NCOP rubber-stamps NHI Bill: What’s next?

The contentious National Health Insurance (NHI) Bill was adopted unchanged by the National Council of Provinces (NCOP) select committee of health during a plenary sitting on Wednesday afternoon.

The NHI, in a nutshell, aims to establish universal healthcare for all South Africans, with services that will be free to the public at the point of delivery.

Section 33 of the NHI Bill, which spells the end of private healthcare for the nine million medical scheme members as well as many valuable business interests within the country’s R250 billion private healthcare industry, has been a bone of contention since its proposal. 

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What’s next for NHI Bill?

• The bill will now go to the desk of President Cyril Ramaphosa for consideration and promulgation.
• Once it receives presidential assent, the bill will become an Act of Parliament, creating a statutory mandate for the Health Minister Joe Phaahla and the Department of Health.
• This will enable key institutional and organisational structures, such as the NHI Fund, to be formally established in line with the provisions of the NHI Act.
• Section 9 of the bill serves as the initial point of action, establishing the NHI Fund as an autonomous public entity.
• This provision requires the establishment of a board and other governance structures for accountability.
• The health minister is empowered to appoint the board, which in turn needs to be approved by the Cabinet.
• Once regulations are finalised, the health minister and department will establish the NHI Fund.
• The process of establishing the fund, is expected to take between six to 12 months post-proclamation of the Act, with subsequent phases involving additional regulations and implementation steps.

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‘Phased-approach implementation’ – Phaahla

In his response to the adoption of the NHI Bill, Phaahla said it it is important for all stakeholders and the public to note that this does not mean the provisions of the NHI Act (once promulgated) will all be implemented once-off without due consideration of the key requirements for transitional arrangements.

“Our intention has always been to have a rational, structured and phased-approach implementation,” he said.

The actual implementation of the various provisions will be pending until specific sections of the Act are proclaimed as law.

“The Constitution empowers the president to set different dates for the effectiveness of various provisions within the Act,” Phaahla explained.

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NHI Fund set to be SA’s largest SEO

According to BusinessLIVE, many estimates are that the NHI Fund’s revenue streams will total about R500 billion per annum, making it the country’s largest state-owned enterprise (SOE) by a significant margin. 

Business organisations and the medical fraternity have objected to the bill, claiming that it was approved by the NCOP select committee of health on 22 November without taking into account submissions made.

The National Assembly (NA) adopted the bill on 12 June before referring it to the NCOP.

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