I misjudged set-up time for NHI pilots, admits Motsoaledi

HEALTH Minister Aaron Motsoaledi has admitted that he underestimated the time it would take to lay the foundation for the National Health Insurance (NHI) scheme, confiding to MPs that he was left virtually in tears by the lack of interest in the scheme displayed by the Eastern Cape.

Briefing MPs on the progress his department has made towards realising the NHI scheme, which the government hopes will guarantee universal quality health care, the minister said he had hoped it would take two months to consult with key players in the districts where the scheme is being piloted. But the consultation process had gone on for nine months already, and the Eastern Cape’s OR Tambo district (in the former Transkei), an area that Motsoaledi described as “extremely problematic”, was yet to be consulted.

He told the parliamentary oversight committee on appropriations: “I thought it was a small job… it was bigger. The fact that I took nine months is because I met problems that I never anticipated.”

The minister added that tan- gible changes would only be visible after April at the pilot facilities when the 600 GPs contracted to 533 clinics were scheduled to begin their work.

Rural clinics in the pilot districts would also acquire new medical equipment in April.

But the OR Tambo district would not benefit because of the numerous problems that the department had encountered there.

Motsoaledi admitted that if anyone wanted to assess the progress of the NHI now, his department would probably get zero.

He told MPs he “deliber- ately wanted excluded” the OR Tambo region since the province had shown no interest in the NHI pilot, and had failed to notify people when Motsoaledi went on a road show.

“When I left there I was nearly in tears. The province had failed me dismally. So I said let the other districts start in April with all this equipment. Once they’ve started, I will go back to OR Tambo to start from the beginning,” he said.

MPs heard that the health department has so far filled just less than half (46 percent) of the specialist posts in the pilot hospitals and mobile units, and that those employed included senior gynaecologists, anaesthetists, paediatricians and advanced paediatric nurses and midwives.

More mobile units were to be launched from April as part of a Schools Health Programme, aimed at providing health services to the country’s 12 million pupils.

The department was criticised for underspending on its NHI grant of R150m, which has been divided to provide R11.5m for each of the 11 pilot districts.

So far only 14 percent of the total NHI budget has been spent, with Limpopo and the Northern Cape each spending about R500 000.

KwaZulu-Natal, the Eastern Cape and the North West had each spent just over R1m.

Dr Mark Blecher, the National Treasury’s chief director of health and social development public finance, said the districts were expected to have spent 83 percent of the budget by now.

The committee’s chairman, Mshiyeni Soguni, said it seemed that provinces had different understandings of how the grant needed to be used, with some seeing it as a substitute for their equitable share.