Motsoaledi spells out non-negotiables for NHI

Friday, March 23, 2012
Gabi Khumalo

Pretoria - With 10 districts being identified for piloting the National Health Insurance (NHI), the Department of Health has set out its non-negotiables for a successful health system.

The 10 districts were announced on Thursday by Health Minister Dr Aaron Motsoaledi for NHI pilot activities, which will focus on key elements such as district health services, service delivery, strengthening of health systems and health financing.

Presenting the non-negotiables, Motsoaledi warned that they would be strictly monitored and under no circumstances would the department accept excuses from districts that fail to comply with these non-negotiables, which include:
* infection control services
* medicines and medical supplies, including drug dispensary
* cleaning material and services
* essential equipment and maintenance of equipment
* laboratory services (National Health Laboratory Services)
* blood supply and services (South African Blood Services or Western Province Blood Transfusion Services)
* vaccines
* food services and relevant suppliers
* non-communicable diseases
* child health services (including neonatal and perinatal)
* maternal and reproductive health services
* registrars
* family health teams
* district specialist teams
* infrastructure (including maintenance)
* HIV/AIDS and TB.

"Under no condition should infection control ever be compromised. We don't want to hear any province telling us that due to budget constraints, they don't have child vaccines," said Motsoaledi.

The NHI will be gradually implemented in three phases from 1 April, spanning over a 14-year period.

The districts are: OR Tambo (Eastern Cape), Gert Sibande (Mpumalanga), Vhembe (Limpopo), Pixley ka Seme (Northern Cape), Eden (Western Cape), Dr K Kaunda (North West), Thabo Mofutsanyane (Free State) and Tshwane (Gauteng).

Two districts have been identified in KwaZulu-Natal - uMzinyathi and uMgungundlovu, due to high population numbers and a high disease burden. However, the province has added a third district, Amajuba, and will be using its own funds to carry out the pilot.

There are other activities that will be undertaken in other districts over and above the 10 selected districts, and these activities will be directed towards reducing maternal and child mortality.

"To ensure access to quality health services and for NHI to succeed, the National Health Council agreed to funding allocations for certain areas that have been considered to be non-negotiables, which should be guaranteed in the provincial health budgets for 2012/2013," said Motsoaledi.

With regards to cleanliness, long queues and drugs stocks in hospitals, the minister cautioned that people should not expect to see drastic changes come 1 April.

"[1 April] is the day on which we start putting up the official building blocks... It might not mean that on that same day, people are going to see very serious tangible changes," said Motsoaledi.

He explained that the date was chosen because it was the start of the new financial year, and it would help with the purposes of budgeting to achieve the objectives set out in the NHI.

European Union representative Professor Neil Johnson commended South Africa for its efforts, noting that the NHI was aimed at achieving quality and affordable health care for all South Africans -- an objective fully supported by the EU.

"The European Union, through the commission, is pursuing a programme in the [primary health care] sector to the amount of R1.26 billion, which is one of the largest programmes in the health care sector that the EU pursues ... The European Union stands by South Africa in the reforms that the minister is pursuing in the health sector," said Johnson.

The first five years of NHI roll-out include strengthening the health system, improving service delivery as well as policy and legislative reform.

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