Durban - Opposition parties the DA, IFP and EFF have all rejected the National Health Insurance (NHI) Bill in its current format, saying corruption, inadequate facilities and staff shortages were among the problems in the public health-care sector that the government had failed to address.
The bill moved one step closer to being signed into law after it was passed by the National Assembly on Tuesday.
Michéle Clarke, the DA spokesperson on health, said the party did not support the bill.
“We believe the NHI will never reach its outcomes because of the environment we are operating in. We can’t just take private medical aids out of the situation, we need to form partnerships with private medical aids so that they can assist the capacity within the state. If you take the 9 million people who are currently on medical aid and they now have to use the state facilities, that will add another huge burden to the state.
“We already have infrastructure that is crumbling and are short of medical staff in terms of nurses and doctors.”
She added that the main concern was corruption.
“Despite the ANC’s best attempts to create the impression that the private health sector is to blame for the public sector’s deficiencies, it is the government’s mismanagement, cadre deployment and corruption that has caused, and now perpetuates, the destruction.”
Mkhuleko Hlengwa, the IFP’s national spokesperson, said while universal access to health care was a right, the party believed that the bill would lead to the denial of access to existing health care, rather than promoting the same because of the enormous amount of funding that was needed.
“The IFP remains extremely concerned about the poor state of access to medical health-care services in rural areas and communities. NHI could further limit access to such services through its proposed implementation of referral and accreditation networks, which could exclude specific clinics.”
The EFF also denounced the bill. The party said the passing of the bill was a catastrophic development in the midst of the ongoing collapse of the public health sector. The EFF said it had, on countless occasions, highlighted problematic clauses within the bill and its fundamental position on the development of a funding pool.
“It (the bill) will have no material impact on the lives of those who suffer the inhumanity of collapsing public health care, and will only further entrench the existing inequalities between private and public health-care institutions,” the EFF said.
Professor Saloshni Naidoo, head of the Discipline of Public Health Medicine at the University of KwaZulu-Natal, said the bill sought to ensure that people could access health care as and per their needs at a cost they could afford.
“The principle of universalism is a good one, bearing in mind we have great health inequity in our country, with more than 80% of our population using the public health sector, and a large number unable to access this sector.”
However, she said that in the current state, our public health sector would be unable to cope because most facilities had serious infrastructural challenges and growing constraints on human and other resources within the system.
“Far more discussion is needed on the processes and implementation.”
The Hospital Association of South Africa said that approving the NHI Bill without substantive consideration of the many valid and significant recommendations made during the Parliamentary hearing was deeply regrettable.
“There is broad support for universal access to quality health care. Passing such vast, complicated, risky, and consequential legislation requires confidence, trust, and collaboration among all stakeholders.”
Trade union Solidarity’s CEO Dr Dirk Hermann said they would challenge the bill in court.
“We realised from the outset that the NHI would probably be tested in court. The government’s plans to capture health care are unaffordable and unimplementable. It would lead to a mass exodus of health practitioners from the country.”
Foster Mohale, the Health Department’s spokesperson, said there were many processes to be followed before the bill became law. He said the bill would next go before the National Council of Provinces (NCOP).
“The NCOP will most likely take it to the provinces for public comment, and from there the NCOP will have to approve it before sending it to the Speaker. The Speaker will then give it to President Cyril Ramaphosa for signing in its current form. There are a lot of processes before it comes into operation, and once it is signed it will be implemented in stages,” he said.