South Africa

Doctors will not work under NHI

Trade union Solidarity said that its research shows that doctors in South Africa are unwilling to work under the new National Health Insurance (NHI) scheme, with many saying they will leave the country. 

Solidarity’s medical sector coordinator Peirru Marx spoke to Newzroom Afrika about the controversial NHI Bill passed by the National Assembly last week. 

Marx said that NHI could not work because it is practically and financially unfeasible. Moreover, it will not result in better healthcare for South Africans. 

Nationalising private healthcare to form one healthcare system with a single-payer will not increase healthcare standards in South Africa. 

According to Marx, The NHI will give everyone equal access to equally bad healthcare provided by the government. 

The government cannot manage the current public healthcare system, which makes it highly unlikely that it will be able to incorporate the private sector into the existing system. 

The existing public healthcare system is riddled with poor governance, deteriorating infrastructure, and staff shortages. 

South Africa has only 0.3 doctors per 1,000 people and 4.6 nurses per 1,000 people. According to international standards, South Africa should have 8.5 nurses per 1,000 people. 

Marx estimates the current deficit of healthcare workers to be around 60,000. 

This makes implementing the NHI Bill even more puzzling for Marx, as Solidarity’s Research Institute (SRI) has done research indicating that doctors will leave South Africa if NHI is implemented. 

This will exacerbate the existing shortage of doctors in the country. 

“My phone has not stopped ringing since the Bill was passed, with doctors and specialists saying that they will not work under NHI”, Marx said. Many of them said they would leave the country. 

Solidarity has stated its intention to fight the NHI Bill in court as they believe the Bill is unconstitutional. 

NHI will not be implemented

Professor Alex van den Heever of the University of the Witwatersrand has said that the government’s NHI Bill will take 1,000 years to implement as it is “far too complex for this government ever to achieve”.

He said that the proposals contained in the Bill are financially and institutionally impractical.

The government aims to consolidate the public and private healthcare systems into a single system that does not yet exist.

This consolidation is to be done by a department and a government that cannot run state institutions effectively, according to Van der Heever.

He said it is “far too complex for this government to achieve”. Parliament only passed the Bill to give the impression that the government is doing something.

In reality, the Bill is “merely window-dressing health reform and is not substantive”, Van den Heever said. The can will just be kicked down the road, and “nothing of substance will happen”.

NHI in South Africa has become a political tool for the ruling African National Congress to score political points and is “not a true, public interest-oriented health reform”.


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