Ramaphosa signs death certificate for SA's failing health system – Siviwe Gwarube

DA Chief Whip says NHI will not equalise our healthcare system; in its current form, it lacks the necessary investment

Ramaphosa signs the death certificate for SA's failing health system

15 May 2024

Please find attached a soundbite by Siviwe Gwarube MP.

The DA firmly believes in the constitutional provision of quality healthcare for all South Africans. Section 27 of the Constitution is clear about government’s responsibility.

However, the ANC's track record of failure in delivering this fundamental right is evident in the countless horror stories emerging from hospitals and clinics nationwide.

Universal Healthcare is not just a concept; it's a necessity to ensure that no citizen is left behind or subjected to second-class healthcare. However, the proposed National Health Insurance (NHI) scheme, touted as the panacea for our healthcare woes, is nothing more than a political tool wielded by the ANC to manipulate voters in this upcoming election.

Contrary to popular belief, the NHI will not equalise our healthcare system. In its current form, it lacks the necessary investment to provide accessible and quality healthcare as mandated by our Constitution. The notion that individuals will seamlessly access private hospitals under the NHI is a fallacy and an intentional lie peddled by the ANC.

What we need is a comprehensive overhaul of the entire healthcare system, utilising the significant portion of our GDP allocated to healthcare, which the ANC has failed to deliver over the past three decades. The NHI is merely a desperate attempt to deceive the public into thinking that the ANC can remedy a broken system it has perpetuated.

The NHI Bill has failed spectacularly in achieving its purpose. More questions have been raised than answered. Some key problems facing the Bill are as follows:

Pilot Projects and Ideal Clinics

The failure of previous NHI pilot projects due to the government's inability to compensate contracted General Practitioners (GPs) raises serious doubts about the feasibility of implementing such a system on a national scale. All in all, the pilot programme since 2012/13 has cost the taxpayers over R5.1 billion, with nothing to show for it.

Moreover, the majority of healthcare facilities do not meet the criteria for an "ideal clinic," highlighting the systemic issues that persist within our healthcare infrastructure. What this means is that if the NHI were to be implemented, only a fraction of hospitals and clinics would legally be allowed to provide healthcare.

Corruption and ministerial powers

The centralisation of such vast sums of money under the control of a single minister and a board raises serious concerns about the potential for corruption and mismanagement, akin to the scandals that have plagued other State-Owned Enterprises (SOEs) like Eskom. The NHI presents a fertile ground for corruption, with implications far graver than the Digital Vibes debacle.

Funding and additional tax

The exorbitant cost of implementing the NHI, estimated at R300 billion annually, coupled with a shrinking tax base and a significant portion of the population living in poverty or unemployed, makes it clear that the burden of funding this scheme will fall disproportionately on South African taxpayers. South Africans simply cannot afford to pay more tax and we will see tax emigration en masse, as a result.

Flawed Parliamentary process

The dismissal of thousands of public submissions and the disregard for input from industry experts and healthcare workers during the parliamentary process underscores the ANC's determination to push through the NHI regardless of its flaws or public opinion. Public consultations were a sham, not properly arranged and did not meaningfully or reasonably take into account the views of the people.

Additionally, the lack of parliamentary oversight on the proposed board further undermines accountability and transparency. The Department and Minister, at every turn, shot down calls for amendments to be made, and these should fire immediately fire of warning signs to South Africa.

Constitutional concerns

There are significant constitutional concerns regarding the NHI bill, particularly regarding the provision of healthcare services to the people. The DA will closely examine these flaws and articulate our legal challenges in due course.

For one, the NHI will centralise control of all healthcare provision in the country, usurping the powers and functions of provincial governments.

The NHI will inevitably phase out medical aids, create mandatory pathway systems and require certificates of need to operate in certain areas. These provisions fundamentally affect a person’s right to healthcare of their choice, freedom of association and choice and employment.

Section 27 of the Constitution enshrines everyone’s right to healthcare. Should the removal of medical aids or access to private healthcare diminish a person’s ordinary access to healthcare, it would no doubt violate their rights in terms of section 27.

Lastly, the Bill is fatally flawed simply due to its impossibility of implantation. A law cannot be implemented where it is impossible to operate. The public healthcare system is on the brink of collapse, thousands of doctors’ posts are vacant, government’s failure to pay contractors timeously, and the fact that only a fraction of hospitals will be certified by the OHSC to operate will mean that the healthcare system will collapse overnight.

In summary, the NHI will not address the underlying issues in our healthcare system; it is financially unfeasible, an election gimmick, and will burden South Africans with increased taxes. The potential for corruption is staggering, and the flawed parliamentary process further erodes public trust. The DA will pursue all legal avenues to challenge the NHI and ensure that the rights of all South Africans are upheld.

Issued by Siviwe Gwarube, Chief Whip of the Official Opposition, 15 May 2024