Covid-19 pandemic makes a strong case against the NHI Bill resuming in Parliament in coming weeks

9 September 2020

Note to Editors: This statement follows a virtual press conference this morning. Please find attached a soundbite by Siviwe Gwarube MP. The press conference document can be found here.

The National Health Insurance Bill (NHI) will be making its way back to the normal programme of Parliament in the coming weeks as the portfolio committee of health resumes the legislative process. The Democratic Alliance (DA) contends that a compelling case has been made for the rejection of this Bill in its current form by the weakness shown by our health system over the past six months since the outbreak of Covid-19. It is for that reason that we want to ensure that the legislative process is followed to the letter with no political pressure to rush this Bill for the sake of ANC political pressure.

It is also for that reason the DA will be submitting its non-negotiables for this process to the Chair of the Portfolio Committee, Dr Sibongiseni Dhlomo, the Chairperson of Committees in Parliament, Mr Cedric Frolick and to the Speaker of the National Assembly, Ms Thandi Modise. This will be accompanied by a fierce opposition to the process being rushed in committee as we deliberate on this matter in the coming weeks.

The DA undertook a national oversight tour across all nine provinces which displayed the true nature of our health system. This underscored the need to design a universal health system that fixes what is broken and deters the grand theft of public money. South Africans have waited long enough for dignity and quality healthcare.

The NHI public hearings were concluded in February this year before the outbreak of the global pandemic. The process was suspended as Parliament migrated to a new way of conducting its business. In the next coming weeks, we will be resuming the process on this legislation. While we have noted the deliberate rushing of the process by the ANC, we are committed to ensuring that we conduct this work deliberately and thoroughly.

During the public hearings across the nine provinces the committee heard and received 961 submissions from just over 11 500 attendees. This information has been compiled by Parliament and will require the committee to scrutinize it over the coming weeks. In addition to this, Parliament has received over 64 000 written submissions in response to the advert both hand-delivered and emailed. This will include the thousands of submissions that the DA handed in on behalf of South Africans who made use of our online portal. The next phase of the legislation process is to process, hear and consider oral and written submissions from the various entities that have taken part in the process. 121 entities have indicated their intention to deliver oral submissions to Parliament, a process that the committee now has to decide on. These include trade unions, hospital groups, medical schemes, academics and industry experts.

Parliament has made the case for an independent entity to assist the committee in processing the submissions – oral and written – in order for the process to be efficient. The terms of reference for the service provider are yet to be decided on and the process is still in discussion with parties and their respective leaders.

The DA is committed to ensuring that this process is open, transparent and fair. In addition, we will ensure that Members of Parliament carry out their constitutional obligations of law-making. As such, we will be pushing for the following non-negotiables to the committee:

The role of the external service provider can only be limited to organizing the submissions and conducting logistical support. It cannot be in any way a substantive role that replaces the role of the Members of Parliament that requires us to actively engage with the views of the people of South Africa;

The tendering process, selection and ultimate appointment is the function of Parliament, however the DA members will keep a close eye on the provider chosen as this will have an impact on the objectivity and the integrity of the work done by the service provider. We have seen how this process can be manipulated during the Section 25 amendment process where the service provider is said to have provided feedback on the process to the ANC leadership before it came to Parliament, the independent legislative arm of our country.

While the ANC in Parliament seeks to rush this process, the DA will be making a written submission to the committee and to the Speaker that each presentation by an entity needs to be no less than 30 minutes and allow for 30 minutes engagement with the committee members. There has been a desire to limit the presentations to 10 minutes in order to cram as many as possible. We will fight against this. Ultimately, this process must be underscored by transparency and fairness.

The DA will support a hybrid system of engaging with stakeholders in an effort to accommodate as many of the 121 organizations that have indicated their desire to take part in this process.

We will argue that the committee should dedicate Tuesdays and Wednesdays to this process in order to allow members to still continue with their constituency obligations. The push for hearings to span over 5 days and on weekends is another attempt to rush this bill through without any proper engagement with what is being presented to us as law makers.

Ultimately, the process should be divided into the following steps: the consideration by the members of the oral submissions obtained from the public, the written submissions from the public; an agreement of the terms of reference for the independent service provider and then the roll out of the oral submission process by the various 121 entities.

In addition, it has been reported that the money lost or misappropriated due to corruption or irregular tender processes is estimated at R5 billion. This is money that could have gone into our Covid-19 response efforts but was feasted on by the corrupt and political elite. While investigations have been initiated by law enforcement agencies, this will yield very little results and virtually no recuperation of the money lost if there is no political will to prosecute guilty politicians in particular. We have seen this movie before. High ranking officials are scapegoated and guilty ANC politicians play musical chairs and are rewarded with seats in Parliament and legislatures or ministerial postings. This, in particular, makes the most compelling case against the establishment of an NHI fund that will be managed by a politically connected board. What we saw with the looting of Covid-19 relief funds will be replicated on a larger scale should this Bill pass in its current form.

While Covid-19 was an unavoidable health crisis that held even the most advanced health systems in a chokehold, our health system was never ready for something of this nature. Should the status quo remain, the system will collapse and all South Africans – regardless of their socio-economic status- will suffer. That is why we remain committed to ensuring that the country enjoys a system review that will:

Close the inequality gap which inhibits access to quality services;

Improve the quality of healthcare in the country;

Design a system that will allow for effective partnership between private and public health actors like we saw during this pandemic;

Give effect to the intention of the National Health Care Act of 2003 that allows for national government to regulate the private healthcare sector in a way to protect the consumer of the service and ensure quality;

Ensure strong governance systems that would allow for independence from political actors in order to root out corruption;

Ensure dignity for all South Africans which they currently do not enjoy.

That is the DA’s alternative to the National Health Insurance Bill which is encapsulated within the party’s Sizani Universal Healthcare Plan. This plan has formed the basis of the party’s submission to Parliament in order to aid the law-making process. The NHI Bill will do little to serve the people of this country. That is why we will continue to mount fierce opposition to this Bill.

Issued by Siviwe Gwarube, DA Shadow Minister of Health, 9 September 2020