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The South African health ministry says the provisions outlined in the NHI Bill represent a comprehensive and transformative approach to healthcare delivery in South Africa.
“It is founded on the principle that every South African, regardless of their socioeconomic status, should have access to a comprehensive set of health services without facing any financial barriers,” said Health Minister Joe Phaahla.
Phaahla added:
This comes after the NCOP on Wednesday voted in favour of the NHI system, which strives to create universal health coverage in South Africa.
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Phaahla explained that there had been positive and negative experiences encountered on the taxing journey for South Africa to reach this point. He added that the journey in the process of the NHI Bill had not been without challenges, which include financial considerations, health workforce capacity, and the integration of existing, in some instances parallel, healthcare systems, which have posed complex issues.
Phaahla continued:
The minister said government remained committed to addressing these challenges through strategic planning, collaboration with stakeholders and ongoing evaluation of the implementation processes.
"We recognise and appreciate the role that proactive stakeholder engagement plays in the implementation of such an important policy and legislative reform," Phaahla explained.
Phaahla said that collaboration with all stakeholders, transparent communication and a phased approach to implementation were crucial components of "our strategy".
Phaahla said:
He said, however, that it was important for all stakeholders and the general public to note that this did not mean the provisions would all be implemented once-off without due consideration of the key requirements for transitional arrangements.
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"Our intention has always been to have a rational, structured and phased approach implementation."
He said the actual implementation of the various provisions would be pending until specific sections of the act were proclaimed as law. Without the accompanying regulations, directives and operational procedures, the transformative impact of the act cannot be realised. The Constitution empowers the president to set different dates for the effectiveness of various provisions within the act.
Phaahla said Section 9 of the bill served as the initial point of action, establishing the National Health Insurance Fund as an autonomous public entity, as outlined in Schedule 3A of the Public Finance Management Act.
"This provision requires the establishment of a board and other governance structures, critical for accountability. The minister is empowered to appoint a board, but the process involves multiple conditions and steps, such as conducting public interviews, public nominations, shortlisting criteria, appointment of the chairperson and requiring Cabinet approval. This being the inaugural board, a comprehensive regulatory framework to enable this is essential," he explained.
He said the department would prepare detailed regulations, covering all aspects of the process, as mandated by Section 55. Accordingly, the minister will publish these regulations for public comment, encouraging transparency and inclusivity in shaping the governance of the NHI Fund and its enabling structures.
"Let me also express my gratitude to the provincial legislatures for putting the health interest of the people, 85% of whom solely depend on the underfunded public health system, are unemployed and rely on having access to better health services."
