Rush to push through NHI Bill before ANC conference
Parliament’s ANC-dominated health committee is racing to complete its work on the contentious National Health Insurance (NHI) Bill, intent on getting it through the National Assembly before the party’s elective conference in December.
Approval by the National Assembly is a milestone in the bill’s passage through parliament, which will then submit it to the National Council of Provinces for concurrence.
The NHI has been on the ANC’s political agenda since 2007 and has featured prominently in its election promises ever since. If the bill is approved by MPs, health minister Joe Phaahla will be able to show delegates to the conference, which begins on December 16, that the current administration is making progress towards implementing the policy.
The bill is the government’s first piece of legislation for breathing life into its plan for universal health coverage, which aims to ensure everyone can obtain health services that are free at the point of delivery. The bill proposes sweeping financing reforms that would ultimately lead to a central NHI fund purchasing services from accredited providers on behalf of the entire population. It also contains controversial provisions that would sharply reduce the role of medical schemes.
Parliament’s portfolio committee on health has been considering the bill since August 2019 and is nearing the end of its work, with two meetings left before it draws up its “A list” of amendments to the bill, according to chair Kenneth Jacobs.
On Wednesday, the committee is scheduled to hear the department of health’s final response to its clause-by-clause deliberations on the bill, and on Friday, it will get input from the state law adviser’s office and parliament’s legal advisers.
Jacobs said in an interview with Business Day on Monday evening that the committee hopes to have the bill adopted by the National Assembly by December 6. Parliament has extended its term until December 6 in order to hold a special session to consider an independent report on whether President Cyril Ramaphosa has a case to answer after a burglary at his Phala Phala farm.
Once the health committee has completed its work on the A list, parliament will draw up a revised version of the NHI Bill, known as the “B version”, incorporating the amendments approved by the committee. It will then be submitted to the National Assembly for a second reading debate and a vote.
Give that the ANC holds the majority of seats on the committee and in the National Assembly, it is expected to drive through a version of the bill that differs little from the document tabled in 2019. Throughout its deliberations, the committee has been sharply divided on party lines, with opposition MPs raising detailed concerns about the bill’s provisions and ANC MPs expressing few reservations.
On Tuesday, MPs were provided with a high-level summary of the concerns raised during public consultations on the bill, which included provincial hearings, written submissions and parliamentary hearings. MPs were not given an opportunity to interrogate the material presented by the committee’s content adviser, Lindokuhle Ngomane, but opposition parties voiced their frustration with the committee’s processing of the bill and reiterated their calls for the Treasury and the minister of finance to
provide them with details on the funding of NHI.
“The ANC is going to do the NHI whether we like it or not. Regardless of political allegiance
… this bill will have our names stamped on it. We should not just be sidelined,” said EFF MP Naledi Chirwa. “The request to have the minister of finance come to this committee ... needs to happen as a matter of urgency.”
Munzoor Shaik Emam of the National Freedom Party said the question of how NHI would be funded should not be shrugged off. “If there are unanswered questions, is it not our responsibility as legislators to interrogate them?” he asked.
The ANC’s Nhlanhla Xaba dismissed opposition MPs’ complaints that their concerns had been ignored. “The ANC has seriously analysed the submissions made by stakeholders and made changes, where necessary, clause by clause,” he said.