Professor Alex van den Heever.Picture: Bongani Shilubane/African News Agency (ANA)
Professor Alex van den Heever.Picture: Bongani Shilubane/African News Agency (ANA)

Tough talk by practitioners on inadequacies of NHI

By Rudzani Matshili Time of article published Aug 22, 2018

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THE National Health Insurance (NHI) was not designed to work; instead, it was an aspirational proposal nobody really had to deliver on, but just keep promising endlessly into the future.

And if implemented, both the private and public health systems would deteriorate further, Professor Alex van den Heever, a former senior adviser on the Council for Medical Schemes, warned.

Van den Heever yesterday did not mince his words in his criticism of the NHI during a crisis summit hosted by Solidarity Research Institute in Centurion.

The institute presented its report on research, conducted among 3983 health practitioners.

According to the draft NHI bill, the fund will be the single public purchaser and financier of health services. The fund will also be a “mandatory prepayment health services system”.

But Van den Heever said: “My central concern with the way in which the public and private and health systems are operating is that there are vested interests driving those and the patronage model of governance of the health and private systems is going to continue.”

He said the private sector was also failing and there were people who benefited immensely from this.

“Our problem going forward is that the public and private systems will continue to deteriorate and nothing will change because there is actually no proposal on the table to address what is failing in either of the system and no political world to address those failures.”

Dr Chris Archer, a health care practitioner, specialising in gynaecology and obstetrics, also thought the NHI implementation was a bad idea and needed to be debated.

“I encourage other organisations, particularly the business community to seriously start debating this issue because we have not. Health Minister Dr Aaron Motsoaledi has gone around the country talking, but there is never any opportunity to debate the issue.”

Archer, addressing the impact on specialists and specialist services, said there was not much on the NHI document about specialists.

He said opportunities for corruption would be vast, should it be a success. “NHI proposal is not in the best interest of the people of this country,” he said.

Research psychologist from Solidarity Research Institute Nicolien Welthagen said: “During our research we came to understand our people are not knowledgeable on the NHI. I sent out an electric questionnaire and we did an opinion study. The results were that people don't have the knowledge; 93% of people were concerned they would (not) be able to implement the NHI, how it will be managed and how it will be rolled out.”

The report presents significant findings regarding health care professionals’ knowledge on the NHI, how informed they were, and their opinions regarding the state's ability to implement it successfully.

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