Doctors cite the NHI’s dangers

In a bold move that reveals rising tension between health care professionals and the government, the SA Medical Association (Sama) is considering legal action against the government for signing the National Health Insurance (NHI) Bill, saying the health care system is not ready due to “controversies on the ground”.

Despite grave concerns around the Bill, President Cyril Ramaphosa yesterday announced the legislation had been passed by both the National Assembly and the National Council of Provinces (NCOP).

ALSO READ: ‘I am looking for a pen’- What Ramaphosa said about the NHI at Sona

“The National Health Insurance Bill has been passed and will provide free health care at the point of care for all South Africans, whether in public or private health facilities.

“We are working to improve both the quality of health care and equality of access,” he said.

Speaking at a media briefing ahead of its annual conference, themed Strengthening Health Systems, Sama chair Dr Mvuyisi Mzukwa hinted the association was already in talks with its legal department.

“We were hoping the president would send the Bill back to parliament to point out the deep concerns highlighted by many other stakeholders. “It was our hope that would be the case,” Mzukwa said.

“I must assure the nation and the president that we’re also looking to instruct our legal department to follow up on this, after the Bill has been signed.”

The association, according to Mzukwa, believed the Bill was not yet ready for implementation, citing “evident controversies on the ground”, including a crumbling health care system, the shortage of professionals and underpaid doctors.

ALSO READ: Response to NHI: Medical brain drain risk

While proponents stressed that it would address disparities in access to health care and improve service delivery, critics, including Sama, have raised concerns about its feasibility and potential impact on the quality of care.

“Doctors in SA are underpaid. “The salaries they are getting now, they were supposed to be getting in 2015,” Mzukwa said.

“You cannot come up with a system where there are dire shortages.

“As we know now, the ratio in the public sector is 0.35 doctors per 1 000 citizens compared to the private sector which has about 1.75 doctors to 1 000 citizens.

“So, if you look at all those disparities – and shortages of beds with babies put in cardboard boxes – it’s evident the system is not ready.”

He said there was a need for a critical dialogue between the state and the private sector to make sure the burden of training doctors, which was now solely the state’s, could be lessened.

ALSO READ: We simply can’t afford the NHI

Mzukwa confirmed that lack of training and underpayment was driving doctors offshore. “It will be a sad day in South Africa when we allow these young, innovative minds to leave and go abroad and advance other countries, having used taxpayers’ money [to study],” he added.

Sama’s Dr Mzulungile Nodikida agreed with Mzukwa and confirmed that doctors were getting paid 13% less than they should get paid at the moment.

Nodikida emphasised the urgency of the situation, stating that South Africa cannot afford to rush through a flawed health care system that will ultimately harm both patients and health care professionals.

Meanwhile, during the State of the Nation Address (Sona) debate Health Minister Joe Phaahla announced that his department and National Treasury have found a solution to the crisis of unemployed doctors.

Phaahla previously cited budgetary constraints and an excess of medical graduates as the reasons for the crisis. Responding to Ramaphosa’s Sona, Phaahla said: “We have found a solution to the current difficulty of employing doctors who want to work in the public service.

“We are going to fund these posts, working with the finance minister. The details of how this is going to be funded will be stated by the finance minister next Wednesday when he delivers the budget speech.”