Johannesburg – The Public Servants Association (PSA) on Monday weighed in on the National Health Insurance (NHI), saying it was not the solution for “access to meaningful healthcare services”.
The PSA said while it supports any effort to ensure universal access to healthcare it said, “this should be meaningful access with quality service, adequate medical supplies, clean and fully equipped facilities, adequate staffing with experience and expertise”.
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Representing more than 235 000 public-sector employees, the union said, “A single healthcare system, such as the NHI, is not the solution for access to meaningful healthcare services”.
The PSA said: “Over years, the country has witnessed a decline in the quality of public services owing to various reasons, including human-capital flight, poor infrastructure maintenance, a lack of accountability, corruption, etc.
“The question is if the NHI would yield better benefits for public servants and how it would impact on their disposable income as many of them are already subscribers to a variety of medical-aid schemes.
“The notion that workers could be expected to pay for private medical insurance and the NHI simultaneously, induces anxiety amongst public-sector employees.”
The union said the priority of health reform in South Africa must be the rehabilitation of the public-health sector.
“This can best be achieved by a competent, non-partisan public-health service, free of corruption and political interference,” said the PSA.
“South Africa’s two-tier healthcare system is not the cause of problems in the sector.”
The PSA added: “The demise of the private-sector system through the introduction of a single-purchaser model of the NHI and the imposition of a tax, equivalent to the average medical-aid spend, will also not produce effective management and administration in the public healthcare sector.
The PSA called for a “progressive realisation” of the right of access to healthcare within the resource constraints of the state.
“The proposed mechanism should strive to make healthcare accountable, affordable, and efficient through strengthening what works in the public sector and removing deficiencies,” the union said.
“This must be planned and implemented in a responsible, affordable, and sustained manner.
“The goal to achieve universal access to quality healthcare must not push us into implementing any and every programme without considering efficacy and effectiveness.”
The PSA said full implementation of the Human Resource Strategy would resolve skills shortages in the health sector.
“There must be a clear human resources plan to ensure training and staffing of facilities,” the PSA said.
“There can be no reform of the public sector if shortages of skilled personnel persist.
“In addition, the graduate output must be improved on an urgent basis to meet health-sector demands.”
The PSA said it was also concerned about the future of medical-aid schemes and how these will be incorporated into the NHI, else this could be the beginning of the end of medical-aid schemes.
“The introduction of the NHI may reverse gains achieved for public servants in respect of access to quality healthcare,” the union said.
The PSA said there was still much to be done before South Africa will be ready to implement the NHI as a one-tier health-reform system.
“The PSA thus urges President Cyril Ramaphosa to carefully consider all inputs before forcing a system onto the citizenry with dire consequences for the country.”
