Cape Town - More than 12 000 doctors, who are members of the South African Medical Association (Sama), have submitted a 50 000 signature petition to the National Council of Provinces chairperson asking him to stop and listen to their concerns before the NCOP votes on the adoption of the NHI Bill in its current form.
Sama chairperson Dr Mvuyisi Mzukwa said the country’s oldest and largest association of medical doctors had been very involved in the bill’s legislative process from its inception.
“We have made written and verbal representations to Parliament outlining our concerns regarding the bill and its potential implications.
“Regrettably, our views have been largely disregarded, leading to the adoption of the bill by Parliament’s portfolio committee on health in May, and its subsequent adoption by the National Assembly on June 13.”
He said Sama had decided to exercise its constitutional right to petition the NCOP as a last resort.
In the petition, Mzukwa said: “The NHI Bill aims to create a fund, to which taxes will be allocated, and will be controlled by the Department of Health. Medical aid schemes will no longer be allowed to cover medical services.”
Mzukwa said the bill didn’t address the management, infrastructural and staffing issues faced by the public healthcare system and national Treasury had not even agreed to the funding required to implement the bill.
“It is highly likely that the NHI Fund will be mismanaged and will leave all South Africans worse off with poor private and public healthcare systems.”
Responding to the petition, National Health Department spokesperson Doctor Tshwale said the ministry had noted the issues of concern and “believes that they make a huge part of the reform programme that the department is currently undertaking”.
Tshwale said with regard to personnel training, the department, jointly with provinces, was implementing the human resources in health strategy to train and acquire skills of medical officers and nurses to strengthen the system and care.
“All these are mutually inclusive, and are implemented parallel to the process to build the NHI to ensure a good start as it begins to render services.”
Opposition DA health parliamentary spokesperson Michele Clarke supported the Sama appeal to the NCOP.
Clarke said the DA believed that universal healthcare and coverage should be pursued, but the NHI Bill was not the correct mechanism.
She said the biggest problem with the NHI was that the ANC was trying to legislate an idea instead of implementing a thoroughly considered plan.
Clarke warned: “If doctors were to leave in droves, it would have significant and concerning impacts on the country’s healthcare system and the population’s access to medical services.”
Medshield Medical Scheme principal officer Kevin Aron said: “While the NHI could provide universal access to healthcare for all South Africans, it is critical to address several shortcomings to ensure its success.”
Aron quoted statistics from a survey of medical aid scheme members in South Africa 2021, by population group, which showed that only 16.1% of South Africans were covered by a medical scheme due to perceived high premiums.
He proposed a “mixed system” where private and public healthcare co-existed equally.
“It would be a system that allows patients access to quality healthcare from a state provider or a fixed-fee service from private providers regardless of income level.”
He said such a system could be regulated by the Council for Medical Schemes and the Health Professions Council of South Africa and would weed out the issues such as corruption and mismanagement of funds as well as quality pointed out by the bill’s critics.
Bonitas Medical Fund principal officer Lee Callakoppen said: “At this stage the bill is still not clear on what will and will not be offered by NHI and the role, if any, private medical aids will play.”
mwangi.githahu@inl.co.za