NEHAWU statement on the National Health Insurance
7 October 2019
The National Education, Health and Allied Workers’ Union [NEHAWU] welcomes the long overdue publication of the National Health Insurance Bill. The bill is consistent with the White Paper on the NHI and so NEHAWU throws its weight fully behind this legislation as it seeks to create a single purchaser, universal health coverage and integrated health system.
NEHAWU also welcomes the extension of the period for the submission of comments by the public on the bill to the 29th November 2019. This should create an adequate consultation period not only in Parliament but throughout the country through the provincial public hearings.
As NEHAWU, we shall make our contributions in the deliberations in Parliament, across the provincial legislatures, and in the broader national debates in support of the NHI. Simultaneously, we are creating a platform for the voices of our members and working people in general to be heard in their support for the principles and the objectives of this legislation for the NHI, in the midst of this debate that is dominated by the right-wing elite. Therefore, our submission shall be backed by a pledge carrying signatures of scores of our members and the broader working class - calling for decisive implementation of the NHI bill and the transformation of the healthcare system.
In addition, we are announcing an extensive programme of action on the NHI that is inspired by a fundamental principle of our country’s constitution access to healthcare. In this programme we are announcing today under the clarion call that healthcare is a right and not a commodity as NEHAWU we shall undertake the following activities:
- Embark on a countrywide education programme on the NHI and the people’s right to healthcare.
- Mobilise our members and work with our federation COSATU, progressive student organisations and other allied formations to defend the NHI and ensure that the bill remains in keeping the national policy and move the country towards the realisation of the constitutional mandate.
- Campaign for the implementation of the national policy imperatives on the NHI in all provinces including the hiring of more nurses and other medical workers in the vacant posts. The placement of the Community Health Workers on Persal, related benefits, and improvements in the infrastructure and quality service delivery as required by the Office of the Health Standards and Compliance [OHSC].
On the Health Market Inquiry
The successful realisation of the NHI as a health financing mechanism requires the integration of the entire health system including private health industry and independent providers. The report of the Competition Commission’s Health Market Inquiry that has been recently released depicts a shocking state of affairs in the much-vaunted private health industry. As NEHAWU, we condemn the wide-scale profiteering that is taking place across all the key components of this industry, including:
- The fact that even the non-profit medical schemes are now largely driven by their for-profit administrators and managed care organisations as they continuously raise premiums whilst reducing the benefits. They have clearly failed to protect the interests of their members as required by the law.
- The fact that the three giant monopoly hospital groups enjoy huge market power that they are able to willy-nilly use to impose higher tariffs on patients in their narrow focus on profit-margins rather than the health and well-being of the sick. In this regard, the Competition Commission itself has failed in its duty in allowing mergers and acquisitions of smaller hospitals by these monopoly giants over the years.
- The fact that the General Practitioners [GPs] and specialists in the private sector have largely abandoned the ethical code of doing their work in the best interests of the patients. They have taken advantage of the trust of their patients in putting them through unnecessarily expensive and financially catastrophic treatment procedures when more affordable and clinically effective modalities are available.
Despite finding that there is overconcentration and market power exercised by the three hospital groups, overconcentration in the medical scheme industry and over-servicing of patients by specialists – in its findings the Competition Commission failed to provide recommendations with teeth, accompanied by the necessary and decisive remedies to deal with this state of affairs.
As NEHAWU, we believe the present wide-spread profiteering cannot just be attributed to the incomplete introduction of the regulatory measures by government as claimed by the commission, when the private business themselves are responsible for their own actions. It is in the nature of such profit-driven health systems in which healthcare is treated as a commodity rather than a right - to take advantage of the sick in extracting their huge profit-margins.
In line with our NHI mass education and mobilisation programme NEHAWU shall work with COSATU and other progressive organisations to fight against the wide-spread profiteering in the private health industry and to call on government to break-up monopolies and counteract the escalation of medical aid premiums.
On the launch of the Health Anti-Corruption Forum
The national union welcomes the health sector anti-corruption forum that was launched by President Cyril Ramaphosa last week Tuesday with the purpose to fight fraud and corruption in the health sector. Corrupt elements have been running amok in both the public and private sector with impunity. NEHAWU as a union organising in the health sector has been at the forefront of exposing corruption especially in supply chain management, procurement, servicing of medical equipment, human resources and corrupt activities associated with outsourcing.
While we welcome the launch of the forum, we equally find it bizarre that labour as an imperative constituency has been excluded in the forum. In this regard, the national union has written a letter to President Cyril Ramaphosa to demand the inclusion of NEHAWU and other unions in the forum. We hope the President will allow NEHAWU as a union that has unwaveringly fought against corruption to partake and expose more rot that is currently engulfing our healthcare system.
NEHAWU will be submitting a number of cases that must be investigated by the forum as a matter of urgency. The national union would like to prioritise corruption that unfolded during the tenure of the former Premier of the North West which led to our national day of action last year. More corruption incidents were raised by the union in Eastern Cape, KwaZulu-Natal and the Free State. Moreover, we hope the forum will hit the ground running in eliminating corruption at the National Health Laboratories Services [NHLS] and at the forensic pathologist services where money is used to jump the queue in order for people to get their deceased much quicker. As NEHAWU, we believe that there is collusion, price-fixing and corruption in the private health industry which the competition commission report failed to expose. Together with the high and rising costs in the private health sector, this represents a threat to the successful implementation of the NHI and we call on this forum to investigate this.
The tragic incident of Life Esidimeni underscored the deep-seated and immoral parasitism that is inherent in the tender system. To have a meaningful impact in the fight against corruption and to ensure the successful implementation of the NHI NEHAWU calls on this forum to also focus on ending the pervasive outsourcing of clinically critical functions and others such as catering, security, IT, cleaning, etc.
The national union will use all the resources at its disposal to ensure that the NHI becomes the success it is destined to be and wants to warn those opposed to the NHI that we are prepared to defend NHI and the constitutional principle of the right to access healthcare.
Issued by Khaya Xaba, National Spokesperson, NEHAWU, 7 October 2019
