Johannesburg - Minister of Health Aaron Motsoaledi, in an interview with News24, has defended the NHI programme's progress and has vowed to see its implementation through at all costs.
Motsoaledi has come under sustained attack from labour federation Cosatu, which has slammed the slow progression of the implementation of the universal health coverage system for the country.
"I definitely would not sell out on the National Health Insurance [NHI]. It is my passion, it is something I am really prepared to die for," Motsoaledi said.
In the latest attack, Cosatu said it was worried by "government's failure and lack of political will" to implement the NHI.
"The federation forced government to release a white paper of the National Health Insurance and our focus now is on winning the battle of getting the NHI implemented in our lifetime. We will fight any attempt to delay or sabotage the implementation of the National Health Insurance inside or outside of government," Cosatu said following its central executive committee meeting last month.
Motsoaledi said the programme was on course and called for patience from Cosatu.
"I thought I [could] rely on Cosatu to push harder for it [NHI] to go forward, as to why they have chosen to attack me... maybe they are impatient."
Administrative error
"There are some people who believe the NHI can be implemented overnight - almost all the countries in the world that I know that have implemented NHI... it has always been a marathon rather than a sprint. Maybe they think it's a sprint, but I can tell you it's a very long ultra marathon. So maybe the attacks might be impatience," Motsoaledi said.
Motsoaledi however admitted that an administrative error had led to the contracts of some of the doctors contracted for pilot projects not being renewed, but he said they have since resolved the "mistake".
Cosatu had expressed anger after it discovered that more than 170 doctors employed by the NHI programme would be retrenched by 2017.
"That was a mistake done by a very junior official and we soon corrected it. It can't be an indication for my passion for NHI, it just can't be," he told News24.
In 2012 government started a pilot programme at 11 sites to assess the feasibility of the NHI, which will require the reorganisation of both the public and private health sector to ensure equitable access to healthcare services.
Motsoaledi said the Department of Health had noted serious staff shortages in the public healthcare sector including audiologists, speech therapists and hygienists who are largely contracted by the private health care sector.
'American consultants' slammed
He said two million children had been screened so far to assess the physical barriers of learning in the country's poorest schools as part of the NHI pilot, and it had been discovered that a third of them had speech, eyesight or hearing problems.
"When we started we were only contracting doctors but we have learnt that it is not going to work if NHI must be successful. We need to contract other health professionals like optometrists, audiologists and oral hygienists."
Motsoaledi also defended the appointment of the US-based Clinton Health Access Initiative.
Cosatu had slammed the move, saying the department was sidelining supporters of the NHI in the department and replacing them with "American consultants with no clue about the South African health system".
But Motsoaledi said the Clinton Health Access Initiative was brought in to provide "technical expertise" to assess the pilot programme.
"The NHI is on course, I don't believe anyone will say it's not scientifically on course because in 2012 when we started piloting we said it will be done over 14 years and divided it into three phases."
Motsoaledi said the first phase had been scheduled to run from 2012 -2017, "so we are still inside the first phase, which is preparatory".
He said while he had met with Cosatu earlier this year, he was prepared to meet with them again to resolve differences.
He dismissed reports of the pilot projects collapsing and said detractors were "clutching at straws".