NHI bill proposes doing away with healthcare brokers

available to pay for direct health expenses of members rather than to brokers, who are not needed in the healthcare system.”

The draft bill says the fund will be the single public purchaser and financier of health services. The fund will also be a “mandatory prepayment health services system”.

The bill states that the minister must, in consultation with the Minister of Finance, determine the budget and allocation of revenue to the fund annually.

According to the bill, the NHI Fund will:

• Enter into contracts with accredited public and private service providers based on the healthcare needs of users;

• Determine prices annually after consultation with healthcare providers, healthcare establishments and suppliers; and

• Collate utilisation data and implement information management systems to assist in monitoring the quality and standard of healthcare services, medicines, health goods and health-related products procured by the fund.

The fund will purchase health service benefits on behalf of

South African citizens, as well as accommodate people who are permanently resident in the Republic. A temporary resident will have the right to emergency medical treatment in terms of the provisions of his or her travel insurance.

The fund will also service all inmates as provided for in section 12 of the Correctional Services Act. Refugees and asylum seekers who have not been granted refugee status will have the right to emergency healthcare services and paediatric and maternity services at primary healthcare level.

The General Household Survey released by Statistics South Africa this week shows that, between

2002 and 2017, the percentage of individuals covered by a medical scheme increased marginally from 15.9% to 16.9%. This means that more than 46 million South Africans do not belong to a medical scheme.

The Ministry of Health says the Act will be implemented over three phases:

• The first phase, which ran from 2012 to 2017 and included the testing and strengthening of the healthcare system, has ended.

• Phase two runs from 2017 to 2022. It includes the development of NHI legislation and amendments to other legislation. This phase also includes the interim purchasing of personal healthcare services for vulnerable people, such as children, women, people with mental health disorders, people with disabilities and the elderly.

• The third phase, envisioned to run from 2022 to 2026, includes the contracting of selected healthcare services from private providers.

Dr Ali Hamdulay, the chairperson of the Board of Healthcare Funders of Southern Africa, says it is imperative that the private sector collaborates with the Minister and the Department of Health to positively shape the healthcare landscape.

“The private healthcare sector cannot stand by and think that it won’t be affected should the public sector suffer. Public and private healthcare sectors are not mutually exclusive,” Hamdulay says.

“Some schemes use state institutions for designated service providers, and our entire healthcare workforce is trained via academic and public institutions.”

Neil Kirby, the head of