Gauteng Premier downplays NHI problems

28 August 2019

Gauteng Premier David Makhura continues to downplay obvious problems with the proposed National Health Insurance (NHI) that could badly affect health care in the province.

He claimed yesterday in an oral reply to my questions in the Gauteng Legislature that there was “no reason to say that the NHI will not be run efficiently”.

This is despite the example I put to him of badly run state owned enterprises like Eskom, and corruption-afflicted entities like the Gauteng Enterprise Propeller (GEP) run by his own provincial government.

It is proposed under the NHI that Gauteng’s four central hospitals (Charlotte Maxeke Johannesburg, Chris Hani Baragwanath, Steve Biko and George Mukhari) will be taken over by the National Health Department.

This could be very disruptive and fragment our health system, but Makhura says that while details need to be worked out, these hospitals would still be linked to the provincial health system and the CEOs would report jointly to National and to Province.

I am disappointed that Makhura rejected the argument that the public health sector should be fixed first before implementing NHI, especially since Gauteng’s public hospitals are notoriously badly run.

Why does he think national government will run NHI more effectively than Gauteng’s public healthcare which he himself said earlier this year was “on its knees”?

Gauteng has the most to lose if NHI goes seriously wrong as it would bear the brunt of extra taxes that would be needed to fund it, and it has the highest proportion of people on private medical aid (25%) who would lose out if they were forced into dysfunctional public hospitals.

Many medical professionals in Gauteng are likely to emigrate if they are pushed into a dysfunctional NHI system that doesn’t pay its bills on time like most of the public service.

Makhura should be concerned that provincial powers are threatened by the NHI bill which will centralize the provision of healthcare.

The DA is committed to universal health coverage, but this will only be achieved by respecting provincial powers and running a decent public health system in constructive partnership with the private health sector.

Issued by Jack Bloom, DA Gauteng Shadow Health MEC, 28 August 2019