Business Day

Setting up NHI will take ‘twice as long as planned’

- Tamar Kahn Science and Health Writer kahnt@businessli­ve.co.za

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.

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