Can NHS deliver on healthcare promise?

President Cyril Ramaphosa is right about one thing. In a democracy such as ours, it is unacceptable that “access to health services remains dependent on a person’s social and economic circumstances, with poor people still struggling to access quality, reliable healthcare”. Delivering the ANC’s election manifesto in Durban on Saturday, Ramaphosa was emphatic in his stance that the introduction of the National Health Insurance plan will correct this injustice.

The NHI has been in the pipeline for several years, marred by delays and questions over its practicality and affordability.

Speaking to supporters, Ramaphosa said: “We will finalise the enabling legislation for the NHI and make sure that everyone has access to quality healthcare regardless of their ability to pay.

“This is a revolutionary shift, which requires that we promote social solidarity and work towards the cross-subsidisation of services – where those who can afford to pay more assist those who cannot pay; where the young subsidise the old and where the healthy subsidise the sick.” The principle may be a noble one.

However, several legitimate questions remain.

The most obvious being how the government plans to address the infrastructure and capacity problems that often cripple the public health sector.

Put differently, the government cannot force consumers to invest into and be part of a scheme which ultimately subjects them to poorer health services in the name of solidarity and financial subsidisation.

Government, at all spheres, must demonstrate a commitment to build capacity and improve efficiency in the management of clinics and hospitals. It must demonstrate resolve to tackle the corruption and poor management which have become synonymous with the system.

This is the only way to convince a rightfully sceptical public to even consider that this plan is indeed the best way to make quality healthcare accessible to all.