EFF's Health Bill underscores 'massive financial implications of NHI'

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Because the EFF’s National Health Amendment Bill has such ‘massive financial implications for the department and the Ministry’, the cost of providing health services “24 hours a day and seven days a week” will need to be quantified before the National Assembly Health Committee proceeds with considering the Bill’s desirability.

This, observes Pam Saxby in Legalbrief Polity Watch, is the gist of a committee media statement on Wednesday’s meeting, when the Health Department briefed members on the context of the proposed new piece of legislation. As Legalbrief Today has already reported, the private member’s Bill was tabled in Parliament in 2018 by the EFF’s Suzan Thembekwayo and appears to focus on primary healthcare clinics.

While its explanatory memorandum does refer to the “additional staff” likely to be required should it ever become law, the Bill’s obvious limitations draw attention to the importance of adequate research when proposing amendments to any statute. In that regard, the department’s presentation document refers not only to healthcare personnel but also to “medical equipment, administration personnel and security”.

It also underscores the significant challenges associated with effectively providing universal access to quality, affordable healthcare and the role of national health insurance (NHI) in that context. In the department’s view, “legislation is not the most appropriate vehicle’ for introducing the level of service envisaged. This is especially noting that – in terms of its obligations under sub-section 4(3) of the principal statute (eligibility for free health services in public health establishments) and South Africa’s Bill of Rights – the department is required to “progressively increase” the number of clinics operating 24 hours a day all week “when the (necessary) resources become available”.

In that regard, the presentation refers to a raft of shortcomings in existing facilities, including inadequate capacity for dealing with emergencies; “space”; and prevailing working conditions. Given South African Law Reform Commission recommendations for amendments to the 2003 National Health Act – and that the NHI Bill now before Parliament “may” necessitate more – an “holistic”, “comprehensive” National Health Amendment Bill would (in the department’s view) be more appropriate than “piecemeal” changes to existing provisions.

 

Providing round the clock services at all government clinics is desirable but completely unaffordable in the current economic climate, the Health Department has told Parliament, according to Business Day.

EFF MP Suzan Thembekwayo has submitted a Private Member’s Bill, seeking amendments to the National Health Act that would compel clinics and community health centres to remain open 24 hours a day, seven days a week.

Most public sector clinics offer services only on weekdays between 7am and 4pm, compelling patients to seek primary healthcare services at hospitals outside these hours. “The Bill in its current form will have massive financial implications,” the department’s chief director for district health services, Ramphelane Morewane, told Parliament’s Portfolio Committee on Health.

“The country is currently under financial stress and would struggle to adjust the current budget against the health requirements as a result of the COVID-19 pandemic,” he said. Thembekwayo previously told Parliament that the EFF had not costed the Bill’s proposals, nor determined how many additional personnel would need to be hired.

 

Full Legalbrief Polity Watch report

 

Full Business Day report (subscription needed)

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