Health director-general Precious Matsoso broke ranks in truly remarkable fashion last week when she accused President Cyril Ramaphosa’s adviser, Olive Shisana, of sidelining her in the development of the National Health Insurance (NHI) bill. The director-general is the department’s accounting officer and will be tasked with defending the proposed legislation when it is introduced in parliament. Yet she says she played no role in revising its release for public comment in June, a statement confirmed by Shisana. For the director-general to be left out in the cold in this manner is truly astonishing. And for her to lay bare the dysfunction in the government by further claiming Shisana has ridden roughshod over the public-consultation process is even more so. The bill is a key aspect of the government’s ambitions for realising universal health coverage as it sets out the legal framework for establishing a central NHI fund that will purchase health services on behalf of patients from bot...

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