Setting up NHI will take ‘twice as long as planned’
Developing the legal framework to breathe life into National Health Insurance (NHI) policy is likely to take twice as long as the government has planned, one of SA’s leading healthcare lawyers told delegates at the annual Hospital Association of SA conference on Wednesday.
It would require such a complex set of legislative reforms it would be impossible to achieve by 2022, said Werksmans Attorneys’ director of healthcare and life science practice, Neil Kirby.
NHI aims to provide quality healthcare to everyone free at the point of delivery, and to narrow the gap between care currently available to the rich and the poor. The government’s latest policy on NHI is set out in a white paper, which says the enabling legislative framework for NHI is to be developed between 2017 and 2022.
In addition to amending 11 existing healthcare acts, the government would probably need to craft two new pieces of NHI-related legislation, said Kirby. This was likely to involve an act stipulating who would belong to the scheme and the role of providers, and an act to deal with the financing mechanisms, he said.
Amendments would probably be needed to the Consumer Protection Act and the Labour Relations Act. Once the acts had been promulgated, they would require enabling regulations to bring them into effect.
He warned: “This is gargantuan, paradigm-shifting stuff … an incredible burden on Parliament, which has to deal with numerous issues … this is not an issue that necessarily takes precedence over other legislative processes.
“This cannot be rushed. But the slower it is, the more jittery everyone becomes,” he said.
The Hospital Association of SA is an industry body for private hospitals and its conference gathers some of the most influential players in private healthcare. NHI was the key talking point, as the white paper has created a climate of uncertainty for private healthcare providers and funders.
Econex director Mariné Erasmus said patients would get a better deal far sooner if healthcare experts turned their attention to fixing the public sector’s management issues, instead of debating the funding reforms required by NHI.