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New Health Minister, Zweli Mkhize and heads of his Department will be meeting with all healthcare stakeholders in the next six months to discuss the government’s move towards the implementation of National Health Insurance (NHI). Mkhize was briefing the media about the draft NHI Bill that was approved by Cabinet this week. The Bill still needs to go through parliament before it is eventually signed into law by President Cyril Ramaphosa. Mkhize said to implement the NHI, strong co-operation between healthcare professionals in the public and private sector, civil society, patients’ associations, academics and researchers are needed. According to the Minister, he has already consulted with some of the stakeholder groups since his appointment in May and “is encouraged by their support in strengthening the health system”. Mkhize says there has been too much discussion and analysis of the health system’s readiness to implement NHI and that is now time “to jump into implementation”. Presenting a basic outline of what the NHI will look like, the new minister said an NHI Implementation Unit will be established soon while the legislative processes are underway to ensure smooth implementation. He noted that there is a ten-point plan to improve healthcare services that include dealing with staff and medicine shortages and fixing inadequate equipment and aging infrastructure while the implementation of NHI is underway. Same healthcare for everyone According to Mkhize, NHI will give rise to a system where healthcare would be the same for everyone whether they are public or private patients, suggesting that there won’t be a division between public and private facilities once NHI is rolled out completely. “Hospitals, clinics, doctors, specialists, dentists, nurses and all other health workers will be available to provide services equally,” Mkhize said. Although vague about the funding of NHI, the Minister suggested that the scheme will share all the money available for healthcare including medical aid premiums. “NHI is a way of providing good healthcare for all by sharing the money available for healthcare among all our people. The health benefits that you received will depend on how sick you are and not on how wealthy you are.” Mkhize said 42.6 million users of the proposed NHI have already been captured on the DoH’s Health Patient Registration System and that all South Africans will be registered by the end of this financial year. NHI will require a digital health platform that will support the operations of the NHI Fund and work has already commenced in this regard, he added. In the next few weeks, 30 managers who have been identified at various levels of the health system, will be sent overseas to receive training in NHI implementation, learning how it was implemented in different parts of the world to ensure the sustainability of implementation, Mkhize said. Acknowledging that the public won’t accept the NHI if it is built over a dilapidated and decaying infrastructure, Mkhize said R19 billion rand has been set aside to refurbish hospitals and clinics while the scheme is being introduced. “A team of experts in finance and health and infrastructure from both National Treasury and Health has been established to seek creative financing mechanisms and alternative models of delivering of health infrastructure. They have been given a clear directive to accelerate the refurbishment of all old hospitals and clinics and deliver new ones within 5 to 7 years. This is the basis on which NHI will be operating. Preliminary indications are that this is feasible. Based on the developed plan I will engage provinces and other stakeholders on this matter,” Mkhize said. Referring to the 4100 vacant posts for doctors and 3932 for nurses in the public sector, Mkhize said his department is planning to fill almost 2700 doctors’ and 2371 nurses’ posts within the foreseeable future. R330 million rands has already been allocated for the filling of posts in the 2018/2019 period which will go up to R600 million in the 2019/2020 period. The Health Department has also undertaken to ensure that all the qualifying 2625 medical interns and the 700 Cuban graduates are given posts. He added that Treasury has made available R57 million to fund 50 interventions needed for NHI immediately. These include a capitation model for GPs, removing user fees, increasing antenatal visits and extending the distribution of chronic medicine. This amount will go up to R145 million next year and R287 million in the Medium-Term Forecast. He emphasised that the move towards Universal Health Coverage through the implementation of NHI will be based on a primary healthcare (PHC) approach which will require a strengthening of health promotion, screening, disease prevention, rehabilitation and early treatment of disease. “An expansive network of Community Healthcare Workers and Community Care Givers serving a catchment population will be linked to support the delivery of PHC services in our communities. A well-organised upward and downward referral system needs to be built to support the delivery of PHC services through referral to our clinics. Medical Officers based at District Hospitals will be required to perform outreach services at clinics so that we reduce the need for patients to be referred to hospitals to access care,” Mkhezi explained. He said government’s plan to expand the contracting of GPs is supported by various stakeholders such as SAMA, the Unity Forum of Family Practitioners and Progressive Health Forum amongst others.Mkhize emphasised the legislation as it is now is not cast in stone and will be refined “to adapt to the situation as needed”.
Created at 2019/07/24 11:02 AM by Mediclinic
Last modified at 2019/07/24 11:02 AM by Mediclinic