NHI Bill in Parliament reveals more about the intent behind the proposed law

Courtesy of Elsabe Klinck and Associates
The NHI Bill has rapidly progressed through the Health Portfolio Committee in August and September. This has resulted in over 200 pages of minutes, detailing the views of political parties on the Bill.

These views reveal more details on the Bill’s intent and confirm fears in relation to medical scheme cover, and the payment of specialists. It is expected that specialists (and presumably other HCPs working on secondary and tertiary care in the private sector) will be paid through alternative reimbursement methods (ARMs) by, so it seems, private hospitals. Healthcare professionals such as private sector pharmacists, occupational therapists and psychologists do not seem to have a clear “home” in the Bill.

Opposition MPs have raised concerns about the removal of health from provincial powers, and the fact that all public health facilities will become “components” of the National Department of Health (NDOH). It also seems clear that the National Health Insurance Fund will undertake, through its Benefits Pricing Committee, some level of price control over all providers and suppliers.

Some smaller amendments have been proposed, but the Bill appears to largely remain intact. One of the larger amendments relates to the CUPs, contracting units for primary healthcare, which will no longer receive money from the NHI Fund.

Discussions were at clause 47 of the Bill on 20 October with only the chapters on Financing, Transitional/miscellaneous arrangements (some 8 clauses) and the schedule of amendments to other laws, remaining.

As next steps, the NHI Bill will go to the National Council of Provinces (NCOP). Stakeholders may contact the Select Committee to request hearings on the Bill.

The NDOH has indicated that it wishes the Bill passed in parliament by March 2023.

To obtain a copy of the EKA summary of the Portfolio Committee NHI minutes so far, including commentary on the issues of constitutionality and other legislation, please contact Eugenia. Price: R1800 + VAT and an update on the last clauses will be provided for free (Parliament is now dealing with various Annual Reports) once discussions resume.