The National Education, Health and Allied Workers’ Union [NEHAWU] welcomes the signing of the Presidential Health Compact and calls on South Africans to defend the National Health Insurance Act.
On 15 May 2024, President Ramaphosa signed the National Health Insurance [NHI] bill into law, marking a watershed moment in South Africa’s post-apartheid history. The NHI Act is a radical and progressive step towards government fulfilling a Constitutional obligation, in particular, Section 27, Subsection 1. This legislation also lays the foundation for the realisation of Universal Health Coverage [UHC], ensuring that every citizen of South Africa has access to free, quality and accessible healthcare.
The NHI Act and the commitments contained in the Presidential Health Compact also mark a radical shift from the inequalities manifested through the current two-tiered health system. The Presidential Health Compact sets out ten key health pillars which government commits to address; key amongst them is Pillar One which compels the state to augment Human Resources for Health [HRH], a pivotal aspect in ensuring that the UHC is realised.
NEHAWU regards the signing of the Presidential Health Compact as an oath to workers, the poor and our communities. It is a commitment to alter the inequalities in the healthcare system by ensuring that that the eight percent of Gross Domestic Product [GDP] allocated to health is not diluted through the continued resource bias towards the private healthcare system. As it stands only sixteen percent of the South African population have access to private medical insurance, this leaves eighty-four percent of the population reliant on the public healthcare system.
The union has been militantly consistent in decrying the neglect and mismanagement of the public healthcare system, largely as a result of National Treasury’s persistent and inhumane fixation on budget cuts to healthcare in the form of Neoliberal austerity measures. Austerity has led to inadequate and crumbling public healthcare infrastructure, ten thousands of critical posts being left vacant and scores of young medical graduates being left without placement.
During the height of the COVID-19 pandemic, it was public sector healthcare workers that were at the forefront of combating the disease, as well as the Community Healthcare Workers [CHWs] who were deployed in communities, risking their lives in attempting to mitigate the spread of COVID-19. Despite being overwhelmed, understaffed and experiencing burnouts, doctors, nurses and other healthcare workers in our public hospitals and clinics bravely remained committed to the care and treatment of our people. Yet despite this, National Treasury and the current Minister of Finance has not shown the respect due to these workers nor the political will to support and champion NHI and UHC. We have a growing youthful population experiencing rising levels of diseases related to socio-economic stress, over fifty thousand people die of tuberculosis every year in South Africa, these deaths and the rising diseases associated with socio-economic stress and deteriorating nutrition are all preventable.
Whilst NEHAWU commends the President’s commitment to implementing NHI and the eventual realisation of UHC and, in full support of the ten key pillars contained in the Presidential Health Compact, we urge heightened vigilance in the defence of these progressive pieces of legislation and commitments. The Presidential Health Compact was meant to be signed last week but, due to the immoral stance of Business Unity South Africa [BUSA] as well as other forces opposed to NHI and UHC, the signing of the compact was postponed.
NEHAWU would like to remind workers, our communities and South African society as a whole that the NHI Act went through extensive public scrutiny and rigorous debate. Both as the White Paper and legislation it underwent a thoroughgoing process of consultation at NEDLAC, it was endorsed by two Presidential Health Summits, it was overwhelmingly welcomed and championed in two sets of public participation processes and passed through that National Assembly and National Council of Provinces. BUSA and their anti-poor accomplices were present and participated in all of these democratic platforms, yet they leverage their capitalist muscle with the President by sponsoring all sorts of nefarious and dishonest vitriol with regards to the affordability and future functionality of NHI. The real reason why there has been such a well-orchestrated and highly funded pushback from the anti-NHI and anti-UHC elements is their unfettered selfish greed. They will bolster their attempts to discredit this radically transformative legislation because they derive billions of Rands in profit from the current unequal two-tiered system. Executives in the Private Healthcare system accumulate millions of Rands every year, the disproportionate allocation between private and public healthcare is the inequality that BUSA and their allies seek to maintain.
NEHAWU therefore calls on government, workers and our communities to be forthright in the defence of the hard-fought NHI Act. We will mobilise our members, our communities, civil society, doctors and medical staff in defence of NHI and towards the eventual realisation of UHC, we will join government and the National Department of Health in defensive litigious action that seeks to stall or derail the rollout of NHI and we will continue to expose the real rational behind BUSA and their allies distain for the health and well-being of our people.
We further wish to reiterate the importance of ensuring that the commitment to incorporate all the CHW’s into permanent employment by government be immediately undertaken. Lastly, NEHAWU calls for an end to the inhumane and nonsensical fixation on Neoliberal austerity measures by the National Treasury.
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Issued by NEHAWU Secretariat.
Zola Saphetha (General Secretary) at 082 558 5968; December Mavuso (Deputy General Secretary) at 082 558 5969; Lwazi Nkolonzi (NEHAWU National Spokesperson) at 081 558 2335 or email: lwazin@nehawu.org.za