NHI Bill leads primary healthcare sector to its death bed

6 February 2020

Note to Editors: The following is an extract from a submission made at the Metro District Public Hearings in Khayelitsha on the National Health Insurance Bill on Wednesday 5 February 2020.

In recent months, the debate around the proposed implementation of the National Health Insurance (NHI) Bill has gathered pace once more, with a range of opinions and concerns expressed.

While the City supports the implementation of Universal Health Care, we cannot support the Bill in its current form.

As a Primary Healthcare provider, the City of Cape Town wonders how, if implemented, the NHI will affect the thousands of residents reliant on the services offered by our clinics. They manage HIV, TB, hypertension, child care, maternal care and dispense chronic medications, and are the first point of contact with the health sector for many.

A cloud of uncertainty hovers on how primary healthcare services operated by local government will be affected.

The Bill in its current form ignores core primary healthcare components which include promotive, preventative and curative care. It lacks detail on the compensation mechanisms for promotive and preventive services; it does not clarify who will be responsible for the management and oversight of the District Health Management office, nor does it address the role of Environmental Health concerning its function and funding.

Perhaps even more concerning, is the NHI’s proposal to have national government as the sole purchaser of healthcare services, essentially nationalising healthcare in South Africa. In so doing, the national government aims to hijack the responsibility of both local and provincial governments and centralise healthcare along with its more than R250 billion price tag. This devastating prospect will lead healthcare on a similar path of demise as other state-owned enterprises like SAA and Eskom.

The City of Cape Town simply cannot support this and has emphasised these shortcomings in our submissions on the issue.

Issued by Zahid Badroodien, Mayoral Committee Member for Community Services and Health, City of Cape Town, 6 February 2020