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Solidarity released its latest report on the National Health Insurance (NHI), which stresses that the majority of healthcare workers will leave South Africa if the government implements the NHI.
By executing the NHI, the state seeks to restore two critical problem areas in the South African healthcare sector: the unequal distribution of quality healthcare and the fact that medical aid funds and private medical services are unaffordable for most of the population.
According to the state, quality healthcare is only accessible to and affordable for the rich, with poorer people not having access to the same services and quality care. Considering that the government has run the public medical sector for decades, which today is a mere shadow of its former glory, becoming why the state now wants the private medical industry to embrace its NHI.
Nevertheless, according to the mandate, the NHI will be a central state-regulated national health fund that seeks to provide essential healthcare and overall coverage for all South Africans on an equal footing.
In light thereof, Solidarity says the healthcare sector is opposed to the implementation of the NHI. During a media briefing on Thursday, 26 August 2021, Solidarity said healthcare workers have indicated that they have no confidence in the government or its ability to effectively manage such a system.
According to them, this will destabilise healthcare in South Africa, and it will be detrimental to the quality of care provided.
Nicolien Welthagen, Senior Research Psychologist at Solidarity, said, “More than 85% of the healthcare workers who participated in the study indicated that the implementation of the NHI would lead to healthcare workers leaving the country. South Africa will therefore be left with a shortage of medical staff, which implies that quality and specialist healthcare services will be extremely scarce. All South Africans will suffer because of this and access to healthcare will consequently diminish instead of healthcare becoming more accessible.”
It is noted that the report acquired responses from 1,410 healthcare workers in three separate studies conducted in 2018, 2019, and 2021.
About one-third of the respondents (29,5%) are nursing staff, while 19,4% are General Practitioners. There are 7% who indicated that they are Specialists and 21,4% who can be classified in the “other” category of medical fields.
In addition to General Practitioners and Specialists, 45 other medical professions are represented in the study. Most of the respondents who are not General Practitioners or Specialists are Psychologists. Nine respondents indicated that they are paramedics, and six are medical representatives. Five respondents each are Occupational Therapists and Dentists.
Through the three surveys, Welthagen claimed, “Healthcare workers have specifically pointed out that the government is incompetent and that a system such as the NHI will only create another opportunity for further corruption by the government, as this will give them access to more funds that can then be looted. Healthcare workers are also of the opinion that the Covid-19 pandemic made it abundantly clear that the government does not have the ability to manage a system of this magnitude.”
In fact, 93.4% of the respondents have grave concerns regarding the state’s ability to manage and administer the NHI. Furthermore, 87,7% are seriously concerned about the state’s ability to make payments to health practitioners effectively and on time.
The total administration and management of funds and decision-making will be in the hands of the state. The respondents’ opinions are quite possibly shaped by the observed mismanagement and maladministration at institutions such as Eskom, the SAA, and the SABC.
However, the NHI will be significantly more extensive and complex. It must serve a population of more than 55 million people and manage and execute a multitude of contracts.
Alex van den Heever, the chairperson of the Social Security Systems Administration and Management Studies at the University of the Witwatersrand, warns that the NHI’s administrative and management system is seriously vulnerable to corruption and mismanagement and that there is too much power in the hands of the Minister.
Moreover, 86,6% are seriously concerned that the state can determine and enforce tariffs, place of work, type of diagnostic tests and type of medication and treatment. Total state control implies that the tariffs charged per consultation are controlled and that the state can prescribe the equipment, medicine and diagnostic tests and place of work for medical practitioners.
Many respondents (71,7%) are also seriously concerned that they could very well be paid lower tariffs per patient.
The shocking shortage of specialists, doctors, and other healthcare workers is a well-known fact throughout the country, as many continue to leave. With this in mind, former Health Minister, Aaron Motsoaledi, mentioned that at least three times more doctors would be needed for the NHI than in South Africa.
The NHI will be compulsory for all citizens and legal immigrants. 86,6% are seriously concerned about this for obvious reasons.
The report also shows that healthcare workers believe that the government should focus on improving the current public healthcare system and that cooperation with the private sector should be encouraged rather than seeking to centralise and control the entire healthcare sector.
Welthagen stresses that most healthcare workers simply do not want to work with or for the government. They also do not trust the state and do not want to be accountable to the state or be told how to do their jobs. “The fact that so many healthcare workers could leave the country is a major cause for concern. This will plunge South Africa’s healthcare into a crisis for which there will be no solution. We simply cannot allow the state to continue with its plans to implement the NHI and thus alienate and push away our healthcare workers,” Welthagen concluded.
What are your thoughts on the possibility of healthcare professionals leaving the country if the NHI is implemented?
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