The ANC has reiterated its commitment to accelerate the implementation of the long-delayed National Health Insurance (NHI) Bill through the finalisation of legislation and creation of a publicly funded National Health Insurance Fund. Eyewitness News reports that addressing thousands of ANC supporters at the governing party’s election manifesto launch at Durban’s Moses Mabhida Stadium, President Cyril Ramaphosa said all South Africans must be able to access quality healthcare regardless of their socioeconomic status or ability to pay.
“To achieve this seismic shift; we must promote social solidarity and work towards the cross-subsidisation of services – where those who can afford to pay more assist those who cannot pay; where the young subsidise the old and where the healthy subsidise the sick.
“The NHI is a chance for South Africans to contribute to the collective health and well-being of one another and extend access to quality healthcare to everyone.”
The report says in December, last year, Cabinet rejected the revised NHI Bill for submission to Parliament after a leaked Treasury letter raised several concerns over the role of medical schemes and provincial health departments, among others. The Bill was then sent back to the Health Department to be reworked and is expected to be back in Parliament this year.
Ramaphosa said for the ANC government to achieve its dream of quality healthcare for all citizens, they will ensure that resources at the public clinics and hospitals are “well managed and efficiently deployed.”
“We are fully aware that the journey to universal health care has to start with deliberate efforts to address the immediate crisis in the public health system to tackle such issues as corruption, poor management of financial resources, human resource planning, training, budgeting, maintenance and upgrading of equipment and infrastructure.”
The report says the president also welcomed Health Minister Aaron Motsoaledi’s announcement in December to spend R2bn to fill more than 5,300 posts for health workers at public health facilities.
Pam Saxby writes for Legalbrief Policy Watch that Ramaphosa used the anniversary statement to confirm the “enabling legislation” for the finalisation of the NHI, although he did not say when.
Saxby writes that the president may have been responding to widespread speculation about the fate of the NHI Bill, which was apparently due to be considered by Cabinet on 5 December but did not feature in a statement on the meeting’s outcomes. According to Health Department spokesperson Popo Maja, it is scheduled to be discussed at ‘a special Cabinet meeting’ this month.
Against that backdrop, the ANC’s 2019 election manifesto notes that “the tabling of the … Bill in Parliament will be a crucial milestone for rolling out funding’ for quality care, which ‘will be free at the point of use’. All South Africans ‘should be covered by … by 2025’. To that end, ‘legislative measures’ will be used to implement the next phase of the NHI programme’ over a five-year period. It will include: creating ‘a publicly administered NHI fund’; rolling out ‘a quality health improvement plan (for) public health facilities, to ensure that they meet the … standards required for certification and accreditation’; and developing ‘a comprehensive strategy and operational plan to address … (NHI) human resources requirements”.
“Building on ‘the outcomes of the 2018 presidential health summit’, which committed government and its social partners to ‘jointly’ tackling the ‘challenges’ implicit in implementing NHI, there are also plans afoot to: ‘consolidate nursing colleges … and orientate their curriculum towards more practical work at the patient’s bedside’; ‘strengthen and expand the Mandela-Fidel Castro programme to supplement the production of much-needed medical practitioners and other health professionals’; and develop additional training facilities at local universities to accommodate an increased intake of medical students. Reference is also made to an improved ‘health information system’. At grassroots level, the number of community health workers will be ‘doubled’, ‘absorbed’ into the public health system and ‘deployed’ to ‘villages, townships and informal settlements’.”
Saxby writes that the manifesto also commits government to developing “a comprehensive policy and legislative framework to mitigate the risks related to medical litigation”. She says it is not clear where (or if) the State Liability Amendment Bill now before the National Assembly’s Justice and Correctional Services Committee features in these plans.
It was previously reported that the Law Society of SA, the Legal Resources Centre and the South African Medical Malpractice Lawyers Association were among a range of stakeholders ‘united in their criticism’ of the Bill during last year’s public hearings. A second round is expected to take place soon after Parliament reconvenes.