Zweli Mkhize. Picture: TREVOR SAMSON
Zweli Mkhize. Picture: TREVOR SAMSON

National Health Insurance (NHI) will be rolled out in a manner that is affordable and will not pose the kinds of risks to the economy that state-owned electricity generator Eskom has done, health minister Zweli Mkhize said on Monday.

Eskom posted a net after-tax loss of R21bn for the year to March 31, and its debt currently stands at R440bn — double the current health budget.

NHI is the government’s policy for achieving universal health coverage. Its first piece of enabling legislation was tabled in parliament on August 8, paving the way for the establishment of a central NHI fund that will purchase healthcare services on behalf of patients, which are to be provided free at the point of care.

“It is a fallacy to postulate that the NHI will bankrupt the country. This will be an entity in terms of schedule 3 of the PFMA (Public Finance Management Act), which means unlike an entity like Eskom, it will not have the power to take risks and engage in raising debts and other speculative financial transactions.


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“The entity will receive funds from the fiscus and apply the funds to the defined mandate,” the minister told delegates to the annual Hospital Association of Southern Africa (Hasa) conference underway in Cape Town this week.

Hasa is an industry association for private hospitals, and its annual conference draws delegates from across the private healthcare sector. 

However, chapter 6 of the PFMA says schedule 3 entities may borrow under strict conditions, which include obtaining the permission of the minister of finance.

Mkhize said there is sufficient money in the budget for implementing NHI over the next five years, but said it faced a potential funding shortfall of R30bn by 2026.

“There has been continuous consultation with the National Treasury on the financial implications of the rollout of the NHI,” he said.

Mkhize assured his audience that the NHI fund will be protected from corruption.

“Strict accountability shall be enforced and a strong anti-corruption team will be in place to prevent the risk of corruption and act to uproot corruption using advanced technology to monitor transactions,” he said.

kahnt@businesslive.co.za