NHI implementation slower than expected

Minister of Finance, Pravin Gordhan was short on detail regarding National Health Insurance (NHI) in his budget speech, indicating that the pace of implementation was slower than expected. 

“It was not so much what was said, but what wasn’t said. The lack of detail suggests that there is much work to be done on the practical implementation of the process,” says Mark Arnold, Principal Officer of Resolution Health Medical Scheme.

Funding the NHI project

“There is also much to be done in figuring out exactly how it will be funded. The National Treasury is working with the Department of Health to examine the funding arrangements and system reforms required for NHI.

A discussion paper inviting public comment on various options will be published later this year,” continues Arnold.

Gordhan said new policy initiatives such as NHI would only be affordable if South Africa succeeded in driving growth towards 5% a year and government revenue doubles in the next 20 years. 

He said if growth continued along the present trajectory, substantial spending commitments would require reductions in other areas of spending and adjustment to tax policies.

NHI competing against other spending requirements

George Roper, CEO of Agility Africa says, “NHI obviously remains a priority, but is competing against a range of other spending requirements. If it does not deliver, even in the early stages of implementation, it runs the risk of losing its allocation to other programmes.”

NHI pilot projects began last year, and were allocated a R150m conditional grant for the fiscal year 2012-13. Only 14% of the budget had been spent by last month, far short of the 83% benchmark used by the Treasury. Each of the 10 pilot districts was allocated R11.5m, and seven central hospitals in these districts received R5m each.

“When it comes to implementation, most ambitious plans do need refinement,” says Arnold.

Medical staff need to up their game

“The Budget Speech shows there has also been a realisation that health infrastructure as well as medical and nurse training capacity must first be improved if NHI is to be successful.

  In 2012, a total of 1 967 health facilities and 49 nursing colleges were in different stages of planning, construction and refurbishment,” concludes Arnold.

(Press release, February 2013)

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