The exclusion of the implementation of National Health Insurance (NHI) from the medium-term development plan (MTDP) was significant, as it meant there could be no budget and implementation of the scheme for the next five years, DA leader John Steenhuisen said in an interview with journalists on Wednesday.
Steenhuisen addressed a gathering of DA MPs, ministers and the media on the DA’s achievements in the government and its view on the government of national unity (GNU). He said the DA had received an undertaking from the ANC that provisions in the NHI Act that would cause the termination of private medical schemes had been taken out of the plan.
Monitoring planning and evaluation minister Maropene Ramokgopa confirmed in an interview with News24 that the ANC and DA had reached such an agreement.
Asked what that meant, as medical schemes would not be satisfied with simply a gentleman’s agreement, Steenhuisen insisted it was not simply a gentleman's agreement.
“There was a very clear target in the MTDP, which said at the end of the five-year period all medical funds would be collapsed into a single fund. That has now been removed from the draft MTDP as a project. That is in black and white,” Steenhuisen said.
“The ministerial advisory committee is going to look at the modalities and funding models of NHI without crashing medical aids over the next five years.”
He said the ministerial advisory committee would involve players in the private sector as well as healthcare officials, representatives of the healthcare industry and the ministry. Steenhuisen said there would be a discussion on funding models in the committee to ensure that there was a complementary private and public healthcare system through public-private partnerships.
“The MTDP is a document that guides government processes and procedures over the next five years. If something is not in line with the MTDP, it cannot find its way into the budget and it cannot be implemented.
“How are you going to implement the collapse of private medical aids if you have no budget to put towards developing a single fund? It’s not possible.
“We believe we can get to universal access to basic healthcare and get there a lot quicker if we do it in partnership with the private sector, not treating them as the enemy. There is simply no money for government alone to achieve universal access to basic healthcare,” Steenhuisen said. “We need to harness the money and expertise of the private sector and deploy in assisting us to develop a solid, working healthcare system.”
Steenhuisen said the only way to get the NHI right was for the NHI Act to go back to parliament.
“I imagine that over the course of a number of years, that law will be subject to amendment as modalities change and the financial situation changes. Aspects of the law will have to be relooked at,” Steenhuisen said in the interview.
He noted that there were large parts of the NHI Act that the DA agreed with, such as the focus on primary healthcare, improving the quality of healthcare, access to doctors and nurses, access to medication and the way medicines are distributed, among others.
Where the DA disagreed was that it was necessary to collapse the private sector to have a successful public sector. The two should be complementary rather than exclusionary, the party said.
Steenhuisen said the NHI Act had not been discussed in the clearing house set up to sort out disagreements within the GNU.
He warned if the NHI were not removed from the MTDP as promised, the DA could not be party to collapsing the private medical scheme sector and would have to reconsider its position in the GNU.
Steenhuisen said SA was in a tight fiscal space and there was no money to plough into the NHI as currently conceived. The introduction of universal basic healthcare would have to be introduced in a phased approach involving all stakeholders.
On another topic, Steenhuisen said that the DA intended to take the Expropriation Act to court.
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