National Health Insurance (NHI) Pilot Districts: progress report by Minister of Health

Dr Aaron Motsoaledi, Minister of Health, and a delegation from the Department of Health provided an update about the National Health Insurance (NHI) pilot sites on 21 August 2015. The programme focuses on the development of infrastructure for primary healthcare systems and the recruitment of doctors and specialists for clinics. Minister Motsoaledi emphasised the importance of efficiency in human resources management in building up the public health sector. He explained the Department’s consultations with both the World Health Organisation (WHO) and Harvard University in pursuing the NHI programme.

The Department presented the design for an ideal clinic, and is working to complete construction on such clinics in the ten pilot districts; 106 structures have already been completed. The districts were chosen asĀ  representative of the country’s widely diverse demographics, so they therefore vary in size, population, and level of poverty. The Department is working on construction and budgetary matters in conjunction with the Department of Public Works and the National Treasury. Though it has been challenging for the Department to attract doctors and specialists to work in the clinics, the Department has many methods of recruitment as well as training programmes in place for former or current clinic volunteers. Efforts are also underway to address the critical issues of wait times and school health care services.

The Committee had many questions due to the complexity of creating a national health care system, but generally lauded the Department’s efforts and its focus on primary healthcare. Members asked general questions about the influence of business on public health, oversight of and budgeting for programme spending, the Department’s ability to build public confidence in the programme, school healthcare services, and doctor recruitment as well as specific questions about x-ray machines in clinics, examples of clinic construction projects being behind schedule, recruiting doctors from SADC countries, and clinic security.

Minister Motsoaledi noted that many funding issues would be clarified in the soon-to-be-released White Paper, pending work by Treasury on the White Paper. He gave examples where Australia had cracked down on the tobacco industry and said that the Department is working with and drawing funding from the private sector for public health initiatives. The Department will build confidence in the NHI programme over time as the public becomes familiar with the programme. The foreign recruitment of doctors is highly contentious, and Minister Motsoaledi noted that, worldwide, there is a general shortage of doctors. The Department is working with Treasury on infrastructure matters and grant money allocation. He told the Committee that the clinics had x-ray machines and proper security measures, and again emphasised the importance of HR structures.

Source: Drug Information & Policy Information mailinglist

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