President Cyril Ramaphosa has been forced to postpone the signing of the Second Presidential Health Compact amid fierce opposition from business leaders, amid disagreements over the implementation of the National Health Insurance.
Ramaphosa and business leaders werer due to sign the health compact on Thursday, August 15, but this has been postponed for a week, until Thursday, August 22.
The Presidency did not provide a reason for the week-long delay, but it comes amid fierce opposition to the National Health Insurance (NHI) Bill, which was signed into law on May 15, two weeks before the May 29 elections.
Business Unity South Africa (BUSA) said in a statement released on Wednesday that it would not sign the President’s Health Compact as it could not support a policy that explicitly endorses the NHI Act in its current form.
BUSA said it supported the original Presidential Health Summit Compact of 2018 as it focused on immediate opportunities for health improvement, including health infrastructure planning as well as strengthening the supply chain management and fostering accountability.
The references to the NHI in this original document were minimal and more in the context of longer term planning.
BUSA said there had been no consultation on the updated wording in the second compact, which now has a strong focus on the implementation of the NHI.
BUSA said they found this bizarre in light of all the legal challenges that the national health bill currently faces.
“Our concern is that this is at the expense of immediate opportunities to expand and improve healthcare access.
“While everybody supports universal health coverage, there are ways to achieve it other than implementing an unaffordable, unworkable and unconstitutional NHI, which is essentially a funding model that is impractical, inequitable, and not feasible in the South African context,” said BUSA chief executive Cas Coovadia.
“Furthermore, it is putting the cart before the horse to sign and agree to a compact when structured, formal discussions and engagement with government on the NHI, as a key pillar of universal health coverage, still need to take place,” Coovadia added.
BUSA wants to see the NHI Act amended to ensure that South Africa is able to improve universal healthcare coverage without damaging the economy or the existing skills and resources inherent in the private healthcare sector.
“The country should be leveraging these resources to help design and support a system that is fit for purpose and that is able to benefit future generations,” BUSA said.
Widespread opposition
Numerous entities are believed to be preparing potential legal action against the NHI, including the Health Funders Association that represents medical aid schemes, the South African Medical Association, South African Health Professionals Collaboration and the Democratic Alliance.
Trade Union Solidarity has already dealt the NHI a blow in the courtroom in July when the North Gauteng Court ruled that sections 36 and 40 of the Act were unconstitutional.
These sections sought to stipulate that healthcare practitioners would need to obtain a Certificate of Need from the Department of Health before being able to establish a practice in an area of their choice.
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