In a pragmatic move to tackle one of the most pressing problems confronting public healthcare, the Treasury has shifted unspent National Health Insurance funds to provinces so they can fill critical posts. Business Day reports that the development is consistent with the emphasis President Cyril Ramaphosa has placed on tacking the crisis in healthcare, and suggests a pragmatism about NHI in the face of the problems gripping the sector.
“Implementing NHI is a policy priority for the sector. However, the government needs to address staff shortages and other problems in public health facilities before the policy can be fully rolled out,” the Treasury said in its budget review.
The report says speaking ahead of his budget speech, finance minister Tito Mboweni said one of the most pressing issues is the poor state of public hospitals. “There is nothing difficult about getting a hospital to run properly – it’s management. Don’t get caught up too much in conceptual debates.”
The report says he struck a practical note in his speech when he turned to health, saying: “We need simple, effective interventions. We need more doctors and nurses.” The Treasury has moved R2.8bn out of the NHI indirect grant over the next three years to fill critical public-healthcare posts, including interns and community service positions. This will be achieved through a new human resource capacitation conditional grant, which means the funds are ring-fenced and provinces cannot use them for other purposes.
An extra R1bn has been added to the provincial equitable share in 2021/2022 to fund the permanent appointment of interns, while a further R1bn has been added to improve pay for community healthcare workers and bring their remuneration in line with the minimum wage.
The report says, according to the Treasury’s chief director for health and social development, Mark Blecher, the NHI indirect grant includes programmes for mental health, school health and contracting with private-sector GPs. Barely 10% of the R2.3bn allocation for 2018/2019 had been spent by October, and spending has remained slow since then.
Business Day report