As the ANC holds its policy conference from Friday, Cosatu president S’dumo Dlamini has called on the ruling party to agitate for the rapid implementation of the NHI

THE Congress of South African Trade Unions supports the National Health Insurance as a health plan that will ensure that all South Africans have access to health care.

However, as a labour federation we are concerned about the apparent slow pace of implementation of the NHI.

The NHI is about a universal access to health care. In South Africa at the moment, only 16% of the population have medical aid. They are the only ones who enjoy quality health care from the private sector, yet the broader population of South Africa are victims of poor quality of health.

It has been almost 10 years since the NHI was introduced. When it was introduced, we were very excited that Comrade Aaron Motsoaledi led with passion. But we are now observing that suddenly there is just a slow pace in implementing this plan that will help the poor and the working class in particular.

As Cosatu, our approach is that the Health Department should not rely on the private sector to implement the NHI. The private sector’s business is to make money even on issues of health. Right now we do not have state pharmaceutical company.

The private sector can play a role in making treatment affordable in the absence of state pharmaceutical company, but we say that the establishment of a state pharmaceutical company should be the way to go.

The private sector should not be impinging in the implementation of the NHI purely because it wants to make money out of health services in our country. Private health care is costly. People are being chucked out before they fully recover. If you occupy a bed in a private hospital for three days, you are told your medical aid is finished and you are then transferred to a public hospital. Clearly, the NHI will fail if it relies on the private health care.

The private health care system wants to ride on the back of the NHI. They want the NHI to help them build more private hospitals when in fact we need more public hospitals.

Cosatu has campaigned for the introduction of the NHI but there are problems. We have heard people in the Free State saying it’s been months that people who are supposed to get ARVs have not been getting them. That’s a crisis.

It is our view that Cosatu, as a representative of workers, can’t just point an accusing finger at the government because our members who are in Nehawu and Denosa should assist in the implementation of the NHI. Our view is that while we cannot deny that there is a role that workers should play, the bigger responsibility of implementation lies with the employer.

The employer does not provide adequate training and equipment to workers. In some instances, health workers have to cope with what is there.

I do concede that in some cases, our members would be found wanting. I am not going to deny and say people should not blame our members. Yes, our members have a contribution to make as employees. But ultimately, it is the responsibility of the employer to provide workers with skills and tools to render a particular service.

In most cases, public servants have to improvise, they have to do with whatever is there and they make mistakes, and even put lives of other people in danger because there is no supply of equipment. Management does not ensure that people are placed in relevant areas of their expertise.

We must recognise conditions under which that our members are working. We must also recognise efforts of workers to help improve the levels of service in hospitals. For instance, a few years ago, Nehawu led a campaign on service delivery. They had to go to different hospitals like Baragwanath Hospital where there was a problem and the linen had been stolen. They went to Soweto and retrieved what had been stolen and sent back to the hospital. It’s not their duty but it was a way to demonstrate that we must put effective systems in place.

There is no union that will encourage its members to steal. A union must encourage its members to obey the rules and be diligent at work but when an employee is accused of stealing, because you are innocent until proven otherwise, the union has a duty to represent its member.

We must emphasise that trade unions help educate a worker and a cadre who is transformative at work, who will ensure that they are providing services that they are employed to do, who will ensure that they don’t steal.

The reality is that we have resolved to implement the NHI, which will shift focus of health services to the primary health care services. Primary health care services means being proactive. It means you are not focusing on curing but rather on preventing the diseases.

As Cosatu, our frustration is the slow pace of implementing the NHI. Cosatu appreciates the passion and the drive that the minister of health has injected to ensure the health care system becomes the focus of everybody. While we cannot over-emphasize the need to accelerate the implementation of the NHI, we do recognise the role that NHI projects have played on Basic Education, whereby more than three million learners have been screened for defects such as poor sightedness, hearing problems and oral hygiene. In the process, the NHI projects helped these learners with early detection and for that, the department and the minister deserve to be commended.

But what we are saying is that we need to put faster mechanisms in place that so that we realise the full implementation of the NHI during the current administration led by President Jacob Zuma.