The Hospital Association of South Africa notes that the Parliamentary Portfolio Committee for Health has approved the National Health Insurance Bill.

We also note the media statements regarding the concerns and positions against the Bill in its current form from two representative organisations of doctors, the South African Medical Association and the South African Private Practitioners Forum.

We believe that approving the Bill without substantive consideration of the many valid and significant recommendations and contributions made by many participants during the Parliamentary hearing is deeply regrettable and a missed opportunity by the Committee.

As the hearings demonstrated, there is broad support for universal access to quality healthcare. There is a willingness to collectively engage with the Government to craft the best possible legislation.

To summarily ignore the many who voiced their concerns regarding governance structures and operational efficiency concerns, the concentration of risk in a single-payer system in an unstable economy featuring endemic corruption, and the many other concerns raised by State attorneys, is short-sighted and highly unwise.

Passing such vast, complicated, risky, and consequential legislation requires confidence, trust, and stakeholder collaboration. The approach taken undermines confidence and poses a threat to trust.

We urge the National Assembly and the National Council of Provinces in their deliberations on the Bill to insist on a multi-payer model to mitigate against the concentration of risk, an iterative rollout based on milestones rather than dates and to pay heed to the nation’s concerns that the proposed National Health Insurance Fund is susceptible to theft and corruption by proposing and approving alternate and appropriate governance structures.

The healthcare reform decisions taken now will impact the sustainability of South Africa’s health system and will be deeply felt for generations to come.