Durban - THE pilot National Health Insurance (NHI) projects in KwaZulu-Natal have been described as a failure by the Democratic Nursing Organisation of South Africa (Denosa).
The organisation said it believed the country was not ready for NHI, as the projects had failed to produce solid results.
It issued a statement soon after Health Minister Dr Zweli Mkhize’s presentation of the NHI to Parliament last week.
The NHI bill was referred to Parliament’s portfolio committee on health, the chairperson of the committee, Dr Sibongiseni Dhlomo, said yesterday.
Dhlomo said the committee would meet to discuss the draft law, adding that it would have an “extensive” public consultation process.
The long-awaited bill seeks to set up the NHI Fund, which will eventually become the sole purchaser of health care services in the country.
The bill has been met with widespread criticism, with the Institute of Race Relations (IRR) saying it was silent on key issues and its envisioned overhaul of the health care system was a likely vehicle for graft.
Denosa provincial secretary Mandla Shabangu said the NHI had been piloted in the Amajuba, uMzinyathi and uMgungundlovu districts.
He said it had revealed many unresolved infrastructural challenges and backlogs in these areas.
“Many of the clinics have scored poorly in the bi-annual assessments on critical areas like resuscitation equipment. Only 11% of the clinics are ready for NHI in the eThekwini district. It has also been found that staffing norms are not used when hiring staff,” Shabangu said.
He said the integrity of infrastructure scored no more than 27% in clinics, and the response of EMS to emergencies was only at 39% while a whopping 43% of clinics had non-functional ablution facilities.
“While there were areas of improvement for infrastructure in some districts, which is a positive sign, the challenges of human resources and shortage of equipment far outweigh the positives in this regard,” he said.
Shabangu said despite this, the Department of Health was adamant it was ready to start NHI.
“We reiterate that the NHI must not be met with the same challenges that exist today, like the filling of vacant positions created by retirement or resignation,” he said.
Shabangu said issues of staff and resource shortages were still a major factor.
“We understand that the NHI is about financing the healthcare service in the country. However, we are the first to point out that such healthcare services are not going to be rendered in the sky.
“They will be provided by the current health facilities unless government’s hope in the success of NHI rests on the few well-resourced facilities in the private healthcare sector,” Shabangu said.
He said Denosa was concerned about the abandonment of the current solution to the shortage of nurses within the healthcare system in KZN.
There are presently hundreds of newly-qualified nurses who cannot be absorbed by the health system, despite a glaring shortage at state facilities, he said.
“As a result, the provincial government is considering releasing these nurses to other provinces and to the private sector. This dashes any immediate hope of addressing the chronic shortage in health facilities,” he said.
Concerns have also been raised that the NHI could lead to massive job losses in the private health sector and an exodus of doctors.
Speaking at a recent media briefing, Mkhize said the bill could come into law as early as July next year and would seek to improve healthcare for more than 80% of the population who were not covered by medical aid.
Mkhize said taking the bill to Parliament would begin a vigorous legislative process in which the National Assembly and the National Council of Provinces would engage the bill in pursuit of the mandates as set out by the Constitution.
“The process encompasses 61 steps of engagement and re-engagement, including that of public consultation.
“As a department, we look forward to the robust debate that will surely follow. As far as we are concerned all the hard questions only deepen our knowledge and understanding of the nation we intend to serve and the policies we intend to implement,” he said.