Parliament, Saturday, 01 February 2020 – The Portfolio Committee on Health has concluded its first leg of the three legs of public hearings on the National Insurance (NHI) Bill in the North West Province, where the Bill received mixed views from residents with a clear balance between those who support and those who do not support the Bill.

Both sides in the public hearings, those in support and in opposition, highlighted the threat of corruption which will undermine the effective functioning of the NHI fund, and which will, eventually diminish the intentions of the Bill. According to the majority view, the unintended consequences of a corruption riddled NHI fund would render the envisaged healthcare system unable to cope with the demands of the population.

Those in support of the Bill urged the committee to ensure that the governance system on the implementation of the NHI including the fund is strengthened to deter and protect the fund against corruption. Those who oppose the Bill pointed out that the Bill is not convincing on anti-corruption measures and strategies to prevent the fund.

On the creation of boards that are envisaged in the Bill, the residents called for the boards that will be representative of the people on the ground, and the boards that will promote public involvement in the implementation of NHI.

The current state of State Owned Entities, such as Eskom, South African Airways and Prasa was highlighted by the people of Rustenburg as an example of failed state led intervention and the basis of pessimism for the failure of NHI funded healthcare system even before it begins.

The participants concurred that access to quality healthcare was sacrosanct and improvement in the healthcare system is urgent to achieve universal healthcare coverage as per the World Health Organisation’s Alma Ata declaration 0f 1978. Furthermore, they called for fixing of the current healthcare system, and that the government ensures that healthcare challenges that are encountered at primary healthcare level are resolved.

They urged the government to resolve the challenges by eradication of long queues at clinics and hospitals, providing adequate staffing at clinics and hospitals and extension of operating hours at primary healthcare facilities.

Some participants were of the view that NHI is the strategic tool to transform the health sector in South Africa. Others viewed the NHI as limiting the right of choice which is enshrined in the Constitution.

Those in support of the NHI argued that cross subsidisation was necessary to ensure greater equity in relation to access to quality healthcare, and that according to them, will ensure that all qualifying beneficiaries receive quality healthcare irrespective of their social and financial position.

Those who do not support the NHI questioned how the NHI is going to be funded, given the reality of the prevailing difficult economic conditions, high rate of unemployment and the overstretched limited tax revenue base.

Representatives of traditional healers emphasised the need to include indigenous healthcare system and to recognise the important role of traditional healers in the NHI legislation to ensure that the envisaged healthcare system is inclusive.

Regarding cost of healthcare, it was emphasised in some of the oral submissions that NHI was welcomed primarily because it will be a single purchaser of healthcare services which will standardise the cost of healthcare enabling equal access especially for the poor through the creation of a single healthcare system.

Also, the residents emphasised that because healthcare is a human right, everyone should have access to it and that should not depend on a person’s financial status.

The Chairperson of the Committee, Dr Sibongiseni Dhlomo, assured the residents that the committee will consider all the submissions and views at a time to be determined by the committee. “All your contributions will be thoroughly and objectively considered by the committee,” said Dr Dhlomo.


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