SAMA will carefully study NHI White Paper

The South African Medical Association (SAMA) said it will study the White Paper on the on the proposed National Health Insurance (NHI) plan very carefully and submit the profession's views‚ in consultation with its members‚
for consideration to the Minister of Health.

TMG Digital, 16 December 2015

In the policy‚ SAMA said‚ the importance and role of the general practitioner (GP) as the cornerstone of healthcare delivery has been asserted‚ which is a positive step‚ as is the stated importance and funding of the country's central training and teaching hospitals.

However, it said, with training posts being frozen within the next year‚ it is imperative to deal with the issues immediately and not wait for the NHI policy to address these difficulties.

Sama said this move does not support strengthening of the public health sector‚ which is an identified priority in the first phase of implementation. It said pilot projects had been implemented in 10 Districts.

The aim of the pilot projects was to assess practicality and feasibility of proposed models of care. The NHI pilots largely focused on government sector provision of services which included the recruitment of general practitioners in public sector clinics‚ implementation of school health programmes‚ district clinical specialist and ward-based primary healthcare out-reach teams. The Central Chronic Medicine Dispensing and Distribution programmes tested various models of pharmaceutical supply including use of private pharmacies.

Despite this‚ Sama said, it seems not much has been incorporated into the plan and little has been done to test feasibility of healthcare provision by private practitioners despite the NHI White Paper indicating that the state will be purchasing care from both sectors.

It added that Certificate of Need appeared to have resurfaced once more and that it seemed that it was intended to be used punitively. This would be contrary to assurances provided by the Constitutional Court on the matter.

Moreover‚ with the available pool of specialists in South Africa being very limited‚ SAMA is concerned that punitive approaches will work against all South Africans accessing the best possible quality of healthcare. It added that it looked forward to positively engaging the Department of Health on this significant policy initiative.