Parliament, Monday, 24 February 2020 – The residents of Soweto and the Greater Johannesburg Metropolitan area have informed the Portfolio Committee on Health that they support the National Health Insurance (NHI) Bill. They support it because of its potential to deal with the current healthcare sector, which seeks to maximise profits instead of the wellbeing of South Africans.

The issue of affordability of quality healthcare, especially for the poor and unemployed, was raised by most participants. “The issues raised by residents confirm the findings of the Health Markets Inquiry by Justice Ngcobo, which disproves the fallacy that only public hospitals are dysfunctional and private hospitals are providing best services. The people have said to us that we must finally eradicate the inhumane practice of profit-making at the expense of human life, which they are hopeful that NHI will bring,” said Dr Sibongiseni Dhlomo, the Chairperson of the committee.

Most participants also raised concerns about the effective implementation of the NHI, to ensure that benefits reach the envisioned recipients. Concerns raised included that South Africa has good policies, yet they are ineffective because implementation is either slow or non-existent. “It is unacceptable that service delivery continues to be a major concern for our people, especially when there has been regulatory framework and funding made available to ensure service delivery. Consequence management should be the leading mantra in the roll-out of NHI,” Dr Dhlomo said.

Support for the NHI was also predicated on the need to fix many challenges facing the public healthcare system, such as small primary healthcare facilities that handle ever-increasing number of residents, the availability of medication, and need to increase the number of medical practitioners. Others suggested that for the NHI to be successful there must be a resolution on the legislative powers of the Minister of Health and MECs, especially reporting lines between MECs of Health and the Minister.

The role of traditional health practitioners in the NHI was also raised as an issue of concern, especially because of the Bill’s silence on the matter.

While the majority supported the Bill, some vehemently opposed it. One of the major concerns for those against the Bill is the ambiguity in the Bill’s funding model. Furthermore, concerns were raised that the current tax base was limited and already struggling under ever increasing demand.

Other concerns related to a perception that the Ministry of Health has too much power in the appointment of the CEO and Board that are expected to drive the governance of the NHI fund. Concerns about corruption and the NHI was also raised as an issue, leading to many people withholding their support for the Bill.

“We have listened to all views and will take into consideration all views raised by the people of Soweto and Gauteng in general when we deliberate over the Bill. Furthermore, we will invite the Gauteng Health Department to give a report-back on issues raised by community members on challenges they face on a daily basis when visiting healthcare facilities,” Dr Dhlomo said.

The committee will today conclude its Gauteng public hearings in Germiston town hall. Following the conclusion of the public hearings, the committee will engage stakeholders and organisations that made written submissions to receive oral submissions from those organisations. This will form the last phase of public participation of the Bill at National Assembly level.


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