Health minister Zweli Mkhize. Picture: SUNDAY TIMES
Health minister Zweli Mkhize. Picture: SUNDAY TIMES

Health minister Zweli Mkhize and his team presented the skeleton of the National Health Insurance (NHI) Bill on Friday morning, but did not flesh out the details, including what the costing and economic impact would be. 

The long expected draft law, approved by the cabinet on Wednesday, is aimed at giving effect to an ANC resolution to create a universal healthcare system that will replace the current broken public medical service.

The bill will be tabled before parliament, but it is not clear when the legislative process, that includes public hearings, will be completed and the final draft submitted to the president to be enacted into law.

Mkhize told the media on a briefing before his budget vote address that the NHI will be implemented incrementally. 

Mkhize’s address at the department budget vote of R51bn focused on fixing the healthcare system and its infrastructure so there will be a base able to implement the NHI fund. 

This included addressing staff shortages, and re-organising management. 

“It will be impossible to convince the public about the virtues of the NHI if it is built over a dilapidated and decaying infrastructure,” Mkhize said. 

He said an amount of R19bn has been set aside for the three-year, medium-term expenditure framework period to refurbish, maintain and build four hospitals and 34 clinics at R6bn; 85 hospitals and 120 clinics at R5.2bn; and maintain 485 clinics at a cost of R8.9bn.

“While this is a significant amount, it is grossly inadequate. The department has done an audit of all facilities and have costed the entire programme of infrastructure build,” Mkhize said. 

He said a team of experts in finance, health and infrastructure from both the National Treasury and department of health has been established to seek creative financing mechanisms and alternative models of delivering of health infrastructure. 

“They have been given a clear directive to accelerate the refurbishment of all old hospitals and clinics and deliver new ones within five to seven years,” Mkhize said. 

He said this would form the basis on which the NHI will operate. “Preliminary indications are that this is feasible. Based on the developed plan, I will engage provinces and other stakeholders on this matter.”