Ramaphosa implementing NHI paints a ‘cautious’ optimistic era for new government, despite financial concerns

President Cyril Ramaphosa says, over the next five years, the GNU is set to fix and strengthen health infrastructure, train more health personnel and infuse technology in the Health Ministry. Picture: GCIS

President Cyril Ramaphosa says, over the next five years, the GNU is set to fix and strengthen health infrastructure, train more health personnel and infuse technology in the Health Ministry. Picture: GCIS

Published Jul 22, 2024

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President Cyril Ramaphosa says as the National Health Insurance (NHI) Bill is coming into implementation, the new Government of National Unity (GNU) will strengthen health infrastructure, train more health personnel and infuse new technology for quality health care in the next five years.

The NHI Bill was signed into law in May to ensure equal, free and universal access to healthcare services in spite of one’s social class. The bill bridges the gap between the poor and affluent for healthcare accessibility.

Political and public healthcare analyst, Nonhlanhla Masuku, told “The Star” that the president’s plans to revitalise health structural issues was stepping into a “cautious” optimistic era as the success of the department is highly dependent on a well-run multiparty government.

“The feasibility of the GNU’s initiatives to strengthen healthcare infrastructure, is contingent upon effective collaboration and commitment from all coalition partners. There is cautious optimism that this unified strategy will lead to meaningful improvements, though sustained political will and transparent implementation will be critical to achieving these goals. While the challenges are significant, the collective approach aims to address these structural issues holistically,” said Masuku.

The DA has been contesting the NHI, alluding it is unsustainable and will financially infringe on the economy. Among other concerns raised, the bill is likely to affect taxpayers and private healthcare providers, in spite of the Health Ministry receiving a budget increase.

The Department of Health was allocated R62.2 billion, a 3.5% increase from the previous financial year’s R60.1bn.

Although Minister of Agriculture and DA leader, John Steenhuisen, supported Ramaphosa’s address on Thursday, he told media outlets that his party was prepared to head to court and challenge some elements of the NHI.

“There are differences of opinions on the best way to achieve the NHI, how to fund it and whether you need to remove the choice for citizens around the private healthcare sector.

“The courts will be our last resort. We are in government now, we have a forum where we can negotiate and our voice can be heard. There are elements of the NHI that are good, but there elements we also disagree with, which we seek to refine and begin the rollout of fixing primary healthcare facilities, and ensure people obtaining healthcare services from the state, get quality services,” said Steenhuisen.

Parties opposing the NHI are justified, arguing the financial sustainability towards free healthcare is under question, including the ANC mismanaging state entities and failing to fix dilapidated health infrastructure, said Masuku.

She added that the DA’s concern stems from budgetary constraints amid a financially-stretched economy.

“They, DA, advocate for a more pragmatic approach that strengthens existing healthcare infrastructure and ensures fiscal responsibility, rather than a wholesale overhaul that risks unintended economic and social consequences,” said Masuku.

Additionally, without a robust implementation strategy and efficient management, the NHI could indeed become a costly endeavour for the department, potentially leading to economic pressures, said Masuku.

Health Minister Aaron Motsoaledi lamented that South Africa falls under the spectrum as one of the most unequal societies globally. He therefore, told Parliamentarians that contesting the NHI robs the poor of a basic service of health care.

He also said issues of the bill can be “ironed out”.

Masuku hailed the minister for moving the NHI to phase 2, as “it signals a significant step toward achieving universal and free health care in South Africa, potentially heralding a more equitable era,” she said.

Motsoaledi announced the NHI will be implemented in phases, noting the rest of the building blocks in the ministry will “easily fall into place”.

In spite of positive changes in the NHI, Masuku raised concerns about the gradual fall of the private healthcare sector, which could result in the affluent and stakeholders exiting the country, further burdening taxpayers and a possible unstable economy.

“The gradual implementation is designed to mitigate disruption, but concerns persist about the potential erosion of the private healthcare sector, which could drive wealthy individuals and professionals out of the country, exacerbating brain drain and economic instability,” said Masuku.

The Star

hope.mafu@inl.co.za