NHI White Paper released

Friday, December 11, 2015

Pretoria - Cabinet has approved that the national Department of Health publishes the White Paper on the National Health Insurance (NHI) for public consultation.

The process towards the phased implementation of the NHI starts with the finalisation of the White Paper and the subsequent consultation processes. The finalised White Paper will be used to inform the drafting of the NHI Bill, which will have to go through both Cabinet and Parliamentary approval. There will also be a process of public consultation on the NHI Bill.

Speaking on the White Paper on Friday, Health Minister, Dr Aaron Motsoaledi, says it lays the foundation for moving South Africa towards universal health coverage through the implementation of the NHI.

Building on the significant achievements of the last 20 years, the National Development Plan envisions that by 2030, South Africa should have made significant strides in moving towards universal health coverage and that this will be critical to realising the vision of a long and healthy life for South Africans.

The NHI seeks to transform the financing of the health system in pursuit of the goal of universal health coverage.

Minister Motsoaledi described the NHI as a major transition in health, saying it is going to change health care irreversibly.

“It’s going to be a real transition. This transition is not going to be a sprint, it’s going to be an ultra-marathon that takes place for a very long time,” said Minister Motsoaledi.

The White Paper states that the NHI will be implemented over a 14-year period and in three phases.


The first phase extends from 2012/13 to 2016/17. Pilots already started in 2012.

This phase has largely focused on improving public health service delivery, strengthening of management and governance systems, particularly to improve the quality of health services.

All health facilities will be inspected and certified by the Office of Health Standards Compliance using agreed upon quality of care norms and standards.

The second phase will extend from 2017/18 to 2019/2021. The population will be registered and issued with the NHI card at designated public facilities using the unique identifier linked to the Department of Home Affairs.

This phase will also focus on work to develop and implement risk identification and fraud management system.

In the early stages of phase two, a transitional fund will be established to purchase primary health care services from certified and accredited public and private providers at a non-specialist level.

The third and final phase of implementation will take place over the last four years and will focus on ensuring that the NHI Fund is fully functional.

Protection from financial hardship

Those who are legally entitled to benefit from the NHI will be protected from financial hardships as they will not be required to pay directly at the point of health care. Services provided will be paid for through the NHI Fund.

NHI card holders will not be expected to make any out-of-pocket payments such as co-payments and user fees at the point of health care delivery. This will help in preventing demands for informal payments.

The NHI is based on the principles of the right of all citizens to have access to quality health services that are delivered equitably, affordably, efficiently, effectively and appropriately based on social solidarity and health as a public good.

NHI coverage

NHI will extend coverage to all South Africans, irrespective of their socio-economic status. Coverage will also extend to legal permanent residents.

By extending effective population coverage, priority will be given to the population that is in greatest need and must include those experiencing the greatest difficulty in obtaining care.

Vulnerable groups such as women, children, older persons and people with disabilities, orphans, adolescents and rural populations will be covered. – SAnews.gov.za


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