NHI implementation makes a mockery of democracy

The process followed to implement the National Health Insurance (NHI) Bill was inadequate and made a mockery of participatory democracy.

This is the view of Martin Kingston, chairman of Business for South Africa, who told Class Business that the NHI Bill has several constitutional flaws.

This comes after the National Council of Provinces recently passed the NHI Bill without any amendments, despite many concerns and suggested changes from several stakeholders.

The Bill is currently with the President, who must decide whether to assent to the Bill or send it back to the National Assembly to make amendments. 

Kingston said there are several constitutional flaws in the NHI Bill as currently drafted. 

He expressed his support for universal health care in South Africa but said it needs to be implemented responsibly and in a viable manner.

“And at the moment, we consider it to be both unconstitutional and unimplementable,” he said.

He believes the Bill in its current form limits citizens’ freedom of choice and their ability to access healthcare.

In addition, he said it would materially delay access to universal health care if the amendments B4SA and other stakeholders proposed are not affected.

“There wasn’t a single input or amendment from any stakeholder either with respect to the National Assembly or with respect to the National Council of Provinces that was considered and incorporated – not one,” he said.

According to Kingston, this includes comments from the National Department of Health, which suggested amendments that needed to be made.

“We think that the process that was followed was inadequate,” Kingston said.

“In fact, it makes a mockery of a participatory democracy when you ask for comments and not one of them from any stakeholder is taken into consideration.”

“The NEDLAC process was not followed through, and the processes we’ve seen to date were rushed and inadequate.”

Kingston believes the Bill should be sent back to the parliamentary process with all the inputs received, including those from the private sector.

He said this would allow the government to – in a responsible, transparent and thoughtful way – implement a fit-for-purpose national health process that affords universal healthcare to the population at large.