Foreign doctors needed for NHI

2010-09-29 22:37

Cape Town – Foreign doctors will have to be recruited if the mooted National Health Insurance (NHI) is to be successfully implemented, hospital workers union Hospersa said on Wednesday.

"While the government's NHI plan has theoretical merit, in practice it will be exceedingly difficult to implement, particularly within the envisaged timeframe of 14 years," the union said in a statement.

"South Africa already suffers from an acute shortage of skilled health care personnel, yet the new system will require about 80 000 additional posts.

"It will be difficult to meet demands – and it is entirely likely that foreign doctors will have to be recruited," Hospersa said.

The ANC said at its national general council (NGC) last week it wanted to phase in national health insurance over 14 years from 2012.

The plan was expected to cost R128bn in its first year, increasing to R376bn by 2025.

Membership of the NHI would be compulsory for the whole population, but the public could choose whether to continue with voluntary medical aid scheme cover.

The ANC suggested the NHI be funded from various sources, including a surcharge on taxable income, payroll taxes for employees and employers, and an increase in value added tax (VAT) earmarked for the NHI.

Exceedingly difficult

Hospersa said it would be "exceedingly difficult" to implement the plan in the envisaged timeframe.

The union wanted "extensive" consultations with government on the NHI as hospital workers would be the "lifeblood" of any system implemented.

A massive training programme ought to begin immediately if there was to be any hope of realising the NHI ambitions.

"As such, Hospersa supports the call made by KwaZulu-Natal Premier Zweli Mkhize to establish nursing training colleges in numbers."

The union was also concerned about cost factors pertaining to the new system.

"It will be an abysmal failure if working people are required to fund a public health care system that is unreliable – as is the current one – and still pay for private medical cover.

"If the end result is the replacement of the dual system with one massive public health care scheme, then the government and all stakeholders, particularly trade unions, need to consider what will happen to health care if we have a public service strike such like the one we have just encountered," Hospersa said.

The NHI Campaign, whose members include Cosatu and the Treatment Action Campaign (TAC), said the NHI was "potentially" an important reform that could promote equitable access to appropriate health care for all.

Critical responses

"There have been critical responses to the ANC's support for the NHI from those with vested interests in the current health system, as well as some South Africans who are opposed to the high taxation that the NHI will require," a statement from the group said.

"The NHI Campaign believes that there is room for greater taxation without reverting to regressive taxation like VAT.

"We welcome the ANC discussion document on the NHI as a good step towards opening up the debate to the public."

The group said the proposed NHI had to be informed by a wide public debate and not, as had been the case, characterised by "secrecy" imposed by the Ministerial NHI Advisory Committee.

"We reiterate our call for this committee to conduct its work in an open and transparent manner," the group said.

The SA Medical Association (Sama) said a debate on the NHI should not be done in haste.

"We believe any debate should be given adequate time and we support, and (we) will robustly participate in such a debate on NHI," the association said.

"Undoubtedly, without consensus and a buy-in from all on how to achieve universal access to health care, any system will be doomed to failure."