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Mixed reactions as President sets to sign the NHI Bill into law, first appeared on Health-E News.
By Yoliswa Sobuwa
The announcement that President Cyril Ramaphosa will, on Wednesday, sign into law the contentious National Health Insurance (NHI) bill has garnered mixed reactions.
Those opposing the bill say their submissions have not been taken into consideration, and that the bill, in its current form, will restrict healthcare access rather than facilitate it. At the other end of the spectrum, those who support the bill say it will improve the quality of health services.
The NHI bill sets the scene for the creation of a fund that the government will use to purchase health services from healthcare providers in both the public and private sector. This is part of the global push towards universal health coverage which “means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship”.
South Africa currently has a two-tiered health system. The well-resourced and pricey private sector caters for around 16% of the population, while the public sector that caters for a majority of the population is underfunded and poorly resourced.
While many agree with the principle of universal health coverage, major concerns have been raised about the bill.
Current bill is “unworkable”
Among the bill’s fiercest critics are health professions bodies such as the South African Medical Association, South African Society of Obstetricians and Gynaecologists, as well as the Federation of South African Surgeons. These organisations, along with six other healthcare practitioners’ associations make up the South African Health Professionals Collaboration which represents 25,000 healthcare professionals.
In a statement, the collective argues that it had made “many submissions and engagement in the NHI parliamentary process”, it even went as far as writing to the “President, urging him to refer the Bill back to Parliament on the grounds that it is unconstitutional and not in the best interest of patients and citizens”. The organisation says all these submissions were ignored.
Speaking on behalf of the collective, Dr Simon Strachan says the announcement that the bill will be signed into law is disappointing.
“Our members have made submissions at every stage of the legislative process, dating back to the release of the green paper in 2011. It is disheartening to see our efforts to contribute to a more robust, workable and patient-centric healthcare system being ignored.
“Where we are now is unprecedented. We believe that the NHI, in its current form will reverse, rather than progress, equitable, quality healthcare in South Africa. We have no doubt that the NHI Bill will be challenged in the courts, and we are currently exploring all our options in this regard,” Strachan says
Business Unity SA, an organisation representing the business people, is considering taking legal action if the bill is signed. Cas Coovadia, CEO of BUSA says the bill in its current form, is unworkable.
“We will pay close attention to the President’s announcement on Wednesday based on which we will consider our options.
“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,” Coovadia says.
He says the business unit fully supports the objective of universal health coverage but the current version of the bill will hamper rather than promote access to quality healthcare for all citizens.
“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,” he says.
NHI bill ensures quality healthcare
Unions representing healthcare workers say it’s about time the NHI bill gets signed.
The Democratic Nursing Organisation of South Africa (Denosa) spokesperson Sibongiseni Delihlazo says it is about time there is justice for access to quality healthcare services for all South Africans, regardless of their socio economic status.
“As Denosa we are consistent in our full support of NHI bilI and we feel that it should be implemented as soon as possible. We were a bit worried when it was taking time for the president to find his pen. This is simply because healthcare workers are the ones dealing with patients on the ground and we witness the challenges,” he says.
He says the money made available through the NHI Fund will ensure that there is enough medication, equipment and resources, and nurses would be able to provide comprehensive care services to the patients.
South African Medical Association Trade Union (SAMATU) has also welcomed the signing of the NHI bill. This is the exact opposite of the stance of strong opposition its parent body the South African Medical Association holds.
The trade union says this historic step represents a monumental shift towards achieving universal health coverage.
SAMATU general secretary, Dr Cedric Sihlangu says the NHI will go a long way to addressing disparities in the current healthcare system.
“This development indicates that the government is cognisant of the inequalities that exist in South Africa’s healthcare system, and is committed to reforming the system, [and] alleviate the burden on our public health facilities while also improving the quality of healthcare services across the board,” he says. – Health-e News
