Signing of NHI misguided and opportunistic – EFF

Fighters say South Africa’s public healthcare system has completely collapsed

EFF statement on the signing of the National Health Insurance Bill

15 May 2024

The Economic Freedom Fighters (EFF) rejects the National Health Insurance (NHI) Bill that Cyril Ramaphosa signed into law today. The signed NHI Bill, presented as a solution to universal health coverage, is misguided, disingenuous, and opportunistic. The outgoing ruling party is using such an important intervention, which is supposed to give our people dignified public healthcare, for political score.

The EFF maintains that South Africa's public healthcare system has completely collapsed.

We highlighted the crisis facing South Africa's public healthcare when we dedicated 2018 as the Year of Public Healthcare. We demonstrated to society that our people go to hospitals to die instead of receiving healthcare and treatment, despite denials.

The majority of public health facilities are in dilapidated buildings. These facilities were built during the apartheid years, and all the post-apartheid govemment did was add poorly designed structures around facilities that were not built with the current population in mind.

Public healthcare facilities do not have dependable and drinkable water, and patients are
forced to bring their own water.

During COVID-19, we witnessed pregnant women queuing for water from JOJO tanks in hospital clothes because there was no water in their matemity wards. Many public healthcare facilities have broken windows, non-functional toilets, and no believable or practical maintenance plans, a situation made worse by consistent and irrational yearly budget cuts.

The EFF has long raised the issue of understaffed and underpaid medical health practitioners, particularly nurses and medical officers, in public health facilities. Many medical health practitioners in public healthcare facilities are depressed, tired, and more are committing suicide due to burnout. There is a shortage of medical officers, nurses, and community health workers, while trained and qualified medical practitioners are sitting at home doing nothing but willing to work because of joblessness.

While there are exceptions, particularly tertiary health facilities linked with academic institutions and big hospitals built by the apartheid government, many public healthcare facilities are not suitable for operation and are not places of healing. This is exacerbated by corruption and maladministration in provincial departments of health.

The EFF warned South Africa during the processing of the NHI Bill in Parliament. We warned that the Bill ignores all systemic challenges facing public healthcare and is an admission that the ANC government has failed to build a national health system that is inclusive, free, and prioritises prevention, education, and care. Instead, the ruling party, desperate to hold on to power by hook or crook, has signed into law the outsourcing of healthcare to the private sector. The EFF rejects the claim that the NHI will usher in universal coverage depending on the private sector, which continues to rely on the systemic exploitation of consumers. The Competition Commission market health inquiry has demonstrated that the private healthcare sector is parasitic, poorly regulated due to ANC incompetence, and operates as a law unto itself. Subjecting South Africans to private healthcare under the auspices of universal health coverage is akin to leaving sheep in the care of wolves.

The NHI, as a piece of legislation, has too many gaps and unanswered questions, and the ANC has failed to accept many submissions made by various stakeholders. The Bill, as signed into law, is explained through PR gimmicks because there are questions that cannot be answered. Questions such as how much the government thinks it will cost to roll out the NHI, where the administrative capacity is, and what lessons were learned from pilot sites.

Instead, criticism is dismissed as anti-universal health coverage, which is nonsensical and should be rejected. There is no evidence that the ANC government has the political sophistication and competence to roll out anything that requires a complex system due to their own ineptitude and corruption.

The EFF maintains that the most practical solutions to fixing public healthcare start with the decommodification of healthcare. Healthcare cannot be sold for profit in a market; it must be provided by the government as a public good. Secondly, South Africa's public healthcare must shift its focus to primary healthcare and prioritise preventative measures instead of waiting for people to get sick and treating them later at inflated costs that benefit private hospitals, not patients.

Thirdly, we must improve working conditions for medical health practitioners through rigorous maintenance of existing infrastructure and the building of new hospitals and clinics, including clinics and polyclinics in every ward.

Furthermore, the genuine fight is for a functional, well-resourced, and capable public healthcare system with competent and well-paid personnel, insourcing of critical functions, a clear and practical maintenance plan, and proper political oversight to eradicate corruption.

To fight for a particular NHI instead of functional public healthcare that will permit universal health coverage is to concede to the commodification of public healthcare.

The EFF rejects the NHI and will continue to advocate for universal health coverage as a public good and not a product of profit maximisation driven by greed. The private sector is not a solution to fix broken public healthcare.

Issued by Leigh-Ann Mathys, National Spokesperson, EFF, 16 May 2024