Ina Opperman

By Ina Opperman

Business Journalist

NCOP committee passed NHI Bill ‘without enough consultation and review’

"It is totally irresponsible to rubber stamp into law legislation that will have such a severe impact on the country and her people."

The National Council of Provinces’ health and social services committee voted to accept the NHI Bill without enough consultation and review, says the SA Health Professionals Collaboration (SAHPC).

SAHPC says the committee did not make any amendments and failed to adequately consult or consider submissions from numerous clinician bodies that safeguard the future of healthcare in the country.

The SAHPC is a newly formed national group of nine medical and allied healthcare practitioners’ associations and represents more than 25 000 dedicated private and public sector healthcare workers.

“It appears that comments and recommendations were not sufficiently considered in the final committee vote and therefore, the SAHPC urges the National Council of Provinces (NCOP) plenary to send the bill back to the committee on procedural grounds, when it votes on the NHI Bill on 29 November,” Simon Strachan, a spokesperson for the SAHPC, says.

“The SAHPC, which includes family medicine GPs, specialist doctors, dentists and allied healthcare workers, is deeply concerned about the unintended consequences that will likely arise from the hasty adoption of the NHI Bill in its current format.”

 Strachan says the potential consequences of rushing through the NHI Bill without critical amendments are far-reaching and will further undermine the country’s ability to deliver quality healthcare to the very patients it seeks to protect. 

ALSO READ: Increasing taxes to fund NHI will ‘destroy economy’ – expert

Current version of NHI Bill not in interest of anyone

“The SAHPC does not believe that this version of the bill is in the best interest of patients, who are at the heart of any healthcare system. The bill will also have severe repercussions for the economy and the country’s long term economic sustainability.”   

The bill recommends a complete overhaul of the country’s healthcare sector and Strachan says while reforms to the public and private healthcare sectors are urgently needed, there is too much at stake for the country’s healthcare system to get the NHI wrong.

“We are concerned that the bill’s hasty progression through the legislative process, without taking into account the diverse perspectives and expert insights delivered through numerous prior expert submissions, is a lost opportunity to put the country on a pathway to quality healthcare for all.” 

He says in the same way that healthcare workers’ primary responsibility is to their patients, parliament’s main responsibility is to the people.

“This required thorough interrogation of the NHI Bill to ensure that the final product is workable, affordable and that it improves the quality and sustainability of available care.  We do not believe that the bill, in its current format, achieves this.”

ALSO READ: NHI: what about medical schemes and medical insurance?

Busa and B4SA also concerned about lack of due process

Meanwhile, civil organisations Business Unity SA (Busa) and B4SA wrote to the presiding officers of the NCOP as well as the deputy president in his capacity as leader of government business in parliament, to register their deep concern regarding the lack of due process in the NCOP Select Committee when it adopted the bill without any amendments.

Busa and B4SA said in the letter that no consideration was given to the many procedural and substantive constitutional issues in the bill raised by four provinces and a wide range of stakeholders. 

They say this amounts to a serious and significant procedural lapse and a violation and disregard of parliament’s own public participation model, fundamentally undermining the principles of participatory democracy on which the Constitution is based. 

They also requested the NCOP and the deputy president, that the NCOP does not consider the bill during its plenary session on Wednesday, but rather defers consideration of the bill until the Select Committee substantively discussed and engaged on the comments and proposals put forward by stakeholders.

“For the National Assembly and the NCOP to disregard proposed amendments that will have a beneficial and tangible impact on citizens, or indeed would prevent harm to them, in the interest of rushing the bill through parliament, is unconstitutional. It makes a mockery of due process and portrays the NCOP as nothing more than a rubber stamp,” Cas Coovadia, CEO of Busa says.  

“We believe the bill in its current form is utterly unimplementable and will have severe consequences for South Africa, the economy and every citizen, for generations to come.  The self-evident truth is that there is no money to fund this NHI Bill and there is no clarity over its benefits, contracting terms, capacity, systems, management, governance or even a plan that begins to outline a viable approach to these fundamental considerations. 

“We also repeatedly cautioned against a single fund for the NHI that will require taxes to be raised to unsustainable levels. This is unaffordable, unsustainable and presents a material risk to the economy,” he says. 

ALSO READ: Healthcare leaders reiterate NHI Bill concerns

Current NHI Bill will infringe on rights of 9 million people

As currently drafted, the bill limits access to healthcare for more than 9 million South Africans, infringing their constitutional rights. No other country in the world has a legislated limitation on the role of private health insurance, not even the wealthy countries with a substantial tax base and extensive publicly funded healthcare.

 “Government’s mandate is to act in the best interest of all of its citizens. It is totally irresponsible to rubber stamp into law legislation that will have such a severe impact on the country and her people, ignoring the legitimate and substantive inputs that have been made by multiple stakeholders to date. 

“We recognise that the passing of this bill is a key aspect of the upcoming election but it must properly take into consideration due process and afford the necessary time and engagement to achieve that,” Martin Kingston, B4SA steering committee chair says.

The approach adopted with respect to the NHI Bill, including certain key aspects, has created substantial and widespread uncertainty, which is already impacting investment into the sector and more broadly for the country. 

Kingston says by amending Section 33 and clarifying a number of other critical aspects of the NHI Bill, introducing low-cost medical options and reducing the cost of private care, the country can build a better overall healthcare system with immediate benefit for all. 

“This will attract more capital and investment into the healthcare sector without government needing to raise taxes to unsustainable levels or take on additional debt, while retaining the country’s precious healthcare workforce. These proposed amendments and reforms will strengthen the NHI, to secure access to quality healthcare for all citizens, for generations to come.”

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