Minister of Finance, Pravin Gordhan was short on detail
regarding National Health Insurance (NHI) in his budget speech, indicating that
the pace of implementation was slower than expected.
“It was not so much what was said, but what wasn’t said. The
lack of detail suggests that there is much work to be done on the practical
implementation of the process,” says Mark Arnold, Principal Officer of
Resolution Health Medical Scheme.
Funding the NHI
“There is also much to be done in figuring out exactly how
it will be funded. The National Treasury is working with the Department of
Health to examine the funding arrangements and system reforms required for NHI.
A discussion paper inviting public comment on various
options will be published later this year,” continues Arnold.
Gordhan said new policy initiatives such as NHI would only
be affordable if South Africa succeeded in driving growth towards 5% a year and
government revenue doubles in the next 20 years.
He said if growth continued along the present trajectory,
substantial spending commitments would require reductions in other areas of
spending and adjustment to tax policies.
NHI competing against
other spending requirements
George Roper, CEO of Agility Africa says, “NHI obviously
remains a priority, but is competing against a range of other spending
requirements. If it does not deliver, even in the early stages of
implementation, it runs the risk of losing its allocation to other programmes.”
NHI pilot projects began last year, and were allocated a
R150m conditional grant for the fiscal year 2012-13. Only 14% of the budget had
been spent by last month, far short of the 83% benchmark used by the Treasury.
Each of the 10 pilot districts was allocated R11.5m, and seven central
hospitals in these districts received R5m each.
“When it comes to implementation, most ambitious plans do
need refinement,” says Arnold.
Medical staff need to
up their game
“The Budget Speech shows there has also been a realisation
that health infrastructure as well as medical and nurse training capacity must
first be improved if NHI is to be successful.
In 2012, a total of
1 967 health facilities and 49 nursing colleges were in different stages of
planning, construction and refurbishment,” concludes Arnold.
(Press release, February 2013)