Cabinet turns down contentious health bill
Cabinet has rejected the fiercely contested National Health Insurance (NHI) Bill, sending it back to the health department for further work, it emerged on Thursday.
The bill paves the way for farreaching health reforms aimed at achieving the ANC-led government’s ambition of providing universal health coverage.
Its main aim is to establish an NHI fund that will purchase health services on behalf of patients from public and private sector providers, which will be free at the point of care. A key aspect of the bill is the future role it envisages for medical schemes, which provide cover to about 8.9-million people.
The bill has been mired in controversy in recent weeks, after a leaked Treasury letter laid bare conflict between its officials and presidential adviser Olive Shisana. She reversed aspects of the bill previously agreed to by the ministers of health and
finance. The Treasury raised a host of concerns, ranging from the sharply diminished role of medical schemes laid out in the revised version of the bill to a lack of consultation about farreaching proposed changes to the role of provincial health departments.
Shisana heads the NHI “war room” in the presidency, which took control of the NHI process in August.
Shortly after the Treasury letter was leaked in mid-November, health directorgeneral Precious Matsoso went public with her concerns, saying she had been completely sidelined in the process of revising the proposed legislation after the public comment period closed, despite being the department’s accounting officer.
The bill was redrafted by Shisana and two people picked by health minister Aaron Motsoaledi — his adviser Aquina Thulare and deputy directorgeneral Anban Pillay.
Without directly alluding to it, a statement issued on behalf of the cabinet on Thursday made it clear it had not approved the bill for submission to parliament at its latest meeting, which took place on Wednesday. It was not on the list of bills and policies approved for public comment, nor on the list of draft legislation given the green light to enter the parliamentary process.
Presidential spokesperson Khusela Diko confirmed the bill came before cabinet on December 5 and had not been approved. “It will be finalised in the new year.” She declined to elaborate on cabinet’s concerns about the bill, saying she was unable to comment on cabinet processes. Attempts to obtain comment from acting cabinet spokesperson Phumla Williams were unsuccessful.
Motsoaledi’s spokesperson, Popo Maja, declined to comment on the cabinet’s deliberations or on the status of the NHI bill, as did finance minister Tito Mboweni’s spokesperson, Jabulani Sikhakane.
Motsoaledi has previously defended the government’s approach to crafting the bill, saying there was nothing irregular in the manner in which it was being processed.
8.9-million the number of people covered by medical schemes in SA