NHI papers to be ready by election

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Patients wait for treatment at a women's ward at the Chris Hani Baragwanath Hospital in Soweto. The Department of Health will get R18.1 billion in the medium term towards establishing infrastructure for the National Health Insurance scheme. Photo: Antoine de Ras

Johannesburg - The National Health Insurance (NHI) White Paper and the financing paper may be presented to the public before the May 7 election.

Finance Minister Pravin Gordhan said both papers had been completed and would be tabled in the cabinet “shortly”. The National Treasury put together the financing paper but Gordhan did not want to discuss the details of its proposals yesterday.

“All we can say for now, is that both papers will go to cabinet… It’s our hope that we’ll see it before the election,” he told the media ahead of his Budget speech.

The National Treasury has budgeted R18.1 billion over the medium-term expenditure framework (MTEF) period for infrastructure components of the national health grant and the NHI grant.

The national health grant is managed by the Department of Health, while the NHI grant is managed by provinces. While the provincial governments were previously allocated more money to deliver health-care services and infrastructure, the Treasury said over the MTEF period for the three years to the 2016/17 fiscal year, the national Department of Health’s allocation would grow at a faster rate. This was because certain functions of the NHI would be centralised and controlled at national level.

The department’s allocation would grow at an average of 16.3 percent annually over that period, while that of provincial departments would grow at 6.9 percent. But at R155.49bn, the provincial budget would continue to dwarf the R3.6bn for the national department.

The division of revenue between national and provincial departments was crucial, given the importance of the implementation of the NHI.

Health Minister Aaron Motsoaledi said last week that some provinces were not spending NHI conditional grants and hospital revitalisation grants aimed at fast-tracking the re-engineering of public health facilities.

Gordhan also acknowledged yesterday that there were many instances where direct grants went to provinces but were spent on other things, not only in the health sector but in other departments as well.

Gordhan announced that R1.2bn had been allocated for piloting contracts for general practitioners (GPs) over the next three fiscal years.

This budget would also be used to develop reimbursement methods for central hospitals under the NHI.

A total of R221.9m is budgeted to strengthen district health authorities. The office of health standards compliance, which will be launched in the 2014/15 fiscal year, will receive R369.5m funding over the MTEF period.

Addressing the parliamentary portfolio committee on health before the Budget, Motsoaledi said NHI or universal health-care coverage was going to be the world’s third agenda when the deadline for reaching the Millennium Development Goals came in 2016.

He said there was a consensus among health ministers that the structure of health budgets globally resulted in the funds reaching primarily the rich and other elites.

“In the US, health finance can’t reach 53 million people, which is 16 percent of the population. In our country, it’s even worse,” Motsoaledi said.

He said that this was because health financing was only done in the form of budgets with not much follow-up on implementation.

Gordhan said South Africa needed more effective implementation and better outcomes from its tabled budgets. - Business Report

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