DA supports SAMA’s fight against NHI

25 July 2023

The DA takes note of a South African Medical Association (SAMA) petition against the National Health Insurance (NHI) Bill with more than 56 000 signatures to date, and we encourage all medical professionals, stakeholders and South Africans to sign the petition.

SAMA shares many of the DA’s concerns with not only the NHI Bill, but also the fact that criticisms and objections to the Bill have been wilfully ignored by the ANC members of the parliamentary portfolio committee on health, who pushed the Bill through the National Assembly.

We implore the members in the National Council of Provinces (NCOP) to truly scrutinise the Bill, take the concerns of medical professionals, experts, stakeholders and the wider public into consideration, and reject the Bill.

The consequences of policymakers ignoring the concerns and grievances of health professionals and experts will be perilous and will certainly not encourage them to invest their skills in a country that refuses to take them seriously.

The DA believes that universal health care and coverage should be pursued, but the NHI Bill is not the correct mechanism.

Like SAMA, our objections to the NHI include the lack of a feasible funding model, human and other resource scarcities – which will surely be exacerbated by the inevitable brain drain as soon as the NHI is implemented – unsafe and improper facilities and equipment, maladministration, corruption and lack of consequence management.

If doctors were to leave in droves, it would have significant and concerning impacts on the country's healthcare system and the population's access to medical services.

The exodus would exacerbate the shortage of medical professionals already hobbling the public health sector, leading to decreased quality of care, longer waiting times, reduced access to specialized treatments, and overcrowded hospitals. The workload on the remaining medical personnel would increase, with increased risk of burnouts and potentially even more medical errors – medico-legal claims are already swallowing large portions of the provincial budgets.

It is possible that rural and already underserved areas would be disproportionally affected by the mass emigration, which might also affect medical education and training programmes as fewer specialists would be available to mentor and teach students.

Public trust in the public health system already seems to be at an all-time low, which could be exacerbated by the NHI and the inevitable increased waiting times, as well as the opacity regarding which services would be covered under NHI and the out-of-pocket impact on all South Africans.

The biggest problem with the NHI, however, is that the ANC is trying to legislate an ideal instead of implementing a thoroughly considered plan. Unfortunately, like most things touched by the ANC government, the NHI will inevitably succumb to corruption and cadre deployment, and it is the populace that will suffer.

Issued by Michele Clarke, DA Shadow Minister of Health, 25 July 2023