Patients wait to be seen by healthcare practitioners at the Wesfleur Day Hospital in Atlantis. Picture: African News Agency Archives (ANA)
Patients wait to be seen by healthcare practitioners at the Wesfleur Day Hospital in Atlantis. Picture: African News Agency Archives (ANA)

NHI aims to provide access to health services for everyone

By PHUMLA WILLIAMS Time of article published Aug 5, 2019

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There are few things more devastating than being denied quality health care because of one’s socio-economic status. This, sadly, is a reality faced by the majority of South Africans.

The country’s health-care system has over the years resulted in disparities in how it is administered. It is based on both the private and public health systems.

Up to 84% of the population receive services through public health facilities which are inadequately resourced, while only 16% have access to the private health-care system, which is highly resourced.

More so, the unfortunate reality is that even those who are members of private medical aid schemes often find themselves in a quagmire as medical aid savings and benefits are exhausted before the end of the annual financial contribution cycle.

This is always attributed to the exorbitant price structure in the private health system. This, then, cannot be a fair system.

In redressing this anomaly, our National Development Plan (NDP) envisages a health-care system that works for everyone.

It provides for several key elements aimed at putting programmes that will meet the constitutional mandate which instructs that the government provide health-care services to all South Africans, irrespective of their socio-economic background, and within the available resources.

One of those elements in the NDP proposes that the government implements a financially-sound health system based on universal health ­coverage. It is a system that will pool funds to provide access to health services for all South Africans.

This system is the National Health Insurance (NHI), which will be implemented in phases to tackle the unacceptably high levels of inequality, particularly as they relate to the health-care services in the country.

Addressing the country during his recent State of the Nation Address, President Cyril Ramaphosa said: “By introducing the NHI together with a multi-pronged quality improvement programme for public health facilities, we are working towards a massive change in the health-care experience of South Africans.”

As the president indicates, the programme to change how we provide health-care services to all of South Africa will be multi-pronged.

This will, among many interventions, deal with the country’s preventative programmes, improve the quality of our health infrastructure and human resource capacity in our health facilities, strengthen the partnership between the private and public sectors and strengthen our governance structures and information system.

Through the NHI, the government envisages that private and public health care can equally share resources to accommodate all South Africans who need medical care without compromising quality and service standards.

It will draw in hospitals, clinics, doctors, specialists and dentists from across the health sector. Work has already begun to strengthen this sector and to engage stakeholders through the Presidential Health Summit convened in October last year.

Last year the Cabinet approved the NHI Bill for release for public comment over the 90 days ending in September that year. The bill proposes the establishment of an NHI Fund Entity in terms of Schedule 3 of the Public Finance Management Act. This structure will oversee the funding and procurement of the health services of all registered beneficiaries.

Out of the public consultations last year, this bill was enriched with inputs from various communities.

Last month, a revised bill was presented for consideration by the Cabinet. It was approved for submission in the National Assembly to also go through another rigorous parliamentary process. The process will again entail public consultations and will be debated in both the National Assembly and National Council of Provinces.

The bill will only be passed into a law that will serve its intent once all of us have made our inputs, which will be canvassed through those public consultations.

In line with Section 27(1)b of the Constitution, the NHI will be implemented in various phases depending on available resources. An implementation plan will also be put in place to ensure transparency.

The implementation plan of the NHI, together with several key elements still to be put in place, will help reverse inequalities in health care inherited from the apartheid system.

Before 1994, health services were racially segregated and black people were provided with an inferior public health service compared to that of their white counterparts.

There have, understandably, been many varying opinions about the proposed NHI, with some claiming that it will harm the private health-care sector. It is therefore important to state that the NHI will create space for the private and public sectors to complement each other in serving the health needs of our people.

* Williams is the acting director-general at the Government Communication and Information System (GCIS)

** The views expressed here are not necessarily those of Independent Media.

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