Mixed views on NHI implementation plan, draft regulations to be published

Political parties and medical bodies have expressed mixed views on government’s implementation plan for the National Health Insurance (NHI). Picture: Armand Hough Independent Newspapers

Political parties and medical bodies have expressed mixed views on government’s implementation plan for the National Health Insurance (NHI). Picture: Armand Hough Independent Newspapers

Published Dec 28, 2024

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THERE has been mixed reactions from political parties to government’s plan to move ahead with the implementation of the National Health Insurance (NHI) with a board expected to be appointed next year.

ActionSA posed a parliamentary question to the Department of Health on what specific targets and benchmarks have been set for the implementation of the NHI.

In response, the department said that Phase 1 of the implementation of the National Health Insurance is for a period of four years from 2023 to 2026.

A board is expected to be appointed by November 2025, while draft regulations are expected to be published soon for public comment.

The department said that the associated costs are part of the current Medium-Term Expenditure Framework (MTEF) allocations to the department for this period of Phase 1, including conditional grants.

Speaking on the Power 987 radio station recently, Health Minister Aaron Motsoaledi said the regulations had been delayed by issues of interpretation.

He added that it was too early to assign a specific cost to the NHI.

The cost and funding of NHI has been the main bone of contention for some political parties while other parties said that the process is taking too long.

Alan Beesley, ActionSA MP, said that the party believed that there were too many uncertainties and unknowns pertaining to NHI, including the costing and funding thereof.

“As such, the appointment of a board by November 2025 would be extremely premature, and if it goes ahead, it will be another case of an enormous waste of scarce resources.”

Beesley added that even by August 2025, there will be no fund for the board to oversee.

Steve Swart, African Christian Democratic Party (ACDP) MP, said that while the party noted the announcement of a board for the NHI next year, the ACDP is on record as opposing the NHI.

“In our view, it amounts to an expropriation of private health care. The NHI has not been adequately costed and would be susceptible to corruption should it be implemented. We believe that there should be a national dialogue on access to universal health care, but that in the meantime, resources should rather be allocated to improve public health services which are in a dismal state.”

Michele Clarke MP, DA spokesperson on health said work was being done to bring other acts in line with the NHI.

Clarke added that to date, there has been no list of procedures that will be allowed by the fund, and she questioned what would happen if the fund does not provide a particular service.

“NHI has serious constitutional concerns regarding the right to access to health care, trade and occupation of medical aids, and freedom of association.”

Vuyolwethu Zungula, president of the African Transformation Movement (ATM), said that the department was stalling and delaying the processes.

“It is as if it wasn’t ready for implementation, which is odd because the bill was signed into law ages ago. Universal healthcare is critical in ensuring all people get decent and quality healthcare.”

Dr Cedric Sihlangu, South African Medical Association Trade Union (Samatu) general secretary, said that the union was encouraged by the continued advancement towards the implementation of NHI.

“We once again underscore our unwavering belief that the NHI is the key to liberating South Africans from the inequalities of the current two-tier system. The NHI symbolises a pivotal shift towards fairness and equality, promising to dismantle the barriers that have long hindered access to quality healthcare for all South Africans.”

Sihlangu added that it was with great optimism that Samatu acknowledged the minister of health’s commitment to appoint the board of directors for the NHI by November 2025.

“A crucial milestone that signifies a unified vision for equitable healthcare in our nation. We believe that this pivotal step will signify the importance of the NHI as the expertise of the appointed board would further catalyse the objectives of the NHI.”

The minister confirmed that Phase 1, focusing on the roll-out of electronic medical records, is currently under way, having commenced in November 2024.