Health and Wellness
Hon Booysen.
- What is the projected impact of the recently signed National Health Insurance Act on healthcare provision in the province in terms of (a) costs, (b) patients’ ability to choose a healthcare provider and (c) the overall quality of healthcare in public hospitals;
- whether there has been any indication from the national Department of Health or the national Treasury that the provisions of the NHI that have to be implemented by provincial governments will include the allocation of sufficient resources to fulfil their mandate; if so, what are the relevant details?
(1)(a) The projected impact of the National Health Insurance Act on healthcare provision in the province includes uncertainties regarding costs. The role of provincial health departments is also unclear, but it appears that their powers will be reduced. Conditional Grants and Provincial Equitable Share (PES) intended for ‘personal healthcare’ will be redirected to the National Health Insurance Fund (NHIF) which will pay providers directly. This will impact the Western Cape Health Department’s ability to ensure the standard of care that is currently provided. It will also limit the Department’s ability to innovate to find solutions that work best for our communities and to expand on the significant progress that has been made in ensuring access to quality medical care for all inhabitants of the province.
(1)(b) In terms of patients' ability to choose a healthcare provider, the Act allows all users to register at an accredited health care facility of their choice and facilitates referral to higher levels of care as clinically required. The exact package of care to be provided, the accreditation requirements and the referral procedures, have not yet been finalised.
(1)(c) Regarding the overall quality of healthcare in public hospitals, the implementation of the Act will depend on the availability of resources and the specifics of the funding allocations that have not yet been confirmed. Further there is uncertainty surrounding the administration, management, budgeting and governance of central hospitals (Groote Schuur, Tygerberg and Red Cross War Memorial Children’s Hospital) which the Act provides to be made a competence of national government. The likely reduced role of provincial health departments should be noted as a risk to the quality of care in public hospitals in the province.
(2) There has been no confirmation from the National Department of Health or the National Treasury that that the provisions of the NHI that have to be implemented by provincial governments will include the allocation of sufficient resources to fulfil their mandate.
