Health minister Joe Phaahla says that the government will take its time to carefully and transparently implement the National Health Insurance (NHI) scheme once it becomes law in South Africa.
This follows the passing of the NHI Bill by the National Council of Provinces (NCOP) on Wednesday (6 December), by an ANC-led majority.
Phaahla said that the department will continue to engage with stakeholders, continually assess and evaluate the scheme and regulations, and – most importantly – won’t rush through the implementation of the complex and highly controversial system.
These assurances stand counter to the feedback from healthcare professionals, hospitals, legal experts, analysts and private businesses, who feel that the bill was passed in haste while ignoring their pressing and legitimate concerns, inputs and submissions.
Meanwhile, the health minister feels that more than enough was done.
“We recognise and appreciate the role that proactive stakeholder engagement plays in the implementation of such an important policy and legislative reform,” Phaalha said.
“That is why we have developed and adopted a comprehensive approach to stakeholder engagement to ensure diverse perspectives are considered as we move on. Continued collaboration with all stakeholders, transparent communication, and a phased approach to implementation are crucial components of our strategy.”
The health minister said that the next step of the process is for President Cyril Ramaphosa to sign and promulgate the bill and make it an Act of Parliament.
He assured the public that this does not mean the full bill will be in effect and that it will only be the launch of the long road ahead.
“Our intention has always been to have a rational, structured and phased approach implementation,” he said.
However, the signing of the bill into law will lay the foundation for establishing the NHI Fund, which will ostensibly be the home of the billions of rands the government will need to draw from taxpayers to finance its lofty goals.
The specifics of how this will be accomplished are still a mystery, with no apparent answer forthcoming from anyone in government.
The health minister even acknowledged this as a challenge – among many others, such as health workforce capacity and the integration of existing, in some instances parallel, healthcare systems, which have posed “complex issues”.
Regardless, according to Phaahla, the actual implementation of the bill’s various provisions will be pending until specific sections of the Act are proclaimed as law – so these challenges will be gradually addressed.
“Without the accompanying regulations, directives, and operational procedures, the transformative impact of the Act cannot be realised. The Constitution empowers the President to set different dates for the effectiveness of various provisions within the Act,” he said.
Following the establishment of the NHI Fund, the minister will be tasked with setting up the NHI Fund board and related regulations, which will face their own public consultation process and challenges.
Ultimately, however, the minister vowed that as the process moves forward, “(the government) remain(s) steadfast with the implementation of NHI, guided by Constitutional values and the principles of social justice and the right to health.”