NHI: Civil society share concerns
The decision by the National Assembly Portfolio Committee on Health to adopt the National Health Insurance Bill (NHI) in its current form has concerned civil society organisations.
The bill was first introduced in parliament in August 2019 and will now be debated in the National Assembly.
The NHI is a health financing system designed to pool funds to provide access to quality, affordable personal health services for all South Africans based on their health needs. It seeks to realise universal health coverage for all. This means that ‘every South African will have a right to access comprehensive healthcare services free of charge at the point of care at accredited health facilities, such as clinics, hospitals and private health practitioners.’
The bill aims to ‘create mechanisms for the equitable, effective and efficient utilisation of the fund’s resources to meet the health needs of users. It also seeks to create mechanisms to preclude or limit undesirable, unethical and unlawful practices in relation to the fund.’
What are the concerns?
The concerns centre around the lack of feasibility studies, unqualified public health facilities, lack of capacity, funding resources, and corruption within government departments, including the health ministry.
Several organisations shared their views with Health-e News
People’s Health Movement South Africa
People’s Health Movement Coordinator, Tinashe Njanji told Health-e News that some parts of the bill are problematic. He says that the draft of the proposed NHI bill is written almost without context, as if South Africa is a functioning state that is free of corruption and is capable of introducing and managing the far-ranging changes to the health system that will be required.
Njanji says that it is concerning as some of the raised questions about the NHI bill still hang in the balance. “There’s a lack of detail about upgrading of the public health sector,the possibility of exacerbating inequality, failure to distinguish between primary health care and primary care and the lack of adequate mechanisms for civil society engagement”, he says.
According to Njanji, it also remains concerning that the most recent report of the Office of Health Standards Compliance (OHSC) found that only a small fraction of public health facilities surveyed met to meet the norms and standards required for certification.
He says that private facilities are not only more likely to get accreditation but are also overwhelmingly urban-based. “This increases both urban-rural and private inequality. There is a possibility that people living in some areas will not have access to NHI funded health care at all.
Facilities that already lack staff, medicines and equipment will not find it easy to register users as smoothly as those facilities already functioning at a much higher level of efficiency. At the moment many public sector facilities lack easy internet access,” says Njanji.
Treatment Action Campaign(TAC).
TAC General Secretary, Anele Yawa, says that they support the NHI but they have concerns which remain unanswered regarding the bill and how it has been structured in the drafted copy. According to Yawa it is concerning that there are a lot of allegations of corruption within the national health department.
Yawa says that it is also worrying that the country is currently battling a critical shortage of healthcare workers as most public facilities remain under-staffed, which negatively affects the rendering of healthcare services.
South African Medical Association
According to SAMA spokesperson, Dr Mvuyisi Mzukwa, the NHI bill has been developed with disregard to the legitimate concerns and recommendation of experts, particularly on critical issues such as the introduction of contracting units for primary Healthcare (CUPS), benefits packages, and reimbursement models.
He says that the NHI bill in its current form sets up the healthcare system for failure at the expense of further deterioration of the health and wellbeing of all who live in the country. “We believe that a robust approach to health systems strengthening is indispensable, as it would rectify the current deficiencies and overcome the challenges posed by the NHI,” says Mzukwa.
The proposed NHI bill is set to be officially fully implemented in 2026.-Health-e News.
Author
Ndivhuwo Mukwevho is citizen journalist who is based in the Vhembe District of Limpopo province. He joined OurHealth in 2015 and his interests lie in investigative journalism and reporting the untold stories of disadvantaged rural communities. Ndivhuwo holds a Bachelor of Arts degree in Media Studies from the University of Venda and he is currently a registered student with UNISA.
Republish this article
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Unless otherwise noted, you can republish our articles for free under a Creative Commons license. Here’s what you need to know:
You have to credit Health-e News. In the byline, we prefer “Author Name, Publication.” At the top of the text of your story, include a line that reads: “This story was originally published by Health-e News.” You must link the word “Health-e News” to the original URL of the story.
You must include all of the links from our story, including our newsletter sign up link.
If you use canonical metadata, please use the Health-e News URL. For more information about canonical metadata, click here.
You can’t edit our material, except to reflect relative changes in time, location and editorial style. (For example, “yesterday” can be changed to “last week”)
You have no rights to sell, license, syndicate, or otherwise represent yourself as the authorized owner of our material to any third parties. This means that you cannot actively publish or submit our work for syndication to third party platforms or apps like Apple News or Google News. Health-e News understands that publishers cannot fully control when certain third parties automatically summarise or crawl content from publishers’ own sites.
You can’t republish our material wholesale, or automatically; you need to select stories to be republished individually.
If you share republished stories on social media, we’d appreciate being tagged in your posts. You can find us on Twitter @HealthENews, Instagram @healthenews, and Facebook Health-e News Service.
You can grab HTML code for our stories easily. Click on the Creative Commons logo on our stories. You’ll find it with the other share buttons.
If you have any other questions, contact info@health-e.org.za.
NHI: Civil society share concerns
by Ndivhuwo Mukwevho, Health-e News
May 31, 2023