President Cyril Ramaphosa has given an indication that he will sign into law the National Health Insurance (NHI) despite opposition to the proposed law.
Delivering his State of the Nation Address on Thursday, Ramaphosa said the bill was on his desk and he was applying his mind after it was passed by Parliament last year.
“While our health system has had a great impact on people’s lives, we are working to improve both the quality of health care and equality of access.
“The NHI Bill has been passed by both Houses and will provide free health care at the point of care for all South Africans, whether in public or private health facilities,” he said.
“The bill has arrived on my desk. I am going through it. I am looking for a pen,” he said, laughing to the delight of ANC MPs.
“We plan to incrementally implement the NHI, dealing with issues like health system financing, the health workforce, medical products, vaccines and technologies, and health information systems,” Ramaphosa added.
His remarks come against the backdrop of calls for him to send the bill back to Parliament for reconsideration and threats of litigation by some political parties, business and civil society groups.
Ramaphosa’s planned signing of the bill has drawn mixed reaction.
DA leader John Steenhuisen said by embracing the NHI, Ramaphosa was taking a wrecking ball to the public health system, driving skilled doctors and medical personnel from the country and killing South Africa’s status as a world leader in health-care innovation.
“We can’t push the NHI through Parliament when government cannot even afford to employ and place our existing graduate doctors,” he said.
“We cannot embrace NHI when the ANC cannot even feed our children. According to the Eastern Cape Department of Health, 1 722 children under the age of five in the province were newly diagnosed with severe acute malnutrition between August 2022 and September 2023. Of these, 114 have died,” Steenhuisen said.
NFP MP Munzoor Shaik-Emam said although the NHI should be welcomed, the country was not ready for it. “I was hoping the president was to tell when he was going to make funds available. The minister of health clearly indicated that we are not going to be able to implement it if we don’t have money,” Shaik-Emam said.
SA Medical Association chairperson Mvuyisi Mzukwa said the health-care system was not ready for the bill.
“It would be good if the president would take his time and look at the bill because there are concerns that have been raised not only by (us), but by business associations. There are issues to be attended to and fears of health-care workers not attended to.
He also said rushing to sign the bill into law would be a huge problem.
“We say the health-care system is not prepared for this bill. We have unemployed doctors.
If you can’t employ 1 000 doctors at the moment, how are you going to be able to attend to the whole country without proper health personnel on the ground?” But SACP spokesperson Alex Mashilo said Ramaphosa should move swiftly to sign the bill to ensure quality health care for all.
“Austerity – the budget cuts that result in under-resourcing of the overloaded public health-care system, lack of critical health-care equipment, as well as shortage of medicine in certain situations, specialists and other health-care professionals – must be reversed.
“The government must ensure adequate resourcing of the public health-care system and its expansion to meet the health-care needs of our people, the workers and poor being the majority,” said Mashilo.
Cosatu acting spokesperson Matthew Parks said they commended Ramaphosa’s commitment to signing the long-overdue groundbreaking bill and were looking forward to its rolling out.
“We cannot continue to watch while millions die of easily identifiable, preventable and manageable diseases and illnesses,” Parks said.