First phase of NHI under way with nine test areas across the country

Published Aug 5, 2024

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The National Department of Health expects to have 90 Contracting Units for Primary Health Care (CUPs) as part of the first phase of the National Health Insurance (NHI).

This is according to Nicholas Crisp, deputy director-general for the NHI at the Health Department, who spoke at the 28th Annual KZN Doctors’ Healthcare Coalition (KZNDHC) conference on Friday night.

Crisp said Phase 1 started in 2023 and would run until 2026, while Phase 2 will be conducted from 2026 to 2028.

CUPs are areas or units where health care providers in both the public and private sector will use the national digital Health Patient Registration System (HPRS) when treating patients.

“In our planning over the next three years, we want to get from the first nine (CUPs) to 90, to the full country and we think there’ll be somewhere between 400 and 500 CUPs by the time we’re done.”

The department said in KwaZulu-Natal there is a CUP site in Nquthu in the uMzinyathi district, another in Soweto, Thabazimbi in Limpopo, Mahikeng in North West, Steve Chwete in Mpumalanga, Dihlabeng in the Free State, Knysna and Bitou in the Western Cape, Ingquza Hill LM in Eastern Cape and Phokwane in the Northern Cape.

He said the NHI needs to be built using a coherent national digital system where patients’ medical history and treatment can be captured wherever they are in the country by any treating physician.

“There are key components which are already in place but only in the public sector, and some provinces use them better than others,” he said.

Crisp said the department is implementing this in the CUPs in the private providers’ rooms.

Crisp said this is a learning process and the cost would then be worked out in terms of whether additional software would be required or if it could be run on their current practice management system.

When asked how soon eThekwini would be getting a CUP, Crisp said it would depend on what they learn in this first phase and which areas the KZN

Department of Health chooses. “The whole of eThekwini can’t be one CUP. There’ll be several CUPs here because it’s too big. The population is huge here,” he said. Crisp added that based on advice from other countries, South Africa would be implementing a single fund system.

“In the case of the state, you’re looking after the money for the 62 million people who live in the country. So you want to make sure that when you spend that, you spend it wisely,” he said.

Crisp noted that fraud and corruption in the public sector had cost the country billions of rand.

“We have got a lot to be embarrassed about. If you design systems that allow perverse incentives to corrupt and to defraud and to waste then we’re doing ourselves and the patients no favours,” he said.

The Mercury