The largest medical practitioner representative body in South Africa has asked the National Council of Provinces (NCOP) to vote against passing the National Health Insurance (NHI) Bill in its current form.
The South African Medical Association (Sama), which represents more than 12 000 doctors, has sent a written submission to Amos Masondo, the chairman of the NCOP, along with a petition signed by more than 52 000 people, urging MPs to reconsider the bill’s provisions.
The NCOP is considering the NHI Bill, which was passed by the National Assembly in June. The bill must be passed by both houses of Parliament before it is submitted to the president for assent.
The bill was preceded by two policy documents: a green paper published in August 2011 and a white paper published in December 2015.
“The reason we have written the petition is we have been ignored since the discussions on the green paper,” Sama’s chairman, Dr Mvuyisi Mzukwa, said. “We have been making submissions, but there has never been any consultation or feedback.”
Sama’s main concerns with the bill include:
- The focus on a funding model without addressing human resource shortages and infrastructure issues in the public healthcare system;
- The risk of corruption;
- A lack of a cost assessment; and
- The restrictions on medical schemes.
“We believe that the Department of Health’s attempt at addressing some of the abovementioned issues in a statement released by the South African Government News Agency on 5 July 2023, after the adoption of the bill in the National Assembly, is itself an indicator that the bill, in its current form, does not address those concerns, as a clarifying statement by the department would otherwise have not been required,” Mzukwa said.
“As the final house of Parliament that will decide on the adoption of the bill before it is signed into law, we implore the NCOP to consider the concerns raised in this submission.”
Opposition to the bill was not limited to healthcare workers, as evidenced by the signatories to the petition, he said. “It is also communities. People don’t trust the government.”
The government’s poor track record in service delivery has left communities sceptical about its assurances that NHI will provide better health care.
“I was born in Flagstaff in the Eastern Cape. In my village, there is still no water; it was promised in 1994. Now the government tells them it will give them a healthcare service under NHI. Yet there is not even a clinic. Communities there say there is no truth to this thing,” Mzukwa said.
In an interview with Newzroom Africa in June, Mzukwa said the NHI Bill was being used for electioneering and not necessarily to ensure South Africans’ dire need for health care was met.
He said the “ideal” healthcare service envisaged by the bill bore no resemblance to the reality of the public healthcare sector, which was characterised by a shortage of healthcare workers, delipidated hospitals, and poor working conditions.
