DURBAN – The parliamentary portfolio committee on health has received more than 10 000 submissions in response to the National Health Insurance (NHI) Bill.
This is according to experts who were speaking the NHI Bill dialogue this week.
Speaking at the NHI Bill Dialogue hosted by the Board of Healthcare Funders (BHF), Dr Yogan Pillay, country director for South Africa at the Clinton Health Access Initiative (CHAI), shared findings from the Lancet Commission on High Quality Health Systems which showed that poor-quality health systems result in more than 8 million deaths per year in low- and middle-income countries (LMICs), leading to economic welfare losses of $6 trillion.
He said the research found that approximately a third of patients in low- and middle-income countries experienced disrespectful care, short consultations, poor communication and long waiting times. It also found that less than a quarter of the people in these countries believe that their health systems work well, compared to half of the people in high-income countries believing that they do.
“Within the context of South Africa, as the country continues with engagements and preparations for the next steps for the NHI, it’s crucial that the NHI Bill addresses these and other important aspects around health-care fairness in the treatment of patients,” Pillay said.
Vishal Brijlal, executive director of CHAI, agreed, adding that the kind of health-care system people wanted should be one that was available to people when they get sick, provides an acceptable level of care, and doesn’t leave people out of pocket.
“It should be a health-care system that treats everyone fairly. It should be one that provides access to specialists and health-care professionals who are adequately trained and have all the resources that they need to do their work. In delivering health-care, they should do so, in a caring, friendly and professional manner,” he said.
"This kind of utopian perspective is what the NHI needs to deliver, and the question on our minds is, will the NHI Bill give us that?”
Brijlal said that based on the inputs made to the portfolio committee on health, people were concerned that the NHI Bill did not seek to deliver all that was required of a health-care system.
He noted that concerns raised in the inputs made to the portfolio committee on the NHI Bill were around decision-making and transparency, and not based on the principles of universal health coverage.
“There needs to be transparency in the entire process, around how decisions are going to be made, because these are some of the challenges making people uncomfortable and anxious,” he said.
“The discussions around NHI should not be about integration between the private and public sectors, or about nationalisation of the health-care system, but about a responsive system that delivers when it is needed and about moving towards that.”
Delegates at the NHI Bill Dialogue agreed that lessons could be learnt from the kind of efficiencies that have been achieved by the National Healthcare Service (NHS) in the UK.
Dr Katlego Mothudi, managing director of the BHF, said there was a need for a standardised approach to the use of technology models across the board, in the public and private sectors.
“The current challenge is that the approach being taken and proposed presents a fragmented approach to health care. There is fragmentation between schemes and administrators in the private and public sectors, across the board. The state should not look at the private sector as a competitor, we need a unified industry to tackle health-care needs,” Mothudi said.
“We need to standardise our approach to technology models. A priority of the NHI Bill should be about outcomes monitoring and reporting, fairness, and resolving the fragmentation in the system. This is not a short-term policy, but a long-term policy of national importance.”
Mothudi said the government also needed to address corruption head-on.
“Good governance is crucial, accountability of public officials needs to be addressed. We should ensure that no one is given unyielding power and responsibilities, and good governance practices should be strictly implemented to counter check the functionality of the NHI and universal health coverage.”
THE MERCURY