Cape Town - Amid concerns about some aspects of the National Health Insurance (NHI) Bill, the national Department of Health (DoH) has assured provincial legislators about financial governance, patient rights and the consequences of NHI on health-care standards.
DoH officials briefed the provincial Standing Committee on Health and Wellness as part of the bill’s progress through the National Council of Provinces.
NHI Deputy Director General Dr Nicholas Crisp answered questions about the integrity and the coverage of the Fund posed by health standing committee members Thembile Klaas (EFF) and Rachel Windvogel (ANC).
Crisp said NHI was a health financing system designed to pool funds to provide access to quality, affordable personal health services for all South Africans based on their health needs, irrespective of their socio-economic status.
He said: “In a way, the fund is more like Sassa. Money is appropriated through Parliament. It’s paid to the fund and the fund pays it out.”
Crisp said the NHI would not run hospitals or clinics as these functions would be left to provincial and local governments.
“You will run them and if your administration now, or after the elections, embezzles or steals or defrauds or does things with procurement contracts using the monies paid by the fund, the fund will pick it up and will blacklist them.”
He said if health providers were found to be unreliable or thieves, the fund would terminate their accreditation, forcing them to appeal if they wanted readmittance.
He said the bill would give managerial autonomy to health providers and that district hospitals would have more powers to directly employ staff.
“The differences that are brought in by the bill are Groote Schuur or Tygerberg, which you’ve already done in the Western Cape, so you shouldn’t even feel threatened by it, (you) will have more autonomy to employ their own staff.”
Western Cape health department head of operations, Dr Saadiq Kariem, said the department supported the strategic intent of the bill in so far as it helped them achieve universal health coverage.
“Should the bill be signed into law we remain committed to working collaboratively with the National Department of Health in order to achieve the intent of the bill and in order to achieve the intended UHC (Universal Health Coverage) reforms.”
Committee chairperson Gerrit Pretorius (DA) said: “While the goal of Universal Health Coverage remains a noble one, the NHI Bill remains an insufficient and deeply-flawed piece of legislation.
“Given this bill’s potential to cause large-scale disruption to health care in South Africa, I and my fellow committee members will ensure that we interrogate this bill to the fullest possible extent, and seek a meaningful dialogue with the public on its merits.”
Pretorius said the process represented a final opportunity to halt or propose amendments to the bill, and called on the public to come forward in their numbers to make their voices heard during the upcoming public participation.
