Financial Mail and Business Day

‘No need to wait for NHI to fix health‘

• Researchers urge action on market inquiry findings

Tamar Kahn Health & Science Writer ● Disclaimer: Kahn was an invited participant in the research. kahnt@businesslive.co.za

The government does not need to wait for National Health Insurance (NHI) to take steps to improve health care, such as those recommended by the Health Market Inquiry, concludes a report from lobby group Section 27 and Concentric Alliance.

The government does not need to wait for National Health Insurance (NHI) to take steps to improve healthcare, such as those recommended by the Health Market Inquiry (HMI), concludes a report from lobby group Section 27 and Concentric Alliance.

NHI is the government’s policy for achieving universal health coverage, which aims to ensure everyone has access to care that is free at the point of delivery. The policy has been more than a decade in the making, and its first piece of enabling legislation — the NHI Bill — is being considered by parliament’s portfolio committee on health.

“We have had real stagnation of health reform efforts while we wait for the NHI Bill. [But] there are things we can do now,” said Section 27 head of health Sasha Stevenson.

The report drew on interviews with 33 participants from a wide range of sectors, including national and provincial government departments, private hospitals, the pharmaceutical industry, medical schemes, trade unions, healthcare workers, academia and the media.

Despite the highly polarised public debate on NHI, the researchers found many areas of consensus among participants. “Everyone agreed on the urgent need for health reform,” said Stevenson at the report’s launch on Monday.

“Everyone agreed there are governance, management and accountability issues that need urgent attention, and everyone agreed there is a need for, and possibility of, collaboration.”

The researchers recommended measures to improve healthcare in parallel to the government’s work on NHI. These include implementing key recommendations from the HMI, reforming procurement systems, setting up projects to measure health outcomes in the public and private sector, and devising pilot projects to experiment with different ways of procuring and financing health services for NHI.

The HMI was established by the Competition Commission in 2014 to investigate the dynamics in the private healthcare market and determine whether there were barriers to competition that hindered patients’ access to care. None of the recommendations contained in its final report, published in 2019, have been implemented. These included establishing a “supply-side

health regulator” to oversee private sector pricing, the quality of services, and the licensing of private healthcare facilities.

“Implementation of these actions does not signal a move away from the NHI agenda. On the contrary, movement in areas of consensus could provide proof of concept for some elements of NHI or illustrate where changes are needed,” said the report’s authors. “Some of the actions are implementable in the short term and there is evidence of agreement on the need for their implementation,” they said.

Nearly all the participants indicated a willingness to attempt dialogue, suggesting scope for building consensus in areas of disagreement such as the role of medical schemes, said Stevenson. One of the most contentious aspects of the NHI Bill is its proposal to reduce the role of medical schemes to providing only “complementary cover”, limited to benefits not provided under NHI.

Discovery group executive director Ayanda Ntsaluba said a variety of parallel processes could be undertaken as NHI was developed, such as strengthening the public sector, implementing public-private partnerships, and implementing the HMI’s recommendations. “There are many people who really want to make sure our country works. Our health system is a key aspect of human capital development and the stability of the country,” he said.

The health department’s deputy director-general for NHI, Nicholas Crisp, said officials had decided which aspects of the HMI report to implement before the onset of the coronavirus pandemic in early 2020, but their work had been delayed as they focused on responding to the Covid-19 crisis.

“We lost two whole years of things we wanted to do.” His unit had also been hamstrung by a staff shortage, which would shortly be rectified, he added.

MOVEMENT IN AREAS OF CONSENSUS COULD PROVIDE PROOF OF CONCEPT FOR SOME ELEMENTS OF NHI

FRONT PAGE

en-za

2022-06-21T07:00:00.0000000Z

2022-06-21T07:00:00.0000000Z

https://bd.pressreader.com/article/281582359301951

Arena Holdings PTY