The National Council of Provinces (NCOP) select committee on health and social services has adopted the contentious National Health Insurance (NHI) Bill without making any changes, dashing the private healthcare sector’s hopes that MPs would soften its provisions on the role of medical schemes.
The development takes the bill one step closer to final approval by the ANC-dominated NCOP, which is expected to vote in favour of it next week, and then submit it to the president for assent. The bill proposes sweeping reforms to SA’s healthcare system that include establishing a single NHI fund to purchase healthcare services on behalf of eligible patients and reduce the role for medical schemes sharply.
“We are obviously very disappointed,” said Business Unity SA (Busa) chair Cas Coovadia. “We have consistently said we don’t have a problem with NHI itself [but] certain sections need to be changed. Our submissions have fallen on deaf ears.”
If enacted, the bill’s provisions would weaken rather than strengthen SA’s health system and raise the risk of an exodus of healthcare professionals, he said.
Last week, Busa and Business for SA (B4SA) expressed optimism the select committee would change section 33 of the bill, which says medical schemes will be allowed to offer cover only for services not provided by the NHI. B4SA was formed during the coronavirus pandemic, and includes the Black Business Council and Busa, which is the Nedlac business representative.
“I am still cautiously expecting that there will be some amendments to the bill before it gets signed into law by the president,” said B4SA chair Martin Kingston. The president has the power to refer bills back to parliament for further consideration.
On Tuesday afternoon, despite extensive public submissions and suggested amendments from the national health department, the committee adopted the bill without any changes to the document it received from the National Assembly on June 13.
The health department’s deputy director-general for the NHI, Nicholas Crisp, told the committee previously it should consider amending the bill to bring it in line with a recent high court judgment upholding the rights of pregnant women and children under the age of five to free healthcare, regardless of their nationality.
He also told the committee that the department was looking at “a possible rewording” of section 33 of the bill to make the intentions clearer, and that a technical correction was required for the section dealing with medical scheme tax credits.
Crisp had not responded to Business Day’s request for comment at the time of publication.
With the exception of Western Cape, all the provinces voted in favour of the bill without proposing any amendments. The same pattern emerged last week, when all the provinces bar the Western Cape submitted their negotiating mandates without putting up any proposed changes for discussion and debate.
Committee chair Edward Njadu had not agreed to the Western Cape’s request for an extension on the deadline for submitting its mandates, which it had asked for to consider the extensive input it received during public hearings, said Gerrit Pretorius, chair of the provincial legislature’s standing committed on health and wellness.
The Western Cape conducted 10 public hearings, and had compiled a document summarising the input that ran to more than 600 pages, said Pretorius.
Njadu had not responded to Business Day’s request for comment at the time of publication.
The DA’s Mbulelo Bara said he believed the ruling party instructed ANC-led provinces to support the bill and ensure it was passed before parliament rose in December.
Public hearings were conducted in all nine provinces, and the NCOP received 106 written submissions from stakeholders. More than 23 000 written submissions were also received by the provinces.
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