Following sustained pressure from the Democratic Alliance (DA) and other organisations, Health Minister Zweli Mkhize has released the report detailing the assessment of the NHI pilot districts across the country.
What is evident is these pilot projects had no baseline targets to measure their success or lack thereof. This was in spite of the R4 billion spent on rolling out the projects in various districts. The report now details the haphazard nature in which various interventions were rolled out, lack of controls and accountability, poor planning and lack of funding in certain instances.
The pilot projects were a complete disaster as vacant posts were frozen due to lack of funding; “[infrastructure] projects were rarely implemented or completed due to the lack of planning and funds not being released in time”; “there was [infrastructure] deterioration because of a lack of basic maintenance”; and only 350 part-time doctors were hired across all 11 projects.
If this assessment is the basis on which the NHI Bill is being brought to Parliament then pertinent questions need to be asked from the minister and an urgent response is needed:
- How were the findings of the pilot projects incorporated in final drafting and approval of the NHI Bill;
- On what basis Cabinet approved the Bill to be sent to Parliament for deliberations when the findings in the pilot project report point to a complete systems failure; and
- Who will be held accountable for the poor performance of the NHI pilot districts and how much more public money is being spent resuscitating projects that are bound to fail due to a weak health system?
The DA has written to the Chairperson of the Health Committee, Dr Sibongiseni Dhlomo, to urgently summon the minister to appear before the portfolio committee and provide much-needed answers on this report.
Parliament cannot simply be reduced to a rubber-stamping station. We cannot deliberate on legislation that has been based on pilot projects which point to a collapse of a health system. What is clear is that if the NHI Bill is rushed through without requisite scrutiny then those failed pilot projects will become the reality of the South African health system across the board.