The Department of Health must get its hospitals running properly before taking on its ambitious five-year plan to set up a R100-billion National Health Insurance (NHI) scheme, health professionals say.
This was the view of doctors after weekend reports that the policy research document on an NHI plan, aiming to provide equitable health care for all South Africans based on an extra health insurance payroll tax, would be released within a month.
Poor people and low-income earners would be exempt in incorporating the private and public health care systems to provide universal services to rich and poor South Africans. And tax deductions for medical schemes contributions may be removed and redirected to the health insurance fund.
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Under the scheme all South Africans would have to register with their closest primary health care "gatekeeper" - doctors who would refer serious cases to hospitals and specialists. The system would need more than R100-billion a year in funding.
Professor Denise White, chairwoman of the South African Medical Association, which represents public and private sector doctors, said the association had agreed in principle to the plan to provide universal access to health care.
"We are committed to engaging with stakeholders around NHI and we are committed to preserving that which is good and excellent in both of these systems. But one must be careful to not throw out the baby with the bath water in looking at it in only an ideological way. We have excellent doctors in both the public and private sectors," White said.
She said it was too early to comment on whether quality standards in private hospitals would be strained "but the private sector is by no means going to take on an NHI that is in a shocking state of disrepair".
"Public health has been chronically underfunded and there has been an absolute deterioration of the health care system - it requires a massive uplifting of that system before one could implement an NHI that could cope.
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