Parliament, Thursday, 6 February 2020 – Residents of the Cape Metropolitan Municipality came out in high volumes to voice their opinions on the proposed National Health Insurance Bill at public hearings held in Khayelitsha yesterday.

Chairperson of the committee Dr Sibongiseni Dhlomo thanked residents for coming, attributing the large number of people to a robust public participation process in which people have a voice in making legislation. “Each and every submission made today is valuable and carries weight,” said Dr Sibongiseni. He assured the hearing that the committee will take into consideration all views shared.

While a number of people opposed the Bill, the large majority spoke in support thereof. Those is opposition of the Bill believe that the NHI will be another failed state-owned enterprise, while those in support believe that the NHI is a necessity, which would benefit the poor and vulnerable who are unable to afford medical services.

Reasons for support of the Bill was based around the arguments of the poor state of public hospitals, the unethical and uncooperative behaviour of medical staff and the severe shortage of medical institutions, especially in areas such as Khayelitsha, which has a very large population. This support, however, was not without questions and concerns. A number of oral submissions made reference to the powers given to the Minister of Health to appoint the NHI Board, which residents felt should not be constituted without community members, labour unions and other stakeholders, who will be able to keep the checks and balances. They further inquired how the NHI will address things such as the shortage of medical staff and how much it will cost per person to fund the scheme.

Residents who spoke in opposition to the NHI are of the opinion that government does not have the capacity or a clear plan on how to deal with such a large fund. The committee was told that the NHI is merely another method for government to loot from the taxpayers and that the NHI has no guarantee of providing quality healthcare services. The committee heard that the provision of public service should be independent of political interference, as the bill does not guarantee an independent board.

Concerns were also raised about the uncertainty created among medical health professionals, which has led to thousands of doctors and nurses threatening to leave the country. The committee heard that the Bill should provide clarity on the implications of NHI for medical professionals, while also providing clarity on how the thousands of people living with illnesses such as HIV/Aids and tuberculosis will be catered for.

With that said, there was consensus on the need for NHI, as residents are hopeful it will address the many challenges faced at medical institutions in areas such as Khayeltisha. One of the oral submissions heard highlighted the vast difference between hospitals in areas such as Khayelitsha and those in more affluent areas. “NHI will close the gap between the rich and the poor,” said one resident as she proclaimed her support for the Bill. However, she also pointed out that the current state of hospitals needs to be addressed as a matter of urgency.


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