Despite legal and civil society calls for a more considered process with the NHI Bill, the National Health Department is maintaining a hectic pace, writes MedicalBrief. It has allowed only a four-day window (including a weekend) for nominations to one of the steering committees, while ignoring, so far, calls for the period for public comments to be extended beyond 11 October.
In a Times Select report, Katharine Child writes that with law experts warning of court action if ‘level heads’ do not prevail, the National Health Department is rushing through the appointment of members to an interim steering committee to slug out the details of the National Health Insurance (NHI) Bill. On Friday, 13 September,, a letter from the deputy director of the department, Yogan Pillay, was released asking for nominations for the steering committee of the national benefits committee by Tuesday, 17 September. .
She writes that the rush to appoint an interim steering committee comes as the Helen Suzman Foundation (HSF) requested more time from Parliament’s Health Committee to send comments about NHI. The HSF believes ‘the NHI Bill is far too important and complex to be adequately engaged within this short comment period’. Experts said it was difficult for people to make ‘informed’ comments because the suggested law does not say what type of healthcare services the fund will buy and what it will cost.
MedicalBrief writes that while the HSF said was concerned about the present system's failures, ‘we do not think that there is just one way to achieve the desired outcomes. There are as many ways as there are countries in the world, and then some. Nor do we believe that the government has yet spelled out adequately what it wants to do.
‘The shaping of the system has a long way to go, and much honest and open debate about it remains for the future. We are aware of the complexities of health care, and the possibilities of both market failure and regulatory failure. Some may seek to cut the Gordian knot with a sword, but we oppose peremptory strategies, believing that they will result in more harm than good, especially when it comes to consensus building.’
The non-profit Organisation Undoing Tax Abuse (Outa) has also said that the deadline is too short for such an important piece of legislation, and has written to parliament asking for a 90-day comment period.
In the Times Select report, advocate and former lawyer at Section27 Adila Hassim said the Bill only provided the ‘bare bones’. Medical lawyer Neil Kirby, of Werksmans, said people needed to know what health treatments or benefits would be available, in order to respond to the Bill in an ‘informed’ way.
Head of the NHI office, Dr Nicholas Crisp, was unperturbed, saying an Act of law could not be too detailed because its aim was to create an ‘enabling environment’ for further regulations. Crisp said: ‘It will cost as much as we can afford. Pay what you can, to get what you can get.’
[link url="https://www.timeslive.co.za/news/south-africa/2019-09-16-nhi-has-so-many-holes-its-bound-to-sink-experts-warn/"]Full Times Select report[/link] (Subscription)
[link url="https://hsf.org.za/news/press-releases/20190910-nhi-request-for-comment-extension.pdf"]Full HSF submission[/link]