NHI seen as catch-all solution

“To some extent in this document, NHI has become almost like a panacea to solve all the problems in the health system,” Dr Duane Blaauw said during a debate on the ANC’s policy discussion documents at the University of the Witwatersrand, in Johannesburg.

The ANC’s policy discussion document on health focused mainly on NHI, he said. All other health policy processes had been put on hold as a result.

“To some extent, all other policy processes are now on hold … NHI is going to solve all the problems in the health system, somehow it’s a magic bullet and it’s going to fix the weaknesses.”

Blaauw said the NHI was seen as able to decrease the bad things about private sector healthcare, to strengthen primary healthcare and address human resource problems.

“The concern is that nothing else is really happening … At the moment, the health system is in desperate need of intervention.”

The other issues in the document were minor, such as HIV notification and the creation of a state-owned pharmaceutical entity but key issues had not been included.

Private sector
“The NHI debate has created the idea that the main problem with the health system is the private sector,” Blaauw said.

The document did not examine the weaknesses of the existing public health system or look at the various unsuccessful interventions made in the past 18 years to try and fix it.

It also made little mention of the lack of doctors and nurses.

“There is nothing really about how we try and create dedicated patient-oriented doctors and nurses,” he said.

National Planning Commission member Hoosen Coovadia defended the proposed NHI, saying health was a public good.

It had worked in Brazil, China and some Scandinavian countries, and so should work in South Africa, he said.

Blaauw said there was a problem with the general idea of policy in the document.

It seemed to suggest that the ANC developed this policy, handed it over to the government to translate into a plan and implement, and thereby create a better life for all, he said.

Good policies
This could not happen if the initial policy was not good to begin with.

“They are not very well thought out, they are not very well articulated, they are not very well analysed. They do not really have very good policies.”

The health department did not have the skills to develop good policies either, so its policies were developed by external consultants, he said.

“They don’t have the expertise in the national department to develop this very detailed policy.”

Using external consultants led to policy fragmentation as there was very little integration in the department – and this too was not addressed in the ANC document, said Blaauw.

The ANC holds a policy conference every five years before an elective conference, with the next one in Mangaung in December.

ANC branch members and alliance representatives debate policy and any policy changes decided at the policy conference need to be ratified by the elective conference.

The next policy conference will be held in Midrand next month. – Sapa


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