Picture: Timothy Bernard African News Agency (ANA)
Picture: Timothy Bernard African News Agency (ANA)

Concerns that NHI model will worsen state of health care in the country

By SE-ANNE RALL Time of article published Aug 13, 2019

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Durban - THE South African Private Practitioners’ Forum (SAPPF) strongly believes that the proposed National Health Insurance (NHI) model will cause irreparable harm to the country’s healthcare industry if implemented.

In statement yesterday, SAPPF chief executive Dr Chris Archer said NHI would not lead to the progressive realisation of access to health care demanded by Section 27(2) of the South African Constitution.

Financial analyst Professor Dilip Garach said less than 17% of South African households had medical aid, which meant that most South Africans relied on the state to provide them with health care.

Garach said the government had not categorically stated how NHI would be funded.

“What’s clear is that taxpayers will pay more taxes in future,” he said.

Garach said state hospitals were in a poor condition and were not properly managed.

“Government in general has a poor track record in managing state-owned enterprises. Unless proper control measures are introduced, there’s a concern that the NHI system will not be successful in solving the health problems of South Africa,” he said.

He said NHI would mean that private hospitals would have to admit the public at large.

He added that South Africa was plagued with HIV and other epidemics.

“The increase in patient loads will cause medical treatment to deteriorate in private hospitals. In the medical field, there’s a serious shortage of highly qualified medical health-care professionals, and with the introduction of NHI the salaries of professionals will drop and this will lead to an exodus from our country,” he said.

Doctors, who spoke to The Mercury anonymously said they had concerns about NHI.

“It would mean us treating more patients than we are used to. I just feel that more background work should have been undertaken. Government should have spoken to doctors, in both the state and private hospitals, to find out their current challenges,” one doctor said.

Another doctor said the government needed to look at the models in other countries and take into consideration what worked and what did not.

Doubt has also been cast about the care provided by various state-run hospitals, following a number of incidents - including the discovery of a patient’s body in the ceiling at the Mahatma Gandhi Memorial Hospital in Phoenix, and a psychotic patient who allegedly beat another elderly patient to death at the Ngwelezane Hospital in Empangeni.

Speaking on behalf of Medical Rights Advocacy Network (Meran), Mary de Haas said it was good to aim for a national health insurance, but it was premature to think of implementing anything until South Africa sorted out its public health system.

“We can’t afford NHI. I don’t know where the government thinks the money is coming from, until it does something to trim wasteful expenditure in the department.

“We don’t have a proper, independent bureaucracy, but a system that relies on political deployment - as opposed to professional civil servants, which is essential for an ambitious project like the NHI to run properly.

“Sort out the mess that government health services are in first, and take concrete action to stop the political patronage procurement,” she said.

De Haas said provincial government had ruined affordable health care by shutting down hospitals which provided affordable, quality health care for people who could afford to pay something for it but could not afford medical aid. She said the introduction of NHI had to be long term.

“Pushing ahead is premature until the Department of Health gets its own department in order,” she said.

The Mercury

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