COSATU welcomes the release of the long-awaited NHI Bill. The National Health Insurance remains the best vehicle to usher in Universal health coverage. The NHI bill seeks to establish the NHI fund and set out its powers, functions and governance structures to provide a framework for the active purchasing of health care services by the fund on behalf of the final users. The Bill also sets out to create mechanisms for the equitable, effective and efficient utilisation of the fund’s resources in order to meet the needs of the population and to limit undesirable and unethical conduct in relation to the NHI fund.
The South African health system is in urgent need of an overhaul in terms of its financing arrangements, management and the ability to deliver quality healthcare services. There is a general consensus that the health system is dysfunctional, and that the quality of the health services is poor. Access to quality health services often depends on one’s geographic location, race, employment status, income level, gender, and where the healthcare services are delivered: public or private health sector. The inequality in the financing and provision of health services between public and private sectors as well as provincial and district variation has a detrimental impact in terms of the well-being of the population.
The unequal distribution of health spent in South Africa and the deteriorating state of public health care necessitates the implementation of the NHI. Ours is a society that has no option but to muster the courage, to make resources available, to develop institutions and technical capacity and to mobilise the masses of the people to confront our four concurrent epidemics comprising poverty-related illnesses such as infectious diseases (including HIV/AIDS and TB), maternal and child deaths, non-communicable diseases and violence and injury.
COSATU together with like-minded organisations has on an ongoing basis called for the speedy release of the NHI Bill as a step closer towards the realisation of quality health care for many vulnerable groups. Unfortunately, a few organisations with very deep pockets continue to fund the narrative that the NHI is a threat to economic growth and jobs, this narrative, unfortunately, takes us backwards and deny the poor and the working class of their fundamental right to quality health care. President Ramaphosa is providing leadership and stewardship on the NHI implementation process and has reiterated the commitment of the entire South African government to overcome the two-tier health system.
The Federation would like to take this opportunity to welcome the Minister’s efforts to reorganise the Department of health to support the implementation of the NHI as expressed in the Minister’s Maiden budget vote as health minister. The NHI has the potential to massively reorganise the entire health system and requires the National Department of Health as the custodian of national health policy to encompass the required capacity to provide policy direction to the provinces.
The Federation supports the initiative by the Minister to build the capacity of managers to implement the NHI by utilising bilateral agreements with countries that have made a national health insurance sustainable. This move will allow for the building of sustainable local capacity.
We further welcome the establishment of an NHI task team at Nedlac that will be tasked to discuss the NHI bill. This will allow COSATU and its affiliates to strengthen their calls for the implementation of the NHI as initially envisaged at the 2007 ANC Polokwane policy Conference and the 54th National Conference of the ANC. This process will allow social partners (labour, business, community and government) to have a closer look at the finer details of the revised bill and receive clarity on the insertion of any new clauses.
COSATU cannot emphasise enough the urgency in the implementation of the NHI in the face of the quadruple disease burden as well as the triple challenge of poverty, unemployment and inequality. As COSATU we pride and count ourselves amongst the torch-bearers in terms of the role that we have played over the years through our policy advocacy and mass-driven campaigns in advancing and defending the NHI and the course of the realisation of the right of access to health care services to all in line with section 27 of our Constitution
Issued by COSATU
Sizwe Pamla (Cosatu National Spokesperson)
Tel: 011 339 4911
Fax: 011 339 5080
Cell: 060 975 6794