Doctors set to flood out of South Africa due to NHI-Bianke Neethling

Trade union Solidarity said a substantial number of healthcare practitioners plan to leave the country if the government’s National Health Insurance (NHI) scheme is implemented.

This comes after President Cyril Ramaphosa and South Africa’s newly appointed Health Minister Aaron Motsoaledi confirmed that they plan to proceed with implementing NHI.

This surprised some, who thought the ANC’s loss of majority in the general election and establishment of a Government of National Unity (GNU) this year may change its plans for implementing NHI.

However, President Cyril Ramaphosa reiterated the government’s plan to establish NHI in South Africa at his recent Opening of Parliament Address.

“An important task of the next five years is to ensure that we also reduce the high cost of living by ensuring that everyone in South Africa has equal access to equitable, accessible, and affordable quality health care,” the President said.

“As we implement the National Health Insurance, we will focus on strengthening health care infrastructure, improving training of health care personnel and using technology to improve health care management.”

Motsoaledi also recently voiced his support for the legislation, saying that the NHI Act is imperative and must be implemented.

While some believe South Africa isn’t ready for NHI and others consider it unaffordable, it is, in fact, “a health-financing system which is meant to be an equalizer between the rich and the poor”, the minister said.

“If you want to see what inequality means, come to the health sector in South Africa. We can no longer, with our eyes open, sustain such gross inequality.”

However, a study by the Solidarity Research Institute, conducted in July 2018 and October 2019 and updated in 2021, revealed that 13.7% of health practitioners indicated that they had already started the process of emigration.

A further 35.95% indicated they would take the necessary steps to emigrate should the NHI be implemented.

Only around 15% were sure that they would not take steps to emigrate should the NHI be implemented.

“The main issue is that the government relies on the medical professionals to implement NHI,” Solidarity said.

“The reality is that the very same professionals are not supportive of the legislation in its current form hence we are mandated to stand against NHI.”

The union told Daily Investor that its Medical Network is continuously in consultations with doctors across the country.

Many doctors have indicated that they do not look forward to working under the NHI and will either stop working, retire, or emigrate to avoid having to work under the scheme.

Around 68% of respondents who participated in Solidarity’s study agreed that medical aid is too expensive and out of reach for most of the South African population.

However, 85.3% of respondents agreed that implementing the NHI will likely lead to private healthcare professionals leaving the country.

Almost 85% of respondents agreed that the NHI cannot be implemented successfully because the current healthcare sectors have failed to deliver effective healthcare to most South Africans.

78.9% of respondents agreed that the NHI has the potential to destabilise the healthcare system in South Africa.

Solidarity explained that this is why it decided to take a strong stance against the legislation “in its totality”.

The union recently achieved a major breakthrough in its fight against NHI when a core pillar on which the state’s centralisation of health care rests was declared unconstitutional in the Supreme Court.

According to this ruling, sections 36 to 40 of the National Health Act, under which the government would have the power to determine where medical practitioners may practise, are invalid in their entirety.

Solidarity said this case has drawn a line through the controversial Certificate of Need. Consequently, the Department of Health must also bear the costs of Solidarity and the other parties.

Solidarity chief executive Dr Dirk Hermann said this ruling justified years of hard work and sustained support from the general public and role players in the medical industry to oppose the legislation.

“This ruling is a major blow to the whole NHI idea as the principle of central management is a core pillar of the NHI Act itself,” he said.

“The ruling on the certificate of need’s larger consequences is that parts of the NHI Act are most likely also now illegal in principle.”

“The NHI, in its current format, can no longer be implemented as the essence of the NHI is central planning – and this has now been found unconstitutional.”

According to Hermann, the court battle against the NHI law remains fully in Solidarity’s sights as legislation that is more specifically related to the centralisation of funds for health care.

Despite this massive legal win, Solidarity told Daily Investor that its fight against NHI is not over yet.

“Solidarity has been preparing our senior council since we presented our stance to the portfolio committee during the consultation process in the form of court documents,” it said.

“In short, we were prepared from the onset and served our documents on the Presidency on the same day the NHI was signed. We will challenge the legislation in its totality.”

The union added that, to date, the GNU has not approached it as a stakeholder to discuss the NHI legislation.

SOURCE:Doctors set to flood out of South Africa due to NHI – Daily Investor