Finance Minister Enoch Godongwana has thrown the ball into the Health Minister's court, saying if he wants money for the implementation of National Health Insurance (NHI), then he needs to come up with a figure.
Unless a price tag has been attached to the NHI, he can’t budget for it, Godongwana said.
While Godongwana was unable to table his budget over a Value-Added Tax (VAT) proposal impasse with Government of National Unity (GNU) partners last week, he told the media there needs to be considerable improvement of health facilities before a national health insurance can be introduced.
EWN reports that conflicting reports emerging from Cabinet before the State of the Nation Address on how NHI implementation would be accommodated in the Medium-Term Development Plan (MTDP).
Godongwana has said estimated costs to date have all been based on guesswork.
“Minister (Aaron) Motsoaledi must submit a document to government saying how he plans to roll out the implementation … so that all of us can be able to engage with it and understand the full cost … over what period.”
He said “several” health facilities currently don’t meet the threshold of what’s required for universal healthcare, and the untabled Budget proposes a costing exercise to build more hospitals.
"The infrastructure has to be upgraded, substantially, for hospitals to be able to be compliant with the NHI – that’s where we are in terms of the costs.”
The proposed budget aims to fast-track upgrades by increasing the number of bid windows from one to four.
Godongwana was also going to announce that R29bn of this money would be used to keep more than 9 000 healthcare workers in hospitals, allow for the employment of 800 post-community service doctors, and keep pharmacies stocked.
Meanwhile, Motsoaledi has “wasted” R28m of taxpayers’ money on advertising the NHI Act, the DA has fumed, calling the R3m spent every month since April last year “a vanity project”.
Motsoaledi had revealed the figure in a written reply to a parliamentary question, reports The Citizen.
But party spokesperson on Health Michele Clarke described the campaign as propaganda meant to force the implementation of the Act, despite concerns from some members of the (GNU), and called for an end to the campaign.
The money, she added, could have been spent on hiring more doctors and nurses.
“The Minister claims there are no funds to fill the 2 000 vacant medical positions in public hospitals… thousands of qualified doctors and healthcare professionals are unemployed or underemployed.
“It is unconceivable that this government, which cannot provide basic healthcare services to its people, chooses to splurge millions on advertisements that promote an unrealistic, unimplementable healthcare scheme.”
The Minister also noted that the R77.8m allocated in 2019/20 for NHI advertising through the tainted Digital Vibes company was repurposed in 2022 for Covid-19 communication. “This sum is the matter of investigation by the Special Investigation Unit (SIU),” he added.
According to the SIU, Digital Vibes was appointed in 2019 to perform NHI communication services. This was extended to cover Covid-19 communications. Altogether the department allocated about R150m to the company in what the SIU found were irregular procurement processes.
‘Necessary’
Asked whether R28.5m was perhaps an excessive amount, Health Department spokesperson Foster Mohale said it was not, given what was very expensive television advertising. It was necessary to have a broad reach of advertising using a variety of platforms to reach as many people as possible, he added.
Business Day also asked Mohale why it was necessary to promote NHI: “NHI is the policy of government. Just like other policies of government we have to raise awareness. We have to make people aware of the benefits and the intended benefits of this policy.”
“The billboards that decorate our highways, social media and other advertising celebrating the NHI are a slap in the face to every SA taxpayer who is already shouldering the burden of a failing healthcare system,” responded Clarke.
BusinessLIVE – Health department spends nearly R30m on NHI advertising
The Citizen – Health minister slammed for exorbitant spending on NHI advertising while doctors and nurses are unemployed
See more from MedicalBrief archives:
Pinning down the real cost of the NHI: SA tax expert
No plans yet for NHI funding through taxes – Treasury
Motsoaledi must come clean on NHI funding
IRR: Government must tell us what the NHI will cost and where money will come from
Reprieve for medical aids with NHI 'breakthrough'?