Cape Town - The National Budget Speech is expected to reveal
further details on government’s proposed roll-out of the National Health
Insurance (NHI) initiative, yet South Africa’s medical profession remains
divided on whether this is the correct route to take, according to a new survey
released by PPS.
The survey of almost 700 medical professionals, found that
62% of those working in the public sector agreed with the principle behind the
scheme, while only 57% in the private sector felt the same.
When asked whether NHI is the correct solution to fixing the
ailing public health service, the figures were even more alarming. Only 23% of
respondents working in the public sector agreed, while 14% of those in the
private sector said it was the right solution.
Gerhard Joubert, head of group marketing and stakeholder
relations at PPS, said that while government-employed medical professionals
have slightly more optimism than those in the private sector, both segments
still have concerns about the implementation of NHI.
“There is a general assumption that medical professionals in
the private sector have more misgivings about NHI than those in the public,
however, it is clear that both groups still have serious misgivings,” said
Earlier this month, the SA Medical Association warned that
the NHI scheme could collapse if it is implemented now, as the health system is
already overwhelmed by decaying resources, noting that the public sector needs
fewer managers and more people who can fix problems such as in-house
electricians and plumbers.
Joubert says the continued concerns that are being raised
about the NHI scheme show that far greater dialogue needs to be opened between
government and the medical sector - both private and public - in order to find
a workable solution.
“It is commonly accepted that the public healthcare system
is in serious need of an overhaul and that something needs to be done about the
fact that the vast majority of the population do not have access to adequate
healthcare; but this must be done with buy-in from those working within the
industry,” said Joubert.
Further figures released from the survey showed that those
working in the public sector have a confidence level of just 47% in the future
of the healthcare system over the next five years. This drops to a confidence
level of just 41% for those working in the private sector.
“There is clearly more optimism among professionals in the
public sector than the private but in reality, neither group has demonstrated
huge levels of optimism about these plans. Government has committed to spending
R255bn to the NHI project by 2025, yet those actually working in the industry
remain unconvinced,” Joubert said.
Elsewhere, the survey also showed that confidence in their
ability to earn a sufficient income should NHI be implemented was recorded at
60% for those in the public sector and just 50% for those in the private
He said it is critical, particularly since President Jacob
Zuma confirmed in his State of the Nation address that an NHI fund would be set
up in 2014, the same time as the insurance programme is expected to launch
nationally, that such concerns are taken seriously.
Commenting on the results of the survey, Professor Alex Van
Den Heever, Chair of Social Security at the University of the Witwatersrand
Graduate School of Public and Development Management, said: “When many of the
failures of the public health system are systemic, it is furthermore unclear
which systemic problems a “fund” is meant to address and what it’s meant to do.
Particularly as the public health budget is already a “fund” annually allocated
by a parliament.”
“Given the absence of any concrete proposals, including
those regarding governance of such a fund, questions remain as to whether it
will have any proper purpose,” said Van den Heever
“Universal coverage is a worthwhile objective and the
medical profession clearly supports the principles behind its achievements but
the priorities identified by the people working in the industry is to fix the
problems in state services first,” said Joubert.
*Visit our 2013 Budget section for full coverage of Finance Minister Pravin Gordhan's National Budget speech.