Why doctors in South Africa would rather shut their doors than suffer the NHI

 ·13 Dec 2023

Explaining why they would rather close their practices than work under the controversial NHI bill, doctors and specialists in South Africa say it’s about the lack of freedom more than anything.

The NHI bill was recently approved by the National Council of Provinces (NCOP), and it now only requires President Cyril Ramaphosa’s signature to become law.

Daily Investor reported that Peirru Marx, network coordinator of Solidarity’s medical networks, said medical doctors who are members of the Solidarity Doctors’ Network vehemently oppose the NHI bill.

“Our research shows that medical professionals do not support the NHI. They do not want to be part of it – adding that many healthcare practitioners have witnessed how corruption, deterioration and mismanagement hamper the public healthcare system.” Marx said.

A study conducted among doctors by the Solidarity Research Institute (SNI) found that they would leave the country in large numbers if the NHI was implemented.

  • 94% of respondents believe private health practitioners may decide to work abroad because of NHI.
  • 47% indicated that they would start the emigration process as soon as the NHI is accepted in South Africa.
  • 19% said that they had already initiated the process to emigrate.
  • 0% of medical practitioners are optimistic about the NHI.

He further noted that South African doctors and specialists announced that they would rather close their practices than work under the government’s National Health Insurance (NHI).

Speaking to eNCA, an Economic Researcher at the Solidarity Research Institute, Theuns du Buisson, said while the funding mechanism is the main concern for the public and economists, for doctors, the main issue is the lack of freedom for practitioners in the bill.

“There are major concerns; not just funding, but the freedom that they are currently granted in the current system.

“The current system does grant medical practitioners, in this case mostly doctors and specialists, the opportunity to decide whether they would like to be employees, have their own practices or work in the private sector.

“Whereas, under the NHI, they would no longer have those options, and they would all have to work where the state tells them to work,” said du Buisson.

Du Buisson added that the NHI bill would also hurt the freedoms afforded to specialists – who specialise in specific and important procedures – and they would be forced to abandon those specialities and would have to focus on what the government tells them to do.

“It has even turned out that what they’re specialised in would no longer be covered in the NHI scheme, forcing them to resign their practices,” he said.

The concerns raised by these doctors echo those of other medical professionals and business groups that responded with varying degrees of outrage at the passing of the bill by the NCOP.

These groups, Solidarity, and others have all called for President Cyril Ramaphosa to reject the Bill in its current form and send it back for reconsideration.

Read: Big NHI reality check from Discovery CEO Adrian Gore

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