Parliament – Health Minister Aaron Motsoaledi on Tuesday told Parliament he was prepared to defend the proposed National Health Insurance (NHI) "with my life if necessary".
Tabling his department's budget, Motsoaledi said his department has already spent over R40 billion on infrastructure and R1.7 bln on equipment in 10 areas deemed "pilot projects" for government to prepare for the introduction of NHI.
"Within the 10 pilot districts, we have completed the building of 34 new and replacement clinics and we are busy with 48 others. This will be a total of 82 new and replacement clinics," the minister said.
"We have also separately put up consulting rooms for doctors who visit our clinics on a contract basis. We have completed 142 of them and are still busy with 21 others to give a total of 163 doctor consulting rooms."
Some of the successes listed by Motsoaledi include, among others, putting in place electronic systems to keep track of patients, managing drug stocks, and to allow patients to access their medicaiton via pick up points to ease congestion at public healthcare facilities. A "unique patient identifier" system has been successfully piloted.
The system is aimed at keeping track of patients' medical records, irrespective of which clinic or hospital they attend. Registering people on the system is being done at a rate of 80 000 to 100 000 per day. "This programme as of 10 May 2017, has now reached 1 859 clinics, 705 of which are in the NHI pilots. Honourable Speaker, as I am speaking now, 6 355 759 South Africans have registered in this system in preparation for NHI," the minister said.
"Honourable Members, this Unique Patient Identifier is linked to your ID number in Home Affairs and is a cradle-to-the-grave number. This means as soon as you register, you will keep it until you die. If a newborn baby is registered today, that is their number in our health facilities for the rest of their life."
Motsoaledi quoted his former counterpart in the finance portfolio Pravin Gordhan, saying the NHI fund would come into operation this year and may be partially funded through reducing tax credits to medical scheme members.
"The tax credits mentioned in the February 2017 Budget Speech by Treasury is a whooping R20 billion. Yes, R20 billion that in 2015 and annually will leave the fiscus through [the South African Revenue Services] SARS back to the pockets of people simply because they are members of a medical aid scheme," he said.
"Taking so much money back to rich people is like sending coal back to New Castle when you have a neighbour without a simple fire to cook their food. How do we as public representatives, honourable ones for that matter, justify this type of thing happening in our country under our watch?"
Motsoaledi debunked notions that the NHI will resemble a medical aid, saying the latter only catered for 16 percent of the South African population, while the rest of the populace was deprived of access to quality healthcare.
"We are proposing that the first step towards implementation of NHI is to pick up those who are outside the system of medical aids and provide services for them through the NHI Fund which must be created from among others the R20 billion tax credits," he said.
"Please note, this R20 billion credit given to all who have joined medical schemes is separate from the R26.7 billion which is the total of all medical aid subsidies due to all who work for the State – including the honourable members here. I have not as yet even touched that R26.7 billion but I am talking about the R20 billion tax credits."