Cab­i­net turns down con­tentious health bill

Business Day - - Front Page - Ta­mar Kahn Science & Health Writer

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

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