Statement on the Release of the National Health Insurance Green Paper

The mission of the Helen Suzman Foundation is to defend the values that underpin our liberal constitutional democracy and to promote respect for human rights. The Foundation works from the premise that health provision represents one of South Africa’s key human rights issues. Section 27 of the Constitution states that “Everyone has the right to have access to health care services, including reproductive health care; […and that] no one may be refused emergency medical treatment”.

It is with this in mind that the Helen Suzman Foundation welcomes the release by the Department of Health of the National Health Insurance (NHI) Green Paper. The Foundation commends the Department’s acknowledgement of the challenges facing South Africa’s health system, and the Department’s intention to ensure that “all South Africans have access to affordable, quality healthcare services regardless of their socio-economic status”.

Having briefly engaged with the Green Paper, the Helen Suzman Foundation has some initial comments relating to the Paper.

Most importantly, given the extensive and lengthy time taken by Government in the development of this Paper, the public consultation period of only three months is inadequate for necessary and valuable input from the general public and civil society stakeholders. The Foundation is of the view that health care constitutes an essential part of the social compact. Thus, health reforms such as those envisaged by the introduction of the NHI should allow for all affected parties to have the opportunity to participate thoroughly and extensively in the process.

The Foundation is of the view that NHI needs to be recognised as a complementary tool in the larger process of Strategic Health Reform which needs to be undertaken by the State in consultation and in partnership with stakeholders in civil society – which includes the labour movement and business. Furthermore, it is vital that the challenges in the public health system should be pursued on the basis of evidence-based research. This will include well-thought-out, transparent processes and mechanisms of both investigation and feedback.

Especially when considering the delivery of quality public health services, the Foundation emphasises the necessity of transparent and accountable funding and resourcing mechanisms in order to address what is perceived to be extensive, if not pervasive, corruption.

In addition, the human capital deficits across a wide range of functional areas need to be urgently addressed, and a coherent human resource strategy needs to be implemented.

The relationship between public and private sector providers needs to be clarified. This is to give stakeholders a clearer sense of both their rights, but also their obligations. In the case of the private sector, the regulatory regime must be clearly enunciated.

Finally, there is uncertainty about the tax implications of the introduction of NHI. The Foundation urges both the National Treasury and the Department of Health to clarify this matter as soon as possible.

The Helen Suzman Foundation looks forward to engaging further with the NHI Green Paper and views its release as an important opportunity for engaging society in the collaborative development of a health system to the benefit of all. 

12 August 2011