Solidarity beats litigation drum with NHI Bill one step closer

Parliament says the NHI Bill seeks to provide universal access to healthcare services in the country in accordance with the National Health Insurance White Paper and the Constitution.

Parliament says the NHI Bill seeks to provide universal access to healthcare services in the country in accordance with the National Health Insurance White Paper and the Constitution.

Published Jun 15, 2023

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The National Assembly's approval of the National Health Insurance (NHI) Bill has been met with an outcry and threat of litigation by the Solidarity Movement and other critics.

The approval of the bill means the ANC-led government is one step closer to its plans for achieving universal health coverage.

According to Parliament, the NHI Bill seeks to provide universal access to healthcare services in the country in accordance with the National Health Insurance White Paper and the Constitution.

“The bill envisages the establishment of a National Health Insurance Fund and sets out its powers, functions, and governance structures. The fund will purchase healthcare services for all users who are registered with it,” it said.

The bill still needs to be reviewed by the National Council of Provinces, SA’s second house of parliament. The council is not expected to make material changes to the bill before submitting it to the president in the final round of approval.

Despite this, union Solidarity announced yesterday that it was getting ready for a court case against the government’s plans for a national health insurance. This comes after the National Health Insurance (NHI) Bill was approved in Parliament on Tuesday.

Solidarity CEO Dr Dirk Hermann said: “We realised from the outset that the NHI would probably be tested in court. The government’s plans to capture healthcare are unaffordable and unimplementable. It will lead to a mass exodus of health practitioners from the country.”

The Institute of Race Relations (IRR) said South Africans should be deeply alarmed that the National Assembly this week approved the NHI Bill, without knowing how much it would cost.

“The implementation of the NHI will result in the exodus of many health professionals because they believe the NHI will ‘destabilise’ healthcare, rather than improve it. Many are also reluctant to subject themselves to the NHI’s comprehensive controls over their fees and treatment decisions,” it said.

Profmed CEO Craig Comrie highlighted concerns over the NHI Bill, urging policy reassessment. He said concerns remained regarding certain clauses within the bill that might impede individuals’ and medical scheme members’ access to essential healthcare services.

“Without addressing these concerns, the bill’s implementation in its current form could have far-reaching implications for the healthcare landscape in South Africa, casting doubt on the promised improvements in the healthcare system,” he said.

Comrie said the introduction of the poorly drafted NHI Bill could exacerbate the exodus of skilled workers.

“Without a resource plan or incentives to retain critical medical professionals, the bill's nationalisation of their services under a single-payer system poses a significant risk to the availability of skilled healthcare providers.

“Working alongside industry bodies like the Health Funders Association and Business Unity South Africa, Profmed advocates for a reassessment and retraction of the current NHI Bill, aiming to influence healthcare policy and create a realistic, sustainable system that ensures access to care while fostering the growth of South Africa’s economy,” he said.

Ryan Noach, CEO of Discovery Health, told media that at this stage, there was no need to panic over the NHI.

Noach said to cater for 60 million South Africans would take a very sophisticated system, which would take a long time to build.

Noach, speaking to Newzroom Afrika, said the NHI’s money bill – the financing part of the plan, which must come from the National Treasury – had not been published.

Finance Minister Enoch Godongwana made little reference to the NHI in his latest Budget Speech, and Treasury clearly did not do much work on financing the NHI.

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