South Africa – The Democratic Nursing Organisation of South Africa (DENOSA), a key stakeholder in the healthcare sector, has voiced strong support for the National Health Insurance (NHI) Bill and is pleased that President Cyril Ramaphosa signed it into law. While DENOSA commends the bill’s implementation, it also acknowledges various concerns raised by stakeholders about its feasibility and potential impact.
Kwena Manamela, DENOSA’s Deputy Secretary General, stated that nurses welcome the NHI as it will enable them to provide care to everyone, irrespective of their social standing.
He noted that nurses have previously been hampered by insufficient funding and a lack of essential resources to do so. However, the new bill promises access to these necessary resources, allowing nurses to deliver comprehensive care more effectively.
“In their pledge of service, they pledged that they’re going to treat people that come to them for care without looking at where they are coming from. They will treat them in totality. The totality of it was hindered by whether that care was funded. So yesterday [by signing the bill into law], we made sure that whatever the nurses are doing is adequately funded. That there is equitable distribution of essential equipment and essential medicine.”
Despite DENOSA’s support for the NHI and its principles of funding and ensuring equal access to healthcare, Manamela underlines the urgent need for the government to address the numerous challenges in the public health sector. This includes improving infrastructure, staffing levels, resource allocation, and the overall management and governance of healthcare facilities.
“Remember, the aim of the fund is to fund the care. If the care is funded, it relieves the government of other responsibilities. Still, the government now needs to take care of the [public institutions] infrastructure and other things.”
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Various Organisations Criticism of the NHI
Although the NHI aims to provide universal and equal access to healthcare services for all South Africans, it has faced significant criticism. Without the NHI, the current healthcare system may continue to be burdened by high costs, unequal access, and inadequate resources, leading to a decline in overall health outcomes.
Numerous health organisations, medical professionals, and opposition political parties argue that the government currently lacks the necessary resources, funding, and infrastructure to implement such an ambitious health system reform.
In response, the Democratic Alliance plans to take legal action against the government to challenge this decision.
They also express concerns about the potential for corruption, misappropriation and mismanagement within the fund. Critics warn that it could become another means of syphoning public funds, undermining its goal of providing equitable healthcare.
There are also concerns that the NHI may prompt medical professionals and doctors to either leave the country or transition to private practices due to potential changes in the healthcare system. Moreover, the potential financial burden on the already limited number of South African taxpayers raises further questions about the bill’s sustainability and economic impact.
Manamela takes a balanced approach, acknowledging the concerns and recognising that the NHI is a new concept that will significantly transform the healthcare system, and it is natural for people to feel apprehensive about it.
However, despite these concerns, he believes that the NHI will benefit the broader population by providing universal healthcare and improving healthcare access, provided it is governed correctly and overseen by various structures to ensure smooth implementation.
“There will be structures that will be watching over this implementation. And the minister said it will be in phases, so we are not worried. It has to start somewhere. So once it has started, we will see the implementation and watch it with a hawk’s eye.”
