The aim of the NHI Bill is to bring better health care to more South Africans. Picture:Gallo Images
The aim of the NHI Bill is to bring better health care to more South Africans. Picture:Gallo Images

Parliament’s portfolio committee on health has called for public submissions on the National Health Insurance (NHI) Bill, which contains the first concrete proposals for realising the government’s plans for achieving universal health coverage.

It proposes extensive reforms to the way healthcare is financed and provided, with a central NHI fund that will purchase services on behalf of the entire population.

The bill was tabled in parliament on August 8, and interested parties have until October 11 to make written submissions and indicate whether they want to make oral presentations to the committee. The call for submissions was issued on Sunday, and included advertisements in national newspapers.

The bill has already overcome its first hurdle, after the DA asked parliament to seek urgent legal advice on its constitutionality. Last week the state attorney assured the committee that the bill was not at odds with the constitution, despite its proposed changes to the role of provincial health departments.

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The constitution says health is a concurrent power, to be shared between the provincial and national health departments. But the bill proposes shifting much of the funding and responsibilities currently provided to the provincial health departments. The money will be moved into the NHI fund, and the job of contracting with service providers will be devolved to hundreds of new units answerable to district health management offices overseen by the national health department.

Acting chief state law adviser Ayesha Johaar said on Thursday it was the National Health Act that determined the roles, responsibilities and functions of the spheres of government, and not the constitution itself.

“We interpret this to mean provinces many enact provincial laws to deal with health services authorised and contemplated by the national framework and to give effect to national policy. Any amendment to these provisions does not in and of itself offend the constitution,” she said.

The bill had been certified as being constitutionally sound by her office on July 29, she said.

She told MPs that the bill’s provisions were in line with section 27 of the constitution, which obliges the state to progressively realise the right to access health services. The bill was rational, and conformed with SA’s international commitments, she added.

The DA issued a statement on Sunday urging South Africans to make submissions on the bill, which it opposes. It said the bill will impose unaffordable tax increases, and grants extensive powers to the minister of health that leave the NHI fund open to political interference.

It has started a petition against NHI, arguing that it has an alternative plan to provide universal healthcare that can be implemented faster and cheaper than NHI.

“The future of the SA health system and indeed the economy relies on our ability to stop the NHI Bill in its tracks,” said DA health spokesperson Siviwe Gwarube.

Once the bill has been passed by the National Assembly, it will be considered by the National Council of Provinces, which is also expected to conduct public hearings.


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