South Africa pushes ahead with NHI – expects next milestone in February 2021

The coronavirus pandemic shows how a private-public sector partnership resulting in a collaborative healthcare system can be effective, says Health minister Dr Zweli Mkhize.

In a briefing last week, the health minister said that this is important in preparing for a future based on the principles of Universal Health Coverage and the new National Health Insurance (NHI).

“The pandemic also showed the need for the public and private healthcare sectors to work together,” he said. “This is one of the core principles of the NHI.”

Mkhize has increasingly called for attention to be turned back to the NHI as the country refocuses after the pandemic.

“The pandemic brought home the stark realities of the shortcomings of our current system. Indeed, it crystallized the importance of the tenets of the NHI and the fact that we have actually delayed implementing a system that is absolutely crucial to enable us to respond quickly,” he said.

However, it is clear that the pandemic has a had a direct impact on the NHI – including the work of parliament which is currently sorting through a mountain of submissions on the NHI bill.

Parliament’s portfolio committee on Health said it will now appoint an external service provider to deal with the number of public submissions its has received around the planned National Health Insurance.

In a meeting on Tuesday (13 October), the committee dealing with the bill said that it plans to submit a report on the comments by February 2021.

While the deadline for submissions closed at the end of November 2019, the committee has battled to grapple with the sheer number of submission received, with just 1,031 out of 32,217 hand-delivered submissions scanned, validated and captured.

Commenting on the actual submissions, the committee said that it received varying responses around the introduction of the new NHI.

The majority of the submissions made during the provincial public hearings support the bill in its current form. The committee said that a similar picture emerges with the hand-delivered submissions.

By comparison, the email submissions give a contrasting picture and show that a number of people do not support the NHI in its current form.

There are also questions about how the NHI will be funded by cash-strapped South Africa.

Modelling shows that an additional 88,000 additional primary healthcare workers will also be needed by 2025, and that the number of medical specialists also needs to increase significantly to keep up with demographic and epidemiological changes.

Funding this shortfall of workers would cost upwards of R34 billion to cover salaries.

It is not yet clear how the coronavirus and influx of submissions will impact the roll-out of the NHI.

In February, President Cyril Ramaphosa said that government will not be ‘reckless’ in implementing the NHI and that the Department of Health should prepare adequately for the implementation of the system.

“We will implement it in an incremental fashion and aim to cover the whole country by 2025. We will use an affordable approach to progressively move towards a comprehensive NHI environment,” he said.

Ramaphosa further called on the private sector and citizens to mobilise behind the NHI, to see it implemented.

Read: The coronavirus pandemic shows that South Africa’s NHI will work: Mkhize