R4.3 bn wasted on pilot projects shows NHI is a ‘fantasy plan’

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Since 2012, the ANC government has spent R4.3bn on NHI pilot projects to test their readiness, and every single one of them has failed, says Democratic Alliance (DA) leader, Mmusi Maimane.

He spoke during a visit the Eastern Cape towns of Alexandria, Port Alfred and Makhanda (formerly Grahamstown) on healthcare in South Africa.

For a country that spends what we do on healthcare, it is shameful that so many of our citizens do not have access to decent healthcare services. South Africa spends over R220bn across all departments and entities annually. This should be enough to pay for quality healthcare for each and every South African resident, but thanks to corruption, mismanagement and poor appointments, much of this budget is wasted. And as a result, millions of poor South Africans suffer.

The communities I visited this morning in Alexandria have been let down by their government. The nearest hospitals are far away in Port Elizabeth and Port Alfred, and the clinic they have to make do with is completely insufficient. It is small, understaffed and under-resourced. Patients have to wait outside in the wind and rain.

If we want to ensure that the people of Alexandria and Wentzel Park, along with so many other communities like them across South Africa, have access to high quality healthcare near their homes, we have to fix it from the bottom up. We have to ensure that we do the basics right and that all the money spent in the healthcare budget works as hard as possible.

But our government is not interested in doing the basics right. Instead they want to skip this and go straight to a fantasy plan for healthcare that simply cannot work. The same ANC government that collapsed Eskom, SAA, SABC and every other state-owned entity (SOE) through massive corruption and cadre deployment, now wants you to believe that it can deliver a plan that places all healthcare services and budgets in the hands of the state.

They want South Africans to believe that this massive new SOE will somehow be different from all the others, and yet they can’t tell us exactly what healthcare in South Africa will look like under it. They can’t tell us what will still be covered by private medical aid schemes, or whether these schemes will be supplementary or complimentary to the state. And they can’t say where the money will come from. Will citizens be expected to pay more tax? If so, how much more? And where will the rest of the budget come from?

They talk about achieving equality in healthcare in South Africa. But instead of raising the level of public healthcare, the only equality they will achieve is by destroying private healthcare. And this isn’t just negative speculation. We have proof that they can’t make it work. Since 2012, government has spent R4.3bn on NHI pilot projects to test their readiness, and every single one of them has failed. But they now want you to believe that they can implement this nation-wide. It simply won’t happen.

This doesn’t mean that South Africans can’t have access to quality universal healthcare. On the contrary, it can and must happen. But in order to do so, we need to take advantage of what is already there and working, and not tear this down. We need to ensure that we keep our doctors and nursing staff in South Africa and not chase them away. We need to lift public healthcare to the level of private healthcare, not the other way round.

The DA has put together a comprehensive universal healthcare plan, called Sizani, which does just that. It is a plan that will roll out universal healthcare to all citizens in half the time envisaged by the NHI, and within the current healthcare budget.

It is based on a universal subsidy to every South African resident which will cover a comprehensive package of public healthcare services, while also retaining the medical aid system. Where the NHI will have prices set by a ministerial committee and bought by government from only accredited providers, Sizani will see prices kept down through transparency and competition in both the public and private sector.

Sizani will also see improved levels of governance thanks to localising the systems of accountability and decentralising the decision-making and appointment processes. The NHI, on the other hand, places all this control in the hands of the minister. But most importantly, Sizani will offer South Africans the freedom of choice. Whereas the NHI will prescribe to you where you must go for healthcare services, Sizani will allow you to use your subsidy wherever you choose, whether in the public of private healthcare system.

There is a reason why the DA-run Western Cape manages the best provincial health department in the country. It is because the DA believes in accountability, it believes in appointing the best people for the job, and it doesn’t tolerate corruption.

Many of the aspects of our Sizani Plan are already being implemented in the Western Cape, with great success. This is why the province has the lowest mortality rates and the highest life expectancy in the country. The Western Cape also attracts more South African doctors and has the highest number of specialists per resident. It is a system that works, and gets the most out of its budget.

This is what we need to apply for the rest of South Africa, and not some unaffordable, under-resourced and poorly thought through NHI that will see millions of South Africans worse off than they already are. If communities such as this one here in Alexandria are to get the level of healthcare guaranteed in our Constitution, it will require walking away from the NHI immediately, and looking to a plan that we can both afford and implement. A plan like the DA’s Sizani.

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