The people of the Eastern Cape are calling for urgent implementation of the National Health Insurance (NHI) which they hope will translate the constitutionally enshrined right to health of each and every South African into real access to quality healthcare services to all in the Eastern Cape.

This view was amplified by the majority of the residents who made oral submissions at all the public hearings venues in the Eastern Cape in the municipalities where the Portfolio Committee on Health conducted public hearings on the NHI Bill recently. They have told the committee in no uncertain terms that the discussions and the mobilisation of views on the Bill are over, “now is the time for implementation”.

The Chairperson of the committee, Dr Sibongiseni Dhlomo told the residents that, from the committee’s plan, the process will possibly, be concluded by August 2020. He outlined the plan at all the hearings venues to ensure that the people have a picture of how the process is going to unfold after the hearings.

 He said: “We intend to begin early next year with the public hearings in the remaining four provinces of Gauteng, North West, Free State and Western Cape and after that the committee will consider the submissions of both the written and oral submissions then table a report to the National Assembly for adoption.”

Addressing the health stakeholders on the implementation plans of government on the NHI during the signing of the Presidential Health Compact in June this year, President Cyril Ramaphosa indicated that the government intends to implement the NHI incrementally.

President Ramaphosa said: “This means that once the Bill is passed, we will start to incrementally implement the NHI and by 2025 everyone will be covered. We are determined to work together to overcome our two-tiered health system, which is the major barrier to achieve a universal health system.”  

The residents have a view that the implementation of the NHI is delayed, and the delay according to them compromises the good intentions about the NHI. Making his oral submission on the Bill in Mthatha, Mr Paseka Nontshiza said: “Our people are left on the fringes of healthcare dying out there by treatable ailments and because of poverty they are unable to access quality treatment.”  

Ms Zandile Phakathi of the Buffalo City Metropolitan Municipality said she supported the NHI because it stands for the achievement of the progressive rights of universal healthcare system that are internationally recognised as human rights. “We say healthcare is a human right that everyone is entitled to. We are further saying that this right should not depend on a person’s financial standing,” Ms Phakathi said.

Some of the participants told the committee that there is a need to end the commercialisation and privatisation of healthcare as this was an antithesis to the objective of the achievement of the universal healthcare coverage especially for the poor. Furthermore, some of them called for the Bill to prevent the outsourcing of services as this presented an opportunity for corruption which must be prevented.    

Dr Dhlomo appreciated the commitment shown by the South African Medical Association on the Bill in Mthatha, a commitment he said makes it clear that they are willing to work with the government and health stakeholders to effectively deal with the teething problems that were experienced when the NHI was piloted in the OR Tambo District Municipality.

Also participating in the hearings on the Bill in Mthatha, Mr Zweli Mbambisa of the South African Medical Association (SAMA) said the Bill must clarify how Doctors will be reimbursed during the implementation of the NHI. He asked: “Will it be a salary or through claims system?.” However, despite the uncertainty, he said SAMA supported the Bill because it is intended to achieve universal coverage.

The committee will reconvene at the beginning of next year and go to the remaining provinces, Gauteng, Free State, North West and the Western Cape to conduct public hearings on the Bill.

By Malatswa Molepo
4 December 2019