NHI Bill constitutional and won't lead to corruption - Mkhize

Health Minister Zweli Mkhize. File picture: GCIS/Twitter.

Health Minister Zweli Mkhize. File picture: GCIS/Twitter.

Published Aug 29, 2019

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PARLIAMENT - Health Minister Zweli Mkhize on Thursday said the government had assurances that the controversial National Health Insurance Bill was constitutional and vowed to work to disprove fears that it would lead to corruption and cripple the country financially.

Mkhize was facing questions about the bill in the portfolio committee on health amid warnings from several sides that it was ripe for constitutional challenge. 

Chief state law adviser Ayesha Johaar told MPs the bill was certified on July 29.

She said state law advisers viewed it not only as being in line with the Constitution but written to give effect to the right to access health care services enshrined in Section 27 of the Constitution.

"Everyone has the right to access health care services... this bill must then be regarded as a measure designed to give effect to a right enshrined in the Constitution."

The DA earlier this month called on Parliament to say whether the bill had been certified as unconstitutional.

DA leader Mmusi Maimane said it was his view that the draft law may not pass constitutional muster, because it centralised health care services and eroded the powers of provinces in this regard.

Maimane also described the bill as a plan to create another state-owned enterprise, at a time when Eskom's woes has put in question the government's ability to run parastatals.

Mkhize this week told the media that government would handle the implementation of the NHI cautiously and had no intention of bankrupting the country.

On Thursday, he told MPs that the measure was in line with "the principle of social solidarity" by which South Africans took care of each other.

He said it was evident that many of the fears voiced regarding the bill were engendered by the state capture scandal and its impact on utilities like Eskom.

But he sought to give assurances that that a new national health service would be based on successful models implemented in other countries and cleanly run.

"It has made South Africans very nervous, even of things that are procedurally correct. It is actually very unfortunate in this instance because this structure we are using has been benchmarked against many other jurisdictions.

"And I think we must commit that we must work to ensure proper governance and proper administration, because that is what we owe that to our people... We do accept that there is a real concern about corruption."

The bill gives effect to a resolution adopted by the ruling party in 2007.

It is aimed at addressing the imbalance in the health care system which sees 84% of the population rely on an understaffed public system while 16% have access to private health care.

Olive Shisana, President Cyril Ramaphosa's special social policy adviser, rejected suggestions that the national health service as envisioned in the bill would prove unaffordable. 

She said the service would be rolled out using money allocated to health at the moment, with a manageable funding gap foreseen to occur in the medium term.

"We want a system that is affordable, a system where people's rights are respected but at the same time it does not bankrupt the system."

Shisana added that primary health would be "the heartbeat of the NHI".

The proposed system is encountering opposition in part because once it is in place, private medical aid schemes will only be allowed to cater for health services not available to clients on the NHI. Critics say this will make medical aid membership several times more expensive than it already is.

Shisana defended the bill's provisions in this regard, saying allowing medical aid to offer basic health care services would make for needless duplication.

"We are creating a single fund we do not want to create a situation where there is duplication of services the population is offered.

"In the long run if we want to have sustainability we have to move into a complementary system."

African News Agency (ANA)

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