Health department gears up to publish first NHI regulations

The health department expects to release its first set of draft regulations for the National Health Insurance Act for public comment within the next month, a senior official says.

National Health Insurance (NHI) is the ANC’s plan for achieving universal health coverage and aims to scrap SA’s two-tier health system, which sees a wealthy minority able to afford medical scheme cover for private healthcare services, while the rest of the population relies on crowded and under-resourced public health facilities. 

The act paves the way for the creation of a government-controlled NHI fund that will purchase health services from accredited public and private providers on behalf of eligible beneficiaries.

President Cyril Ramaphosa assented to the legislation on May 15, but the act has yet to be brought into effect as none of its sections have been promulgated.

Addressing MPs in the National Council of Provinces on Tuesday, the health department’s deputy director-general for NHI, Nicholas Crisp, outlined some of the preparations under way for the scheme. These include drafting regulations for sections 12 to 30 of the act, which cover the appointment of the board of the NHI fund.

The proposed regulations would be gazetted for public comment after the relevant sections of the act had been promulgated, and interested parties would have three months to comment, Crisp said.

Once the board was established, it would appoint a CEO and set up the requisite administrative structures. Funds would follow the creation of these functions for the NHI fund, a process that could take up to three years, he said.

The health department was working with the nine provincial health departments to test new contracting arrangements for primary healthcare, drawing on healthcare personnel from the public and private sector, he said. The project included maternity and child health services, care for the elderly and people with disabilities, and focused on rural areas.

The health department’s preparatory work for NHI was now funded with a budget allocation earmarked for its NHI unit. These functions would gradually shift to the NHI fund, along with the requisite financing, he said.

“The time horizon is obviously multiyear, and statutory changes and budget cycles will dictate the pace at which the financing reforms and fund shifts will happen.

“While we must embrace the opportunity to address the gross inequity that exists in our health service provision in our country, we need to recognise that reforms of this magnitude must be managed with care over time,” he said.

kahnt@businesslive.co.za