Businesses offer ‘high road’ answer to the NHI
Prominent players in South Africa’s private healthcare industry have called for the government to extend its collaborative efforts with businesses to include health.
This is a so-called ‘high road’ solution to the impasse over the contentious National Health Insurance (NHI) scheme, which is facing ‘low road’ legal challenges that threaten to keep the policy hung up in litigation for the next decade.
Proponents of the ‘high road’ solution say that a public-private collaborative effort could resolve some of the most pressing issues plaguing the country’s public healthcare system, including funding and investment challenges.
This is particularly prevalent as of the 3,092 public healthcare facilities inspected by the Office of Health Standards Compliance (OHSC) only 1,226 or 39.65% comply with the legislated standards, as recently revealed by Health Minister Dr Aaron Motsoaledi.
The ‘high road’ is already a well-travelled path in the country.
In 2023, organised business (comprising about 150 of South Africa’s top CEOs) pledged support to the government to revive a flatlining economy, offering expertise and capital to fix the country’s problems in three key areas: electricity, transport and logistics, and crime and corruption.
In Phase 1, businesses contributed over R250 million in direct funding, deployed 350+ experts, and engaged 57 companies in power station interventions, totalling 9,000 hours to assist Eskom, which helped significantly reduce load shedding.
Additionally, R700 million was invested in transport corridors, 500 security personnel were assigned to Transnet Freight Rail, cutting security incidents by 50%, and R57 million was allocated to establish a forensic analysis centre.
The commitments were recently re-affirmed for South Africa’s new administration, known as ‘Phase 2’.
In recent interviews with Business Day, CEOs of private hospital giants Netcare and Life Healthcare said collaboration with the government could help resolve some of the public sector’s most pressing problems.
“We think there could be similar collaboration (on) healthcare,” said Netcare CEO Richard Friedland.
Life Healthcare CEO Peter Wharton-Hood told Business Day that “I would … commit resources and time to having those dialogues. Let’s get patients in need into facilities that are empty.”
“Co-operation between the public and private sector is the way forward,” he said.
A viable way forward for the NHI?
These comments come as the South African government marches ahead with the rolling out of the National Health Insurance (NHI), which was signed into law shortly before the elections in May 2024.
Very broadly, the NHI is a centralised, national insurance fund from which the government will buy healthcare services from healthcare providers in both the public and private sectors.
However, this has proven contentious; particularly pertaining to the major question marks about how it will be funded.
The act is currently facing three separate legal challenges — from medical schemes, trade union Solidarity and medical specialists.
Regardless, the private healthcare CEOs believe that there are ways forward.
“We face a stark choice between the low road and the high road,” said Friedland.
“The low road is that various parties go to court, and this process is stuck in (court) for five to 10 years, and the high road is that our president galvanises the resources, the know-how and the infrastructure of the private sector together with the public sector, and we find a solution to South Africa’s healthcare issues.
“There are solutions that allow us to begin that process now: that’s the choice that faces us,” he added.
The Life Healthcare CEO said that the group is open to committing resources and time to having those dialogues.
Wharton-Hood noted that many private hospitals are underutilised, while public sector patients experience long wait times for services like cancer treatment and elective procedures.
For example, Netcare, Life Healthcare, and Mediclinic reported in their respective results that their occupancy rate in acute hospitals sits below 70%.
“The capacity in the private sector that is not used should be made available to the state (on commercially viable) terms,” said Wharton-Hood.
It has been reported that President Cyril Ramaphosa is currently considering a confidential alternative proposal on NHI from Business Unity South Africa (Busa), an umbrella body for organised business.
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