SOLLY MSIMANGA: NHI will further cripple Gauteng’s poor healthcare system

The National Health Insurance (NHI) in its current form will not provide universal healthcare to the residents of Gauteng but will nationalise healthcare and create fertile ground for corruption and poor management, similar to what we saw during the Life Esidimeni tragedy and the personal protective equipment (PPE) tender scandal, both of which were caused by the ANC government.

This is despite the government’s claim that it will reshape healthcare in SA, guaranteeing universal health coverage and addressing historical socioeconomic disparities.

The DA’s position is clear: we remain committed to the principle of universal access to healthcare for all citizens. However, the signing of this unconstitutional bill, despite widespread opposition, is nothing more than a political tactic by the uncaring ANC government that has no idea how to cope with healthcare’s complexity and demands.

In Gauteng, where the public health sector is in disarray, this bill would have a devastating impact and further collapse the already disintegrating healthcare system; all the while, premier Panyaza Lesufi makes false claims of “improvement” in the provision of healthcare services.

Prof Alex van den Heever of the Wits School of Governance shares our belief that the NHI programme would lead to corruption. He notes that “the possibilities for corruption are endless. People are concerned because they feel this is largely the purpose behind it — that this is not intended to improve healthcare. It is about vested interests [of people] who have an interest in essentially capturing parts of the state. It would be naive to think otherwise.”

This analysis could not be more accurate based on what we have witnessed in Gauteng. The assassination of Babita Deokaran,  a whistle-blower, days after exposing large-scale suspected corruption at Tembisa Hospital in Ekurhuleni, was a stark reminder of how rife corruption has become in the Gauteng healthcare system. She discovered over R800m in transactions that she suspected were fraudulent and tried to prevent a further R100m in suspicious payments from being processed.

Tembisa Hospital has a severe shortage of nurses and fails to meet international healthcare norms and standards. The money embezzled from the department could have funded new nurses’ salaries and improved healthcare services.

Corrupt practices within the Gauteng health sector are compounded by crumbling infrastructure. A recent example is the Leratong Hospital on the West Rand, where the ceiling collapsed in November last year. Though no-one was injured, the incident resulted in the cancellation or deferral of many surgeries. This is one of many examples highlighting the problem of poor maintenance in our public hospitals, which are becoming hazardous for staff and patients.

Furthermore, Gauteng residents face risks as ambulances take too long to respond. According to the health department’s third-quarter report, Emergency Medical Services (EMS) was allocated R362m and spent R557m. Nevertheless, only 61% of priority 1 calls in urban areas were attended to within 30 minutes, compared with the 85% target. Meanwhile, 90% of priority 1 calls in rural areas were dealt with within 60 minutes, compared with the 100% target. It is scandalous that lives are lost due to poor ambulance response times, despite the large amount of money spent.

Another concern is with antiretroviral treatment (ART) for HIV/Aids. Instead of the 95% target, the adherence rate for adult ART was 65.6%, while viral suppression was 67% in the quarter under review. Patient follow-up has been attributed to this shortfall. A caring government would encourage adherence to treatment throughout the counselling phase and educate patients on the necessity of viral load collection and suppression.

It is also disconcerting that hundreds of cancer patients at Charlotte Maxeke Johannesburg Hospital are suffering because a treatment deal between the department and private hospitals is still pending, despite the R784m budgeted for this in April 2023. It is puzzling that the department has not resolved this issue, given that a tender was issued in October 2023 for the outsourcing of radiation services for cancer patients.

The DA’s alternative model to the NHI will ensure sustainable access to healthcare by reforming the current district management system through governance reform. By combining the strengths of the private and public sectors, the government can ensure that every South African has access to high-quality healthcare without raising the tax burden.

The DA is dedicated to making systems work, not creating an illusion. With Gauteng residents’ support in the upcoming elections, we can work towards creating a healthcare system that truly puts people’s needs first and provides the best care possible.

• Msimanga is the DA’s Gauteng premier candidate.