National Health Insurance Bill a step closer

National Health Insurance Bill a step closer



but that's okay you'll see Sakina in a couple of minutes time let's talk some very very serious issues the national health insurance ball is a step closer to actually becoming law while presenting his budget last week health minister doctors William Kaiser revealed that the document had been approved by cabinet he also gave details of how universal health care for all citizens would bring major changes to the sector to discuss this further from our Pretoria studios we are joined by dr. C PO Cabana he's the CEO and register registrar for the Council for medical skins good to have you doc thanks very much for being our guests there Monning lien and your viewers so the department says it has already enrolled 42 million South Africans in the health patient registration system how ready is the country to introduce nhi well from the regulator's point of view we believe that these pronouncements by the Minister signal you know a degree of agents in the implementation of the nhi we are confident that the entities that we regulate will look at the detail of what sits in the bill and also in the implementation plan and find a way of supporting laci because there's overwhelming support for the nhi yeah overwhelming support but there's also the other side of the story where where there's still a lot of worry about nhi and it's working obviously there were there were seven steps and a lot more clarity given by the Health Minister as to how it's going to work perhaps you can talk a little bit more about the actual workings of nhi well we understand the nhi to be a financing mechanism that ensures that the total population of South Africa gets access to quality health services based on need and irrespective of the socio-economic circumstances this for us means that the current skewed financed furniture the funding of Health will be cleared because currently we've got a 16% of the population you know enjoying up to 45% of the GDP and the 16% you know but having a larger share of that person a percentage of the GDP yeah if this continued please continue oh I was going to say that 84 percent of the population actually gets a lesser portion of the GDP so we need to address this health funding inequity and the only vehicle available for doing that year is through the nhi it's certain years I mean and that there there is a very bad healthcare system and we cannot deny that and I think everybody is looking at it and knowing that something desperately needs to be done what the minister did say was that you know some people criticizing and saying rather fix up hospitals first try and get adequate staffing into the hospitals try and get medical sort of medicines available to people that actually go they sort out the medical system the way it is now but his response was no we've got to bring nhi in before we can fix any of that how does that work I mean what is your understanding of how nhi will actually fix up what is bad currently well my understanding of the minister's pronouncements particularly in the budget speech was that we need to fix the quality of public health services whilst at the same time implementing the nhi that that's why we were very supportive of the announcements that the public health sector is going to be employing 2,600 new employees and another 2,600 intends will be made permanent there were also plans to him of infrastructure equipment and the supply of medication and and as we listen to this we we also had him say that that nhi unit will be established within the National Department of Health which will develop an implementation plan that will make things clearer what will happen in the transition towards universal health coverage yeah so we see these two interventions as is happening concurrently and not in a sequential form all of this of course takes a lot of money some of the the costs we don't know the actual costs that the nhi is going to to come in at but just for a start up program for all of us we're looking at about two hundred and thirty two billion rand this of course is it's a lot of money and especially in an environment where South Africa is not doing so well at well at all actually economically well we have heard the minister himself explaining why we cannot wait until were rich enough to implement the universal health coverage he gave examples of countries that have implemented a similar kind of a you know health reform without having all the resources that it needed and then if I'm not mistaken he coated the United Kingdom as well as Japan as those countries that did not have to wait until they had sufficient resources and and I'm of the view that you know this country also needs to move in the same direction yeah it certainly IIIi did read some of those case studies and Japan is very impressive for how they managed to turn things around but one of the biggest problems and I think many people are worried about that is that South Africa unfortunately does come from a background of huge corruption and a distill corruption that exists right now many fear that this amount of money that's going to go into this pool or this fund into the healthcare of South Africans this is just going to open up a can of worms of mass corruption and looting is this a concern that's been raised Leah and I think everybody needs to be concerned by corrupt or the possibility of a corruption visiting the nhi but I think given the recent developments in terms of how the country through the president has clearly articulated you know a view that is antique or art and with all the Commission's that are going around dealing with corruption and I think our awareness of all of these impacts on the nhi means that we need to be doubly sure that we eliminate whatever corrupt practices that may visit the nhi and and part of this is ensuring that the fund itself is established in a manner that does not allow for corruption and there is a checks and balances to keep whoever is running the funds to be accountable and ensure that this transparency in the manner in which the fund is run the contracting with service providers I'm confident that we're not going into the the universal health coverage in the form of nhi you know without having considered all of these risks and I'm certain that we will manage them yeah let's talk about medical aids um oh there they obviously are not too confident about this and they have expressed their worry and concerns for obvious reasons but how do we get their buy-in and what were medical aids look like once nhi is introduced well Lee and I think we need to start from the point that when when the white people on the nhi was issued its it clearly articulated the view the they are going to have to be massive changes in the health system for both the private and the public sectors now having accepted that here it means we need to also note that the private sector will be affected by the implementation of the nhi but I think the important thing is is that we've got a medical schemes bill that is in the pipeline and therefore me signals that the changes that are going to happen in the medical aid industry are going to be based on legislation and we have been told that all the changes will be clearly articulated in the transition an implementation plan and I think there will be certainty in terms of of how these changes will be phased in Lia yeah you know I I'm bringing in a tweet from one of our viewers because I think it's vitally important to hear from South Africans we can talk but this is what they have to say Theodora actually saying it's not just better health facilities that we need we actually need staff that want their jobs the horror stories we can tell you about what happens in public hospitals after 4:00 p.m. daily would break your heart how are we going to fix that this is a very relevant question we can maybe fix the health care but those that deliver the service of health care how are we going to fix them how we're going to pay them better how are we going to make them actually care about South Africans only and I think the the pronouncements by the Minister in terms of applying appointing additional personnel for the health system will go some way towards addressing that but we've also been told that the students that have been trained in in the country as well as other countries such as Cuba increasing in number and and these numbers are expected to fill in the gaps of the vacant posts that that we are currently thing with the minister also mentioned that there's consensus that the public health sector is underfunded and that through a consultative process with Treasury the baseline of the funding of the public health sector is going to be really looked at so that health is adequately funded yeah yeah well we'll wait and see what that all looks like because I do know that there's a lot to still be done but the reality is that we could have NH I signed into law by July 2020 so that's next year NH I could already be there but I know that during one of the the debates and kione's around the the NH higher and what the minister had said the DA came out saying and to quote them they said that the nhi pilot projects across the country have actually failed Liana I'm not the spokesperson for the National Department of Health what am i aware of is that there was a report that reported on these pilots idea and an out love to direct people to go to that report have a look at it because that report actually talks about what was planed at the pilot sites and what was the ultimate outcomes of those interventions that were put in place and I and I think if people look at that report it may change their perspective in terms of the failure of the pilot sites yeah yeah fair enough doctor I mean you certainly or not with the health department and I think it'll be good to get them in actually to take this conversation further one final question I need to ask you because I see that it's sitting on the front page of one of the the dailies this morning and that's the the issue of black and Indian health practitioners that have been dealt a bit of a blow to waging their war against these medical aid schemes accused of running flood plus operations from what I'm reading is that the the report says that the case was actually thrown out of court against the NH CPA because it had no legal authority representing the medical professionals and that some of its complainants were actually found to have gay engaged in fraud do you know more about this particular casein and and this versus this operation against some black and Indian professionals medical professionals early on I'm aware that there was a case that were was before the courts where these allegations were being tested and that the CMS together with the minister and schemes recited as respondents and the case as far as I know was thrown out on the basis that the entity that had laid these charges didn't have the locus standi for presenting that case in other words the the the the the the contents or details of in substance of the case was not ventilated it was just that a technically technicality you know that was imposed yeah yeah all right we will talk more about this in fact I think it'll be good to to to get the CMS and to to try and clarify what actually happened in court we thank you for talking to us I know that this is just the beginning of a conversation that'll be happening for a long time when it comes to nhi and how it affects South Africans dr. Seibel Cabana CEO and register for the Council for medical schemes reacting to the health ministers budget and of course developments on nhi thanks again to offer your time let's take a break

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