Blow to NHI and Ramaphosa’s Health Compact by Shaun Jacobs

[Nat Quinn]

Blow to NHI and Ramaphosa’s Health Compact by Shaun Jacobs

President Cyril Ramaphosa’s efforts to create consensus around implementing National Health Insurance (NHI) has hit a roadblock, with big business and healthcare professionals refusing to sign his Health Compact.

The Health Compact is Ramaphosa’s attempt to get the government, businesses, and healthcare professionals to support the implementation of NHI in its current form.

Today, the South African Health Professionals Collaboration (SAHPC) announced it will not sign the President’s compact.

The organisation, representing over 25,000 private and public healthcare workers, said the compact is nothing more than an attempt to lock in support for the NHI Act.

The second compact follows the 2023 Presidential Health Summit, which built on the inaugural summit of 2018 and brought together several stakeholders.

These include government, business, labour, civil society, health professionals, unions, service users, statutory councils, academia, and researchers to “develop sustainable and inclusive solutions to challenges in the national health system”.

According to the statement, the stakeholders involved in the Presidential Health Compact are integral to supporting the Department of Health in improving the country’s health system.

While the SAHPC acknowledges that health reforms are necessary to address the challenges in the country’s healthcare system, it does not believe that the NHI, in its current form, is the solution.

“The SAHPC believes the way that the Health Compact has been written is fundamentally biased towards solidifying support for the NHI Act as the sole solution to achieving universal health coverage.”

“The compact heavily focuses on the NHI, presenting it as the only viable option for the country, which we don’t accept,” spokesperson Simon Strachan said.

“Our primary concern is, and always will be, the well-being of patients. We do not believe the NHI is a viable or workable model for universal health coverage. Our numerous proposals and concerns have not been acknowledged.”

“What is needed is urgent formal engagement with the President on the NHI and ways of achieving universal health coverage to ensure health reform is fit for purpose and truly benefits patients, the economy and the country.”

The SAHPC called on the government to partner with the private sector in reforming South Africa’s healthcare system to improve outcomes for patients.

This rejection of Ramaphosa’s Health Compact follows Business Unity South Africa’s (BUSA) rejection earlier this week.

BUSA said it had seen the draft of the Compact, which promotes the NHI in its current form as the foundation underpinning healthcare reform.

“BUSA does not agree with this given the serious differences between us and the government as to the appropriateness of the NHI Act, let alone its feasibility as a legislative instrument to underpin universal health coverage,” said CEO Cas Coovadia.

“The references to NHI in the original Compact were minimal and only in the context of longer-term planning,” he explained.

“There has been no consultation on the updated wording that fundamentally transforms the Compact from health system strengthening to a focus on NHI implementation.”

“Add to this the context of legal challenges around the NHI Act, and the government’s recent public statements indicating an openness to engagement on the NHI makes it all the more bewildering that the Health Compact document has been unilaterally amended and altered in its essence.”

BUSA is concerned that this is at the expense of immediate opportunities to expand and improve healthcare access.

Coovadia explained that while everybody supports universal health coverage, there are ways to achieve it other than implementing an unaffordable, unworkable and unconstitutional NHI.

He described the NHI as a funding model that is impractical, inequitable, and not feasible in the South African context.

“Furthermore, it is putting the cart before the horse to sign and agree to a Compact when structured, formal discussions and engagement with government on the NHI, as a key pillar of universal health coverage, still need to take place,” Coovadia said.

source:Blow to NHI and Ramaphosa’s Health Compact – Daily Investor

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