NEHAWU is flabbergasted by the comments made by Minister of Finance on the implementation of the National Health Insurance
12 September 2023
The National Education, Health and Allied Workers’ Union [NEHAWU] is flabbergasted by the comments made by the Minister of Finance, Enoch Godongwana that the country should prioritize the upgrading and improvement of hospitals over the implementation of the National Health Insurance [NHI].
Such insinuations not only run counter to the fundamental principles of equitable healthcare access but also disregard the imperative need to address systemic issues plaguing our healthcare system comprehensively. The suggestion to prioritize fixing public hospitals over implementing the NHI is flawed. The challenge at hand isn’t about choosing one aspect of healthcare reform over another; rather, what’s required is a comprehensive overhaul and restructuring of the entire healthcare system.
As NEHAWU, we firmly assert that the NHI remains an essential cornerstone in our pursuit of Universal Healthcare Coverage (UHC) and should not be marginalized or set in opposition to the vital task of enhancing our healthcare infrastructure. We advocate for a holistic approach that simultaneously bolsters our healthcare facilities while advancing the NHI, as both are pivotal in ensuring that every South African has access to quality healthcare services.
The current dire state of our public hospitals can be squarely attributed to the National Treasury’s relentless pursuit of austerity measures and ongoing budgetary reductions within the healthcare sector. Despite the mounting demand for essential medical services, the Treasury remains steadfast in its commitment to cost containment strategies aimed at various public service departments. The National Treasury’s unwavering dedication to an intensified austerity program serves as the primary driving force behind the deteriorating condition of our public hospitals, vividly illustrating the adverse consequences of their financial constraints.
- In the current 2023/24 financial year, the total budget allocated to the health department stands at R60.1 billion, which is down from R64.6 billionfor the 2022/23 adjusted appropriation (R64.5 billion in 2022/23 Main Budget). This marks a concerning reduction of 4.9% in health expenditure.
- The decrease translate to a drop in spending for each user in the public health care system from R5,028 in 2022/23 to R4,605 in 2023/24 (constant 2022/23 Rands).
- Primary Health Care shows a decline in allocation of 14%over the 2023 MTEF. This reduction raises concerns about the accessibility and quality of primary healthcare services.
- It is also worth noting that corporate income tax rates have seen a decrease to 27% for the fiscal year ending in March 2023, down from the previous rate of 28%. This change in tax policy has implications for government revenue and resource allocation.
- Additional tax revenue of R94 billion was collected in 2022/23 compared to the 2022 Budget estimates.
In 2022 the country recorded a government debt to GDP of 67.40 percent signifying the level of government debt relative to the Gross Domestic Product (GDP).
- Majority of the additional revenue has been allocated to be used to reduce the debt, rather than expanding social support, or supporting the expansion of employment programmes. Additionally, the budget proposal sets ambitious targets to achieve even higher primary budget surpluses than previously anticipated.
- This evidently signals the extension of austerity measures into the subsequent term, despite their intended conclusion in the 2023/24 financial year as outlined in Mboweni’s plan.
These persistent austerity measures are not only triggering adverse social and economic ramifications but are also significantly impeding our capacity to address the pressing issue of unemployment. Regrettably, the austerity measures championed by the Treasury disproportionately affect the already marginalized and disadvantaged segments of our population, particularly those who depend on public services for their well-being. These measures create additional strains on the very individuals who can least afford them, undermining the pursuit of equitable healthcare accessibility and social justice.
Lastly, we call on all progressive to defend the implementation of the NHI from doomsayers and market-fundamentalist like Minister Godongwana who is opposed to the implementation of NHI. As NEHAWU, we fully support the implementation of the National Health Insurance.
Issued by Lwazi Nkolonzi, National Spokesperson, NEHAWU, 12 September 2023
