They say the compact is an attempt to lock in support for the National Health Insurance Act. From Moneyweb.
Nine healthcare professional bodies representing more than 25 000 healthcare practitioners say they will not sign the president’s health compact on the grounds that it is nothing more than an attempt to lock in support for the National Health Insurance (NHI) Act.
The nine associations, represented by the South African Health Professionals Collaboration (SAHPC), say the compact is fundamentally biased and has been drafted in a way that solidifies support for the NHI Act as the sole solution for achieving universal health coverage – to which they are not opposed.
The compact commits signatories to achieving universal health coverage in SA “enabled through the development and implementation of National Health Insurance”. It goes on to say that despite progress in improving medicine availability under a previous health compact, including during Covid, inequalities remain that need to be addressed. The document posits a largely state-controlled healthcare system with equal access to services and medicine.
“The Compact heavily focuses on the NHI, presenting it as the only viable option for the country, which we don’t accept,” says Simon Strachan, a spokesperson for the SAHPC.
“Health professionals, including general practitioners, specialists, dentists, and allied workers, are the cornerstone of health provision in this country. Our primary concern is, and always will be, the well-being of patients.
“We do not believe that the NHI is a viable or workable model for achieving universal health coverage. Our numerous proposals and concerns have not been acknowledged.”
The NHI proposes offering close to 300 prescribed minimum benefits (PMBs) to all South Africans at any health facility across the country, private or public. Any PMB covered by the NHI Fund to be set up would mean private medical schemes would be prevented from offering these to its members.
It’s been roundly criticised as unaffordable, making it a threat to the economy and likely to drive medical skills abroad.
‘Other ways to achieve universal healthcare’
Business Unity SA (Busa) said it will not support the compact as “it cannot support a policy that explicitly endorses the NHI Act in its current form”.
“BUSA has written to the President to express its concern,” it says in a statement.
“The draft of the Compact that was shared with Busa promotes the NHI in its current form as the foundation underpinning healthcare reform,” says Cas Coovadia, Busa CEO.
“Busa does not agree with this given the serious differences between us and government as to the appropriateness of the NHI Act, let alone its feasibility as a legislative instrument to underpin universal health coverage.
“While everybody supports universal health coverage, there are ways to achieve it other than implementing an unaffordable, unworkable and unconstitutional NHI, which is essentially 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,” adds Coovadia.
Busa wants the NHI Act to be amended to ensure the country can deliver universal healthcare and reform the sector in a way that does not damage the economy and the accumulated skills and resources in the private sector.
NHI ‘will strain resources, limit patient choice’
Adding its voice to the growing chorus of resistance to the NHI, the South African Medical Association (Sama) says while it supports the objective of universal healthcare, the current model proposed would strain resources, exacerbate existing inefficiencies and limit patient choice.
Sama advocates a system of universal healthcare rooted in primary healthcare (PHC), which aligns with the World Health Organisation’s model of cost-effective, equitable, inclusive and efficient PHC.
“In light of our concerns, Sama calls for an open and inclusive dialogue on the best path forward to achieve UHC [universal healthcare]. We urge that future references to the NHI in the Presidential Health Compact be revised to reflect a broader spectrum of potential solutions and that stakeholder engagement remains a cornerstone of this ongoing reform process,” says Sama.
SAHPC has called for an urgent formal engagement with the president on the NHI and ways of achieving universal health coverage that is “fit for purpose and truly benefits patients, the economy and the country”.
“It is important that health reforms are developed in partnership with all those that are mandated to deliver this critical service.”
