There was, by the look of things, no doubt that some National Health Insurance (NHI) pilots were working, the portfolio committee on health said after conducting an oversight visit in North West last week.
The committee spent five days in North West assessing the functioning of the province’s primary health-care system, the roll out of antiretroviral (ARV) drug treatment and the province’s readiness to roll out NHI.
This was the first province to be visited since the conclusion in March of the first year of piloting the NHI.
Monwabisi Goqwana, the chairman of the committee, said even though the hospitals the MPs visited had certain challenges, such as a shortage of medical staff and equipment, North West had made great strides in improving its systems and preparing for the NHI compared with the other provinces they had visited last year.
The committee expected the same could be observed in the other districts as the oversight visits last year were conducted before provinces spent most of their NHI conditional grants.
Goqwana said the committee had not visited primary health-care centres.
The NHI policy puts emphasis on primary health care, with patients only going to hospitals after being referred by a clinic.
The committee visited about five hospitals, including the Dr Kenneth Kaunda Hospital, where most of the refurbishment using the grant took place.
“There is no doubt that there are challenges but there is a lot of innovation, especially around NHI systems. By the look of things in North West, there is no doubt that the NHI seems to be working,” he said.
The Dr Kenneth Kaunda pilot district in North West was one of only four of the 10 NHI pilot districts in the country that had appointed NHI project managers by the end of the first piloting year in March. It had also managed to fill all seven posts on district clinical specialists’ teams. But the overall score of its inspected primary health-care facilities this year was 47 percent and the district had only refurbished two out of five major hospitals.
“The challenges are there but it’s universal challenges like the shortage of staff and poor planning,” Goqwana said.
He added that different provinces were progressing differently in preparing themselves for the NHI as the committee members had witnessed dire conditions during their visit to Gauteng last year.
But the Gauteng Health Department said earlier this year that the turnaround strategy it had implemented last year had resolved some of the challenges that existed previously while others were at various stages of being resolved.
Denise Robinson, the DA spokeswoman for health, said the people in North West were being innovative to create an enabling system for the NHI.
“Although there are shortages of beds and linen and insufficient ambulances, the people are finding different ways of making things happen. It’s looking positive,” she said.
The committee said it did not come across problems of ARV treatment shortages in its oversight visit but it had been getting reports that certain provinces had experienced shortages of medicines, especially for the new single dose ARV treatment.
“But the national Department of Health has committed to helping provinces and this is something it is correcting,” Goqwana said.