Doctors say they ‘will close practices when NHI is implemented’

8 December 2023

Specialists and general practitioners have announced in significant numbers that they would rather close their surgeries than work under the government's National Health Insurance (NHI).

This is according to Solidarity's medical professional networks, whose membership has skyrocketed in recent months as concerns about the reality of the NHI are increasing.

The NHI bill was approved by the National Council of Provinces (NRP) this week and it now only requires President Cyril Ramaphosa's signature to become law.

According to Peirru Marx, network coordinator of Solidarity's medical networks, medical doctors who are members of the Solidarity Doctors’ Network are strongly opposed to the NHI bill.

“Our research undeniably shows that the NHI is not supported by those in the medical profession. They do not want to be part of it. They know it is an election gimmick, and in reality, conditions will be much worse for South Africans and for South Africa under the NHI,” Marx said.

According to him, there is definitely no truth in the government’s statements that the majority of medical professionals support the NHI.

Most have themselves witnessed how corruption, deterioration and mismanagement hamper the public health care system. They are well aware of staff shortages, the lack of availability of essential medication, protracted waiting periods for the acquisition of medical devices and obstacles with medical procedures due to a shortage of specialists.

A recent research study conducted among doctors by the Solidarity Research Institute (SNI) even found that doctors would leave the country in large numbers if this law were to be implemented. 

The study found among other things that:

-94% of respondents believe that private health practitioners may decide to work abroad because of NHI;
-47% indicated that they would start the emigration process as soon as the NHI is accepted in South Africa;
-19% said that they had already initiated the process to emigrate; and
-0% of medical practitioners is optimistic about the NHI.

Marx says although the NHI’s unworkability and unaffordability provide more than enough reason to abandon the NHI plans immediately, this is not the end of concerns.

“We (South Africa) do not have the human resources for it either. There has not been a significant increase in the number of doctors produced during the past ten 10 years. Moreover, we are now producing 58% fewer nursing students than in 2012.

“We just had an online meeting with about 160 doctors who are concerned about the crisis surrounding the placement of doctors for community service. The current public health care administration is already so flawed that they cannot even see to it that doctors get qualified and are placed.

“And to imagine – they now want to roll out an NHI programme,” Marx said.

Although universal health care is desirable in principle, and such systems exist abroad where they are run by stronger administrations, this does not in the least mean that it could work here.

“It is quite correct that other countries also have national health insurance. But there is a huge difference – those countries do not have an ANC,” Marx said.

Should the NHI also be approved by Pres. Ramaphosa, Solidarity will proceed to litigate.

See SNI's healthcare workers' report here.

Issued by Peirru Marx, Network Coordinator: Solidarity's medical networks, 8 December 2023