The recent ruling declaring parts of the National Health Act unconstitutional is likely the first of many. Experts view these challenges as opportunities to find better solutions. A panel of experts, including Professor Alex van den Heever, Professor Saloshni Naidoo, and advocate Rajesh Choudree, discussed the NHI at an event hosted by the History Society at the 1860 Heritage Centre.
Choudree said the court’s ruling halts NHI implementation but doesn’t end it. He believes the legal challenges could energise efforts to improve NHI. Naidoo, head of public health medicine at the University of KwaZulu-Natal, agreed that more legal hurdles would likely delay NHI implementation for decades. She emphasised the importance of criticism to ensure NHI serves the country’s best interests and noted that the government had previously ignored critical feedback.
Funding, corruption and inadequate infrastructure are obstacles to the success of National Health Insurance
Naidoo and Van den Heever highlighted issues like funding, corruption risks, and inadequate infrastructure as major obstacles to the NHI’s success. Van den Heever criticised the plan to fund the NHI through tax increases, calling it unrealistic due to existing tax limits.
Van Heerden also pointed out leadership and governance problems within large health departments, such as Gauteng’s, where corruption and inefficiency are prevalent. Van den Heever also mentioned the lack of employee incentives, insufficient technical analysis, and poor policy solutions as additional challenges.
Naidoo stressed that the current health system has too many issues to address before implementing the NHI, including better leadership, tackling corruption, and improving basic public health infrastructure. She also emphasised the need for an operational health information system, which would be challenging due to connectivity issues and the risk of theft in healthcare facilities.