NHI will be ‘gut­ted by graft’


The Citizen (KZN) - - Business - Suren Naidoo

Pub­lic health pol­icy guru says the NHI is not go­ing to solve the prob­lems in health­care.

Con­cerns have been raised that the gov­ern­ment’s plan to set up a Na­tional Health In­surance (NHI) scheme will re­sult in another state-run mo­nop­oly that will be sus­cep­ti­ble to cor­rup­tion and mis­man­age­ment.

Th­ese fears were voiced by Alex van den Heever, an ad­junct pro­fes­sor at the Univer­sity of the Wit­wa­ter­srand (Wits) School of Gov­er­nance, who was one of the speak­ers at a panel dis­cus­sion on the NHI at the SA Vi­sion 2030 Summit in Ekurhu­leni last week.

Van den Heever, who is chair of So­cial Se­cu­rity Sys­tems Ad­min­is­tra­tion and Man­age­ment Stud­ies at the Wits school of gov­er­nance, is a vo­cal critic of the NHI and has more than 25 years of ex­pe­ri­ence in pub­lic health­care pol­icy and ad­vo­cacy.

“Ten­ders and the ex­ist­ing frame­work in gov­ern­ment health­care have also been af­fected by a sys­tem of pa­tron­age, which is en­demic in the cur­rent sys­tem,” he said. “A new gov­ern­ment mo­nop­oly – in the form of the NHI – is not go­ing to solve the prob­lems in health­care.

“Be­sides the huge costs as­so­ci­ated with the NHI, I be­lieve the plan will cre­ate another state-run mo­nop­oly that is des­tined to fail and be­come racked by cor­rup­tion and state-cap­ture is­sues the likes of Eskom, Transnet and other state-owned en­ter­prises (SOEs) have faced in re­cent years,” he added.

He noted the NHI plan in­cluded mass pur­chase of health­care drugs. “With the NHI, we will cre­ate a ‘mo­nop­oly pur­chaser’, which could open the sys­tem to grander scale cor­rup­tion, like at Eskom.”

He said that while the SA health­care sys­tem needed re­form, im­prove­ments could be achieved “in­cre­men­tally over time” with more ac­count­abil­ity and pol­icy reg­u­la­tion, rather than through “one big mo­nop­o­lis­tic state-run na­tional plan”.

“There needs to be re­form in the health depart­ment at na­tional and pro­vin­cial level as well as within the pri­vate health­care sec­tor, but we can’t have one big plan and wait for the NHI to sort things out.”

Re­spond­ing to Van den Heever’s crit­i­cisms, Dr Ni­cholas Crisp, an ad­vi­sor on the NHI to the depart­ment of health, said a ma­jor over­haul of the whole health­care sys­tem was needed. “Some 45 mil­lion South Africans are not get­ting ad­e­quate health­care and we are see­ing more un­hap­pi­ness around the coun­try. We hope to help turn the tide with the NHI,” he noted.

Nei­ther Crisp nor Van den Heever went into the ex­act costs as­so­ci­ated with the NHI plan, but var­i­ous re­ports have put the bill at be­tween R70 and R256 bil­lion.

Pic­ture: Shut­ter­stock

RISKY. Cre­at­ing a ‘mo­nop­oly pur­chaser’ of health­care drugs could open the sys­tem to ‘grander scale cor­rup­tion’, says Pro­fes­sor Alex van den Heever.

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