NHI Bill’s tabling ‘crucial’ – ANC manifesto

President Cyril Ramaphosa used the 8 January ANC anniversary statement (EWN) to confirm that ‘enabling legislation’ for national health insurance (NHI) will be finalised – although he did not say when. This is with the aim of ‘ensuring’ that ‘everyone has access to quality health care, regardless of their ability to pay’, CompliNEWS contributor Pam Saxby reports. The President may have been responding to widespread speculation about the fate of the NHI Bill, which was apparently due to be considered by Cabinet on 5 December ( Business Day), but did not feature in a statement on the meeting’s outcomes. According to Health Department spokesman Popo Maja, it is scheduled to be discussed at ‘a special Cabinet meeting’ this month (City Press).

Against that backdrop, the ANC’s 2019 election manifesto notes that ‘the tabling of the … Bill in Parliament will be a crucial milestone for rolling out funding’ for quality care, which ‘will be free at the point of use’. All South Africans ‘should be covered by … by 2025’. To that end, ‘legislative measures’ will be used to implement the next phase of the NHI programme’ over a five-year period. It will include: creating ‘a publicly administered NHI fund’; rolling out ‘a quality health improvement plan (for) public health facilities, to ensure that they meet the … standards required for certification and accreditation’; and developing ‘a comprehensive strategy and operational plan to address … (NHI) human resources requirements’.

Building on ‘the outcomes of the 2018 presidential health summit’, which committed government and its social partners to ‘jointly’ tackling the ‘challenges’ implicit in implementing NHI, there are also plans afoot to: ‘consolidate nursing colleges … and orientate their curriculum towards more practical work at the patient’s bedside’; ‘strengthen and expand the Mandela-Fidel Castro programme to supplement the production of much-needed medical practitioners and other health professionals’; and develop additional training facilities at local universities to accommodate an increased intake of medical students. Reference is also made to an improved ‘health information system’. At grassroots level, the number of community health workers will be ‘doubled’, ‘absorbed’ into the public health system and ‘deployed’ to ‘villages, townships and informal settlements’.

The manifesto also commits government to developing ‘a comprehensive policy and legislative framework to mitigate the risks related to medical litigation’. It is not clear where (or if) the State Liability Amendment Bill now before the National Assembly’s Justice and Correctional Services Committee features in these plans. The Law Society of SA, the Legal Resources Centre and the South African Medical Malpractice Lawyers Association were among a range of stakeholders ‘united in their criticism’ of the Bill during last year’s public hearings (Business Day). A second round is expected to take place soon after Parliament reconvenes.