The recent Board of Healthcare Funders Annual Conference was a National Health Insurance (NHI) watershed, Michelle David, an associate in the Employee Benefits Group at Bowman Gilfillan Attorneys, said in Johannesburg.

Over the past few months the NHI, set to be implemented by Government, has been a heated talking point, with the viewpoints conveying differing degrees of fear and hope. Some see it as the pathway to better health at decreased cost, while others perceive it to be the end of good health care provision in the country.

David pointed out that government had throughout the speculation insisted that the NHI would not be implemented without stakeholder participation.

She cited the Deputy Minister of Health's comments during his opening address at the Board of Healthcare Funders Annual Conference, pointing to his statement that that the policy of government and the ANC was that the private sector was an important and treasured component of the South African health sector.

Proposals to make NHI work

"The Deputy Minister called upon the private sector to come up with helpful proposals on how to make NHI work. Throughout the conference, the message from government was that NHI was here to stay but the details were yet to be determined. Importantly, such details would only come after debate with the relevant stakeholders."

David concluded that the time for stakeholders to stand up and be heard had arrived. In this context, she pointed out that the Minister had, in terms of section 91 of National Health Act, established the NHI Advisory Committee, which had been tasked with advising the Minister on the development of NHI policy and legislation.

The specific advice sought was:

  • The development of policy on the implementation of NHI after an extensive and transparent process of public consultation;
    • The drafting of legislation relating to the introduction of NHI; and
  • The development of a detailed implementation plan for the introduction of NHI.

David noted that the Committee was also empowered to recommend the commissioning of research on various aspects of NHI.

"The Committee comprises of at least 22 individuals from a number of stakeholders, both public and private. The Committee's make-up is a good mix of public and private stakeholders and seems to acknowledge the medical funding and provision expertise which resides within the private medical industry.

Made good on its promise

"The Committee includes representatives from government departments, health care providers such as nurses and emergency service personnel, the regulator, the medical schemes industry, the community and other relevant experts such as actuaries and attorneys.

"Government has, with the introduction of the Committee, made good on its promise to involve all stakeholders in the implementation of NHI."

David advised that a secretariat, housed within the Office of the Minister, would provide support to the Committee and would be responsible for assembling technical working groups on various aspects of NHI policy development and implementation at the Committee's direction.

Submit the draft proposals

"The inclusion of stakeholders goes even further," said David, "as the Committee is obliged to invite interested parties to make submissions on various aspects of NHI and must take account of all representations made. The Committee is also tasked with arranging consultative forums to workshop the draft NHI policy."

David expected the Committee to finalise public consultations on the draft NHI policy within three months of its publication and to submit the draft proposals on NHI legislation to the Minister within three months of Cabinet approving the policy. Finalisation of the implementation plan proposal, including the transitional arrangements, was expected by June 2010.

"Given the timelines, we can expect to see a draft NHI policy soon. Stakeholders should spend this time getting ready so that they do not find themselves on the back foot when the policy is published for comment."

Michelle David is an associate in commercial law firm Bowman Gilfillan.