Durban — The government stated that the National Health Insurance (NHI) Bill fund would have a board and various governance structures as required by the Public Finance Management Act (PFMA) and King IV report on corporate governance that will have the responsibility of ensuring that there are institutionalised systems.
There would be policies and procedures that proactively prevented, detected, investigated and corrected incidents/acts of fraud and corruption. The government said this when it was tabling how how it would attempt to prevent corruption once the NHI Bill was implemented.
The bill sought to provide universal access to health-care services in the country in accordance with the National Health Insurance White Paper and the Constitution, the government said. It 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.
This meant every South African would have the right to access comprehensive health-care services free of charge at the point of use at accredited health facilities such as clinics, hospitals and private health practitioners. This would be done using an NHI card. The services would be delivered closest to where people lived or worked.
The government said: “The fund is required by law to establish and operate units that focus on fraud prevention, detection, investigation and correction of fraud and corruption. All employees of the NHI Fund will be responsible for preventing and detecting fraud in the execution of their assigned roles and responsibilities.”
Furthermore, it said the department, in collaboration with the Health Sector Anti-Corruption Forum (HSACF) and the Special Investigating Unit (SIU), was currently engaged in a process of risk identification, analysis and mitigation of all fraud and corruption risks that may affect the Fund.
“The design of the NHI is far less complicated than the present myriad departments and medical schemes. Everything that the fund does, all the contracts with providers and suppliers, and the common set of funded benefits, will be fully transparent. Since every person will be entitled to the same benefits and treated the same way, there is far less incentive for fraud and corruption,” said the government.
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