Friday, August 12 2022

South Africa’s health system faces immense pressure as low-income people continue to receive inadequate care, while middle-class South Africans worry about the changes that will be brought about by the new health regime. National Health Insurance (NHI), according to health experts.

Addressing the Municipal pressSasha Stevenson, health rights program manager at the non-profit group Section27, said efforts to reform the health system in South Africa appeared to have effectively come to a halt.

This comes after more than a decade of discussion and debate, so stakeholders were tired and did not trust the motives and opinions of others, she said.

“This stagnation is fatal. The South African healthcare system is under immense pressure and its inequities are well known. Some people continue to receive inadequate care, while others are overserved for the sake of profit. Healthcare workers are burning out.

“Uncertainty about changes that may never happen causes anxiety in the middle class and impatience in those who cannot imagine that a changed system would make them worse,” Stevenson said.

The government is currently grappling with budget cuts, job freezes and pressure to increase the number of nurses and doctors, says Dr Nicholas Crisp, deputy director-general at the Department of Health.

He added that the current constraints on the government are “enormous” and that it is an “extremely rigid and extremely difficult place to work”.

“Our budgets have been cut and the illusion that there is fresh money being provided for the Covid-19 vaccine is nonsense. More and more positions are frozen every year and the public sector has no no chance of getting better to the extent that people think it’s possible,” he said.

The split of the NHI

One of the stated goals of the NHI is that it will help level the playing field and give all South Africans access to adequate health care.

However, a report published by professional services firm PwC this week shows that discussions around the proposed NHI are still divided. The report took into account responses from 31 leaders of South African healthcare organizations across all sectors and featured both in-depth interviews and online digital surveys.

The report shows that 100% of executives surveyed support NHI’s intent and the universal health coverage model, however, only 50% of respondents think it will be a total or partial success. Respondents were particularly concerned about:

  • The coverage and range of services to be provided,
  • Governance structures,
  • The risk of corruption,
  • Health worker capacity,
  • The impact on the private sector

More than half of respondents thought the NHI was unlikely to improve South Africa’s health outcomes in its early stages. Similarly, half believe that he will achieve or partially achieve his objectives.

However, public confidence in INSA’s health system and governance must first be achieved and considerable change management in both the public and private sectors will be required.

Respondents also felt that unless stakeholder relations are managed carefully and well in advance of rollout, all stakeholders may balk due to a lack of transparency and communication.

Read: Here’s how private medical aids could work with the new NHI in South Africa


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