The South African Medical Association (SAMA) has warned that thousands of doctors will leave the country ahead of the planned introduction of the National Health Insurance (NHI).
The not-for-profit group, which represents the interests of more than 12,000 medical doctors in South Africa, said that its members cannot support the NHI in its current form.
This is because of a deep-rooted lack of confidence in the capacity of government and its financial ability to ensure the success of the service, it said.
A survey conducted by SAMA showed that as many as 38% of its members plan to emigrate from South Africa due to the planned introduction of the NHI.
6% of members said that they plan to emigrate for other reasons, while 17% of doctors said that they were unsure about leaving the country.
Other points that were raised by doctors surveyed include:
- There is doubt that national government is capable of running the system;
- The NHI will not address the failings in infrastructure and management in the public sector;
- The NHI is extremely open to corruption and the minister of health has too much power;
- It is not affordable.
A number of doctors said that the focus should first be on fixing the public sector to a point where it can begin to appeal to private sector patients.
They added that there should be engagement with private doctors to provide additional services funded by the state. The group also called for a proper pilot of the proposed systems and payment mechanisms.
“SAMA is committed to the cause of universal health coverage in South Africa,” it said.
“We have actively engaged in discussions and projects for the improvement of the conditions for patients in both the public and private sectors, quality initiatives, policy discussions and advocated where crises have manifested in service delivery to the country.”
The group said it was committed to serving the patients of this country and improving the levels of quality of care patients receive.
However, it warned that many of the proposed reforms, new structures and changes in governance and accountability have not been tested or explained in a policy document.
“We, therefore, cannot support the NHI bill in its entirety, nor the multiple structural and functional reforms and new entities, units and agencies which are proposed.”
Government has been criticised for shrugging off comment and submissions around the NHI that do not speak in favour of the system. Some groups say they have been unable to effectively comment on the scheme as many of the regulations – such as which services will be covered and how the scheme will be funded – have not yet even been determined or made public.