Experts have warned the implementation of the NHI could threaten over 130,000 jobs in the public and private healthcare sector, but the Hospital Association South Africa (Hasa) says the devil will be in the details\u2014once we eventually get them.<\/p>\n\n\n\n
In the latter part of 2023, health economist and policy analyst Claire Botha noted that the implementation of the National Healthcare Insurance (NHI) would initiate a restructuring process that could result in provinces losing their health functions and shutting down Health Departments.<\/p>\n\n\n\n
She explained that the implementation process would have similar effects to that of the establishment of the post-apartheid administration in 1994.<\/p>\n\n\n\n
“The 1994 restructuring was characterised by much upheaval, with people being redeployed, retrenched, or retired,” she said. <\/p>\n\n\n\n
Botha added that this would be the case for the NHI because there would be a mismatch between the skills required to run the insurance scheme and those working in public service<\/strong>.<\/p>\n\n\n\n Additionally, she said the Health Department will likely not have the required financial resources to accommodate everybody currently employed in administrative positions in the provinces.<\/p>\n\n\n\n This would likely result in very few public servants being absorbed into the NHI.<\/p>\n\n\n\n She estimated this process would impact around 130,000 administrative staff employed across South Africa’s nine provinces.<\/p>\n\n\n\n The Hospital Association of SA (HASA) noted a similar number of jobs at risk in the private sector during a Business Unity SA (BUSA) meeting in 2019.<\/p>\n\n\n\n