President Cyril Ramaphosa has entered into a performance agreement with Health minister Dr Zweli Mkhize which includes a hard implementation date for South Africa’s National Health Insurance (NHI).
The performance agreement, which was made publicly available on Tuesday (8 December) for the first time, states that the NHI should be progressively implemented so that universal health coverage for at least 90% of South African by 2030.
As part of this process, the following deadlines must be met by Mkhize:
- The NHI Fund must be established as a public entity and operational by 2021/2022;
- The Fund should begin purchasing services by 2022/2023;
- Through a progressive process, 90% of South Africans should be covered by 2030.
The performance agreements also require Mkhize to prepare all of the country’s necessary clinics and hospitals for the system by 2025.
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.
“I call on the private sector to join government in seeing the NHI realised. To transform the health care landscape to make it more efficient, cost-effective and value for money requires that we forge strong public-private partnerships for the delivery of services,” he said.
“We remain committed to ensuring there is effective consultation and engagement with all sector partners at all stages of the process.”
It is envisaged that NHI will offer all South Africans and legal residents access to a defined package of health services. It is not clear how comprehensive or wide this range of services will be.
That is dependent upon funding available for NHI – that and structures remain one of the biggest questions and challenges.