South Africa

NHI Bill won’t change anything – for now

President Cyril Ramaphosa’s signing the National Health Insurance (NHI) Bill into law will not change the status quo of South Africa’s healthcare system for the time being.

This is according to Momentum Metropolitan Health CMO Damian McHugh, who said the implementation of the Bill will take some time.

His comments come after Ramaphosa announced that he will sign off on the controversial health insurance Bill on Wednesday, 15 May, two weeks before national elections.

The NHI Bill is aimed at transforming “South Africa’s health-care system to achieve universal coverage for health services and, through this, overcome critical socio-economic imbalances and inequities of the past”, the Presidency said in a statement Monday, 13 May. 

Parliament’s National Council of Provinces approved the Bill in December and referred it to the President for his assent.

McHugh prefaced his statement by saying the intent to enable access to attain more health for more South Africans is positive, and healthcare is a fundamental right for all. 

“For us to create and implement a national health system to enable this, we must be mindful of the current constraints and ensure that we move forward in an informed and sustainable manner,” he said.

McHugh said that the implementation of the NHI Bill in its current format is not sustainable, and he expects the already documented challenges made by numerous stakeholders to become more vocal, particularly around the constitutionality of the Bill. 

Another key consideration is that the South African economy does not have the required funds to support the implementation of the Bill.

He said that, based on these factors, the current private and public systems should collaborate to better utilise the experience and infrastructure of the private industry to augment the public offering.

This will also ensure South Africa does not lose critical, experienced resources from its health economy.

“Critically, even though President Ramaphosa has signed the bill, the current status quo remains in effect, as the implementation of the Bill will take some time,” he said.

“So, our message to our members and the wider South African community is to continue with your current healthcare arrangements.”

Going to court

DA leader John Steenhuisen

South Africa’s main opposition party, the Democratic Alliance, has already expressed its intention to oppose the Bill in court.

The party said that, upon its signing into law by Ramaphosa, the DA will challenge the ANC’s NHI all the way to the Constitutional Court.

“Our legal team was briefed months ago already and will file our legal challenge against this devasting legislation without delay,” it said.

“We have built up reams of correspondence, including with Ramaphosa himself, that we will enter into evidence to show that the process which led to the adoption of this Bill by Parliament disregarded public input and that the Bill itself is flagrantly unconstitutional.”

BUSA CEO Cas Coovadia has also said the organisation fully supports the objective of universal health coverage. 

“However, the NHI Bill in its current form is unworkable, unaffordable, and not in line with the Constitution,” he said. 

“What is especially troubling is that the President is proceeding with the Bill despite extensive constructive inputs made by a wide range of stakeholders, including doctors and healthcare professionals, civil society, public sector unions, academics and business.” 

Coovadia said the unfortunate consequence is that this version will hamper, rather than promote, access to quality healthcare for all citizens in our country.

“Consequently, we will pay close attention to the President’s announcement on Wednesday, based on which we will consider our options,” he said.

“Our subsequent actions will be guided by our belief that it is essential that we get the NHI right through all means still at our disposal, including appropriate legal interventions, so that the legislation that is finally implemented is in the best interest of our country, and all her people, for generations to come.”