South Africa’s National Health Insurance (NHI) plan won’t be taking shape any time soon as the government needs to lay its hands on around R200bn to rehabilitate dilapidated hospitals, says Health Minister Joe Phaahla – who has finally admitted the money won’t be available in the short to medium-term.
In response to a written parliamentary question from EFF MP Suzan Thembekwayo, who wanted to know if the Minister had considered not rushing the implementation of the NHI and instead was paying attention to the infrastructure challenges, Phaahle repeated that the roll-out would be done in phases.
The NHI emerged as an ANC conference resolution more than a decade ago but despite there being a Bill in Parliament, the Treasury has yet to provide details on how the scheme will be financed.
Phaahla also conceded the enormous infrastructure challenges faced by hospitals countrywide, reports News24.
“It is indisputable that public hospitals need infrastructure maintenance and investment. The department quantified the anticipated cost at close to R200bn, which is clearly not going to be available in the short to medium term," he said.
Clause 57 of the Bill states that despite anything to the contrary, the NHI must be implemented over two phases, and also provides for the health system’s strengthening initiatives, such as addressing infrastructure challenges to be undertaken during the transitional period.
While the NHI Bill states broadly that the system will be funded by taxes such as personal income tax and VAT, given the country’s struggling economy, Treasury has been reluctant to raise any taxes. In fact, since 2020, it has been shifting funds allocated to the NHI to other uses, citing slow spending. In the February budget of 2022, the NHI was hardly mentioned.
The DA welcomed Phaahla’s admission, having repeatedly asked for a financial feasibility study. Minister of Finance Enoch Gondwana last year practically confirmed the NHI is a pipe dream when he said the cost model would not automatically translate into budget allocations, according to a DA statement.
Despite the ANC’s continuous denial in committee, Health Ombud Professor Malegapuru Makgoba did in fact state that “with the level of inspections and certification we have done so far … I suspect most of the hospitals will not meet the high standard required of the NHI”.
Oversight visits countrywide have revealed the extent of the decline, with some facilities like the Pelonomi Hospital in the Free State and Livingstone Hospital in the Eastern Cape bordering on human rights violations – with little to no consequence management from the Department regarding these serious concerns as well the various and varied allegations of millions of rands of corruption.
The public health sector’s woes do not end with infrastructure failings. Staff shortages, surgery backlogs, medicine and supply stock-outs, the dire effects of load shedding on health facilities, broken and outdated equipment, maladministration and corruption are just some of the myriad problems crippling hospitals and clinics countrywide.
See more from MedicalBrief archives:
Government dodges issue of NHI funding model – DA
Budget: NHI funding on hold as Gigaba goes to tax committee
NHI — a funding model masquerading as a delivery system
Funding ‘still the biggest stumbling block’ to NHI