastructure, and an escalating number of medical claims. 

However it seems not enough is being done to educate the public about what the NHI is, say a group of five women from Nyandeni Local Municipality. They didn’t know anything about the NHI and what it means because they were asked by a local ward councillor to attend a youth programme discussing youth employment.

Mthatha was the third city to host the public hearings in the province following Port Elizabeth and Queenstown with the final in King Williams Town. Chairperson of Parliament’s health portfolio committee Dr Sibongiseni Dhlomo unpacked the NHI Bill, which was peppered with questions from the public.

Money matters

Among the concerns included the funding model of the proposed legislation, the role of employees and doctors and the challenges that were encountered during the first phase, the pilot system, which ran from 2012 to 2017.

Thabile Kunene from the Congress of South African Trade Unions (Cosatu) provincial structure says there should be a comprehensive report of the first phase.

“Before moving to another phase of the NHI, a comprehensive report should be tabled and analysed about what challenges were encountered when it was piloted and [there should be a] provision of solutions. Some of the challenges experienced are caused by the department, for example, there is a complaint about staff attitude. Obviously, a nurse will have an attitude if the issue of staff shortages is not addressed as they are expected to attend to quite a big number of patients with limited resources.”

Siyabonga Bashe also from Cosatu claims that staff attitude is caused by the department’s failure to pay accruals owed to staff. Corruption remains the key issue that may hinder the success of the NHI in the country, he says. He also slams the outsourcing of services saying it contributes to corruption and alleges that government officials financially benefit directly or indirectly from tenders.

Dr Mzulungile Nodikida of South African Medical Association emphasises that the price of healthcare in the country is unsustainable.

“If there is one thing that unites us as a country is the question of healthcare. The price of healthcare, whether you are poor or rich, remains unsustainable in the country. Workers as the whole need to know their specific role in the implementation of NHI and there is a fear that the skills of workers may be commodified.” Nodikida also brings up the concerns raised by the public about the long waiting lists to access treatment. 

Siphiwo Makinana Qumbu says he is concerned about the issue of infrastructure and whether there will be available funds to ensure that all healthcare facilities are compliant to the NHI requirements, however, he believes this will be a solution to the problems embedded Eastern Cape healthcare system. 

Political support for the bill

Meanwhile, in King Williams Town most of the submissions have been made by either African National Congress (ANC) members or alliance members from the South African Communist Party (SACP) or Cosatu. All support the proposed bill. 

There were a few submissions from ordinary people, like Mam’ Florence Nako, who tells the committee that her grandchild with learning disorders needs to go for urgent blood tests but she cannot afford to pay for it.

While Sindiswa Nqaba, an SACP member, says patients usually arrive at clinics long before staff. “This is not fair on elderly people who wake up early in the morning and sometimes even pass out while waiting to get served,” she says.

She and Mam’ Walekazi Bangusha come from different areas but they both complain about the unhygienic condition of their respective facilities.

Bangusha says: “We have many problems at Litha Clinic. For example, when Mrs Thom who used to be a cleaner at the clinic retired four years ago, [there is] no one [to clean] besides a woman who volunteers to [do so]. As the clinic committee, we have gone through many processes to get a cleaner, and we were told that they will send someone. We are still waiting for them to arrive.”

Another resident, Tata Mlamli Faku laments how medical aids drain pockets of workers. But he also says government health is connected to the socio-economic issues of people. He suggests that since clinics in rural areas have large yards, the spaces should be converted to community gardens so that patients can collect both food and medication from clinics. 

The head of the provincial health department, Dr Thobile Mbengashe was also in the audience. As residents complained about their state of the healthcare services they received, Dhlomo referred people to Mbengashe.

“Dr Mbengashe, the committee is going to call you and ask you on the progress of the issues raised here,” Dhlomo says. 

The Eastern Cape was the parliamentary committee’s last location until public hearings resume next year. While the dates for North West, Gauteng, Free State and Western Cape have not been made public yet, parliamentary staffers have told Health-e the hearings are set to resume mid-January. – Health-e News