Latest news with #NHIFund
IOL News
02-06-2025
- Health
- IOL News
WC the only province to raise objections to NHI Fund draft regulations
THE ANC in the province says the Western Cape Government's rejection of the draft National Health Insurance (NHI) regulations reflects a political choice to defend privilege rather than fix inequality. The province is the only in the country to have raised objections to the draft governance regulations relating to the implementation of the NHI Fund. Health MEC, Mireille Wenger said the Western Cape Cabinet had approved comments from the provincial department of Health and Wellness expressing 'strong objections to the draft governance regulations'. The NHI is a centralised, national insurance fund designed to provide universal health coverage. It aims to ensure all South Africans have access to quality and affordable healthcare services, regardless of their socio-economic status. The draft regulations seek to provide for the establishment of structures and processes for the governance of the fund. It represents the first formal step towards establishing the NHI Fund, to centralise all healthcare funding under the national government, said Wenger. 'While the Western Cape Government supports the constitutional imperative to realise the provision of universal healthcare, it remains concerned that the NHI model in its current form - will weaken existing healthcare systems and reduce the ability of provinces to deliver responsive and accountable services to residents. The draft governance regulations provide for detailed matters pertaining to, amongst other things, the appointment of a board and CEO for the NHI fund. 'In terms of Section 55(1) of the NHI Act, the National Minister may only make regulations after consulting both the National Health Council - which includes all nine provincial health departments and the national department - and the NHI Fund. Should the Minister make regulations without consulting the fund, the regulations will be invalid. Should the Minister wish to proceed to issue the draft regulations without consulting the fund, it will first be necessary to amend the Act to remove the requirement for consultation with the fund. 'The Act specifies the matters on which the Minister is empowered to make regulations, however these do not specifically include 'governance' and hence could be ultra vires to the Act and invalid,' she said. According to Wenger they were also concerned about the minister's powers to appoint and remove role players, 'without sufficient checks and balances to prevent maladministration'. ANC leader of the opposition in the provincial legislature, Khalid Sayed said they supported the NHI and its full implementation. "The ANC fully supports the implementation of the National Health Insurance as a bold step towards ensuring that no South African is denied access to quality healthcare due to their income or location. 'The Western Cape Government's rejection of the draft regulations reflects a political choice to defend privilege rather than fix inequality. Instead of fearmongering about governance, we should be working together to build a just and inclusive health system for all—rural or urban, rich or poor. The people of this province deserve better than two-tier healthcare. The ANC remains committed to making universal healthcare a reality," said Sayed. National health department spokesperson Foster Mohale said the Western Cape was the only provincial government that had raised objections. 'Only Western Cape has raised objections. How does the Minister consult a Fund that does not exist on regulations that will allow for processes to bring it into existence? The regulations do not mandate any power for the Minister that is not already provided for in the Act. What they do is to require absolute transparency in that process. We hope that the Western Cape government has actually commented on the contents of the draft regulations so that their comments can be accessible to the public,' Mohale said. Wenger said the Western Cape Government will submit its formal written comments on the draft regulations in due course.
IOL News
29-04-2025
- Health
- IOL News
Unmasking SAMA: the real motivations behind their NHI court challenge
Mr Kgaile Mogoye works for the National Health Laboratory Services (NHLS) responsible for National Health Insurance. He is also a member of Progressive Professionals Forum (PPF) The South African Medical Association (SAMA) has initiated a legal challenge against the National Health Insurance (NHI) Act, claiming it poses a significant threat to the healthcare system. However, SAMA has yet to clearly articulate its real motives for rejecting the NHI, and their approach appears more rooted in fear of the unknown than in substantive concerns. Throughout the extensive public consultation processes surrounding the NHI Bill, nearly every province and the overwhelming majority of South Africans supported its enactment. Yet, SAMA has consistently failed to specify what they fundamentally oppose about the NHI. Their assertions, particularly concerning the administration of user registration, seem alarmist and exaggerated - suggesting that such a process could collapse the entire NHI system is sheer absurdity. The country already has a comprehensive database of all citizens through the Department of Home Affairs, with advancements in biometric systems that will further enhance the reliability of this system. The National Department of Health already operates a health patient registration systems (HPRS) and HMS2, which have digitised patient records. Regulation can ensure a seamless transition of data from medical schemes to the NHI. Currently, most medical scheme users are subsidised by their employers and enjoy tax credits, meaning their information is readily available. A simple transition of this information into the national patient database managed by the NHI Fund should not warrant threats of impending collapse or claims that it will take years to achieve. The logic simply does not hold. Assertions that the handling of complaints about poor service delivery by the NHI Fund as 'wholly inadequate' seems to conveniently overlook the existence of a well-functioning digitised patient complaint system. Every complaint is directed to the relevant provincial authorities, who follow up with districts and facilities. This system promotes accountability, ensuring that healthcare facilities address and resolve complaints while keeping the complainants informed. Certainly, no system is perfect, and a quick look at complaints handled by the Council for Medical Schemes against private medical schemes reveals significant inadequacies in the private sector. As the Health Market Inquiry noted, there are serious issues regarding information asymmetries, where patients sometimes struggle to understand what their risk pools cover. The NHI simplifies this by creating a single risk pool that promotes transparency. Regarding their claims about the "lack of clarity" on covered services in the act, it's clear that SAMA misunderstands legislative processes. Acts inherently provide a broad framework, with finer details defined through subsequent regulations. Expecting the NHI Act to outline every detail is misguided, revealing an alarming lack of understanding - or worse, a blatant dishonesty in their intentions. The act clearly states that a Benefits Advisory Committee (BAC), comprised of experts, will be tasked with defining the service package. The NHI governance regulations have already been published, detailing the BAC's appointment and functions. Instead of constructively engaging with these regulations to improve any perceived flaws, SAMA has opted to rush to the courts in an attempt to undermine legislation that enjoys support from the majority. Ironically, their concerns about "impossible accreditation standards" are quite rich. Their leadership seems to suggest that striving for high-quality care is something to be frowned upon. Yet, they simultaneously lament poor service delivery, which the NHI aims to address and improve through the Office of Health Standards Compliance. This discrepancy raises questions about SAMA's true intentions. I suspect that SAMA's leadership does not genuinely represent the views of its membership, who will benefit from predictable patient volumes and alternative reimbursement models such as capitation. There's an undercurrent of an elitist's perspective within SAMA, concerned that the NHI will disrupt certain commercial interests. The growth of universal health coverage - widely supported globally, including by the World Health Organization - poses a threat to those invested in the lucrative private healthcare market. For these individuals, healthcare must remain a commodity to be exploited for profit. Any noble efforts towards universal access to quality services, based on patient needs rather than financial ability, will be resisted. Looking beyond the smokescreen, it is evident that SAMA's legal challenge against the NHI is nothing but a tactic to protect commercial interests. It is not a legitimate concern for the quality of healthcare in South Africa. The NHI represents an important step towards equitable healthcare for every citizen, without risks of financial hardship in accessing services. Efforts to subvert it, particularly through unfounded claims, are neither constructive nor in the public interest. * Kgaile Mogoye works for the National Health Laboratory Services (NHLS) responsible for National Health Insurance. He is also a member of Progressive Professionals Forum (PPF)
IOL News
26-04-2025
- Health
- IOL News
Health Department stands by NHI education budget despite calls for reallocation
In defence of spending on NHI advertising, Deputy Minister of Health Joe Phaahla said it is as important as possible in terms of how the Department of Health assisted South Africans to get a fair amount of information. Image: Oupa Mokoena / Independent Newspapers The South African Health Department is standing firm in its commitment to promoting the National Health Insurance (NHI) scheme, even as voices arise, urging a reallocation of funds to address other pressing health needs. Deputy Minister of Health Joe Phaahla has emphasised that the government's strategy surrounding NHI education is not simply a binary choice of either funding allocation or prioritisation of other health initiatives. During a budget presentation to the Health Portfolio Committee, Phaahla outlined that the current opposition to NHI is multifaceted, involving not merely legal challenges but also a broader effort to win the hearts and minds of South Africans. 'The pushback on NHI implementation is not only in courts, but is a battle of the hearts and minds of South Africans. It is important as much as possible in terms of how we assist South Africans to get a fair amount of information. It is neither this nor that,' Phaahla said. He made the statement when the department presented its budget during the meeting of the Health Portfolio Committee on Thursday. The NHI took centre stage during the meeting, with DA MP Michele Clarke noting that Health Minister Aaron Motsoaledi still planned to spend another R10m on NHI advertising. Clarke was of the view the funding could be used toward the treatment of HIV in the wake of the recent withdrawal of US aid funding. In its presentation, the department said there were processes under way in preparation for the NHI Fund. This included the essential equipment list that was to be finalised. 'This is focusing on primary care level as well as accreditation level to be used to accredit service providers that are to participate in NHI,' the department's head of planning unit, Koketso Sebanyoni, said. Sebanyoni also said that as part of NHI preparations, they would track the number of patients actively receiving medication. 'We hope this number can increase to 3.5 million in this financial year.' She added that work was being done on developing the integrated electronic health record system. 'We envisage we will finalise the second phase on the primary care package,' Sebanyoni said. The department said out of its R64.6 billion budget, NHI will be allocated R1.4bn. There was R2.4 billion allocated in the NHI indirect grant for health facilities revitalisation and R7.2bn for the NHI conditional grant. There was also R466m allocation for the contracting of additional health professionals. MPs wanted an update on the appointment of the NHI board and the funding mechanism for the NHI and overburdening of the country's health care system by illegal foreigners, among other things. The department was receiving comments from stakeholders on the regulations that were published in March on the proposed governance regulations of the NHI Fund.
