Coronavirus accelerates South Africa’s NHI plans

There more positives than negatives that will come out of the coronavirus pandemic, says Dr Nicholas Crisp, NHI fund developer and consultant at the Department of Health – including the introduction of the new National Health Insurance (NHI).

Crisp said that part of the NHI’s budget was ‘given up’ to help fund the coronavirus, but that this budget was ultimately used to improve infrastructure, facilities and equipment.

He said that the coronavirus has also helped the government learn new lessons around staffing, health and safety, and health products – all of which will help boost the implementation of the NHI.

“On top of that, our data was a big shambles before Covid and that was one of our big projects in the NHI office. We had to convert our entire NHI’s digital capabilities to look after Covid.

“Now what we are left with is an unbelievably competent digital system that has data in which we would never have dreamt of having before.” He said that this includes data from the private sector which will help boost the NHI’s capabilities.

Crisp said that the ultimate goal of the NHI was to achieve ‘equity’ and ‘good quality healthcare’.

“What we are trying to do in universal health coverage is have a greater number of people, with a greater number of services, with less financial vulnerability at point of care.”

South Africa will need to spend money to ‘make change’ and the country will need to invest to reform the system, he said.

Crisp noted that the country spends 8.5% of GDP on healthcare which is good as a developing nation, but this money is not spent wisely.

“The NHI is a financing mechanism which changes the way we purchase our healthcare. The same money needs to come into one central pool fund, not through 10 different government departments and 78 medical schemes.

“We would like to have one common, sizeable, huge pool of funds which we can use to leverage to purchase the goods and services (needed) to run healthcare.”

He said that the NHI also wants all of the resources used or spent in both the private and public healthcare sectors to contribute towards the fund.

Crisp said it was not necessary to nationalise the companies, but instead, the pool of funds will purchase healthcare from all adequate public and private healthcare providers.

He said that the purpose of the fund was not to compete with similar systems introduced by the UK or US but was instead aimed at giving decent healthcare for every single person, irrespective of whether they can pay for it or not.

In July, Health minister Dr Zweli Mkhize confirmed that government is pushing forward with plans to move towards the NHI.

Presenting his updated department budget vote in a virtual parliamentary meeting on 23 July, Mkhize said that a fundamental condition for growth and development is a healthy and productive population, with access to quality and affordable health care.

He added that his department has put great effort into improving health service delivery to prepare for NHI and achieve universal health coverage.

“Covid-19 has illustrated just how important data and information are in managing health decisions,” Mkhize said. “We are pleased that during the past few months the NHI information systems capacity has been augmented, strengthened, and dramatically improved.

“The investments made in these improvements will all remain and enhance the capability of the department to manage the health system into the future.

“We have established a patient registry through the deployment of the Health Patient Registration System in our PHC facilities and Hospitals. To date, a total of 51,909,554 patients have been registered.”

Mkhize said that his department has also developed a health systems dashboard which will soon go live.

“This system will support the government with early warning signs in surveying hospital infrastructure, alerting us to impending critical mass reach in various areas of our operations, and giving us an opportunity to respond before there is a crisis on the ground,” he said.

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