A recently launched report by the Rural Health Advocacy Project (RHAP) places a spotlight on possible corruption within the National Health Insurance (NHI) fund. 

The report highlights critical gaps in the health sector’s procurement and spending, and a lack of clarity and potential challenges in implementing the NHI procurement provisions. 

The current analysis of procurement entities associated with the NHI reveals vulnerabilities that could expose the scheme to corruption, mismanagement and irregular practices.

Public Procurement Bill

RHAP says the Public Procurement Bill, currently before the National Assembly, has the potential to streamline and consolidate the legislative landscape governing public procurement to curb corruption, promote transparency and ensure better utilisation of public funds in the health sector.

Russel Rensburg, Director at RHAP says the Bill introduces a new regulatory structure to ensure uniformity across the public system, but there are uncertainties.

“Entities are still responsible for their own procurement but it is not clear how compliance with procurement policies will be audited or how often. Lack of compliance with financial management policies have resulted in deterioration of financial management indicators, and increases in the issuing of audit opinions and qualified audits”, says Rensburg.

NHI Uncertainty

It also indicates that the current draft of the NHI bill is not conceptually clear on how the procurement process will work. “The conceptualisation of the exact nature of acquiring public health services from private healthcare providers on behalf of the public in a future NHI should be clarified. It is important to clarify whether the relationship between the envisaged NHI fund and private healthcare providers will take the form of a procurement or not,” reads the report.

The report recommends that the roles and responsibilities of procurement role players under the NHI health system should be clarified before the proposed bill is passed.

Public procurement corruption

The report also highlights corrupt practices in public procurement, such as favouring specific suppliers through tailored specifications, manipulating procurement methods, and collusion among suppliers.

The other highlighted current challenges with public procurement is the issue of ‘fronting’, where bidders misrepresent qualifications and during the adjudication process, leading to fund misallocation and subpar service delivery.

The National Health Insurance Bill is currently before the National Council of Provinces (NCOP).-Health-e News.