Patients in the central corridor of the Charlotte Maxeke Academic Hospital. Delays in moving forward with the National Health Insurance Bill have drawn the ire of SA’s biggest trade union federation, Cosatu. Picture: ESA ALEXANDER Picture: DANIEL BORN/THE TIMES
Patients in the central corridor of the Charlotte Maxeke Academic Hospital. Delays in moving forward with the National Health Insurance Bill have drawn the ire of SA’s biggest trade union federation, Cosatu. Picture: ESA ALEXANDER Picture: DANIEL BORN/THE TIMES

The slow pace at which the government is moving on the National Health Insurance (NHI) Bill has drawn the ire of SA’s biggest trade union federation, Cosatu, which plans to raise the issue at Monday’s meeting between the ANC and  its alliance partners, Cosatu and the SACP.

“We are clear it should dominate the meeting,” said Cosatu spokesperson Sizwe Pamla.

NHI, which was formally approved by the ANC at its 2009 policy conference in Polokwane, was supposed to be fully implemented within 14 years of the publication of  the NHI Green Paper in 2011. However, it has been plagued by a series of delays, and last week the cabinet failed to give the green light to the controversial bill.

The bill is the first piece of enabling legislation for extensive health reforms aimed at realising the ANC-led government’s ambition of providing universal health coverage. It paves the way for a central fund that will purchase health services on behalf of patients from accredited public and private sector providers that will be free at the point of delivery.

One of the most fiercely contested aspects of the bill is the role of medical schemes, which Cosatu wants to see sharply reduced.

The government has not yet offered a formal explanation for why cabinet did not approve the bill at its meeting on December 5. Acting cabinet spokesperson Phumla Williams declined to comment on the matter, and last week presidency spokesperson Khusela Diko would say only that the bill would be reconsidered in the new year.

Pamla said he doubted the bill had been rejected on technical grounds.

“It’s politics, because at the centre of what is being contested is whether it [the NHI fund] is a single payer or whether medical schemes must have a role,” he said on Sunday.  “Treasury is bitterly opposed to our position. It says the fiscus cannot afford NHI.”

Pamla said the health department is deeply divided on NHI, and health minister Aaron Motsoaledi  is not providing adequate leadership.

 “Motsoaledi, unfortunately, has been more than flexible. None of us can predict or explain where he stands. He has made some positive statements, but his actions make us doubt we can count on him as the person to really give us NHI,” said Pamla. “He says all the right things, but the feedback we get from people on the ground is different to his public statements.”

Cosatu has previously called for President Cyril Ramaphosa to fire Motsoaledi, arguing he has failed to turn around the ailing public health system since he took on the job in 2009.

kahnt@businesslive.co.za