South Africa

NHI Bill may destroy entire healthcare system

Implementing the National Health Insurance (NHI) Bill in its current form may end with the destruction of the entire healthcare system as it will not work in its current form. 

This is feedback from the South African Health Professionals Collaboration (SAHPC) spokesperson, Simon Strachan, who told 702 that people have to ask serious questions about the NHI Bill in its current form. 

The SAHPC represents over 25,000 healthcare professionals across South Africa and has been formed to ensure that the NHI Bill is not implemented in its current form. 

“We have got together because we feel like we have just not been heard, even though we have individually participated in every opportunity given to us. We are hoping in this last collaboration that we can be heard,” Strachan said. 

“We are very worried that it will result in much poorer quality of care and much worse access to healthcare, and we are really concerned that it could end up being the destruction of the healthcare system.”

In its current form, the NHI Bill is unworkable as it is fundamentally more of a funding model rather than a policy to improve healthcare in South Africa. 

“This is not going to work in its current form. It has only got this far because healthcare professionals have not been heard, despite our best efforts,” Strachan said. 

He urged the government and the private sector to find a solution where both parties can contribute to providing high-quality healthcare to all South Africans. 

This cannot be done through the NHI. It has to be done by bolstering the existing healthcare infrastructure and building out the public sector’s capacity to provide better healthcare to existing patients. 

Wits professor Alex van den Heever

Strachan’s critique is similar to that of Professor Alex van den Heever of the University of the Witwatersrand. 

Van den Heever said the NHI, in its current form, 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 den Heever. 

He said it is “far too complex for this government to achieve”, and 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 (ANC) to score political points and is “not a true, public interest-oriented health reform”. 


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