During a meeting of the National Assembly’s Health Committee on 29 August, Department of Health DG Precious Matsoso told members that work has already begun on drafting amendments to Acts likely to be affected when the National Health Insurance Bill becomes law. They are listed in a schedule to the Bill and include the 2003 National Health Act. Last week, in a written reply to questions from the DA’s Mbulelo Bara, Health Minister Zweli Mkhize provided some insights into ‘direct powers’ likely to be ‘allocated’ to provincial governments in amendments to this Act.
Readers are encouraged to bear in mind that:
- Any proposed amendments to the Act will need to be released as a draft Bill for public comment;
- Once finalised, that Bill will then need to be tabled in Parliament for processing; and
- Public hearings will then need to be held in the National Assembly and, as the Bill proceeds through Parliament, also in the NCOP and provincial legislatures.
This is just one example of the extent to which NHI implementation is likely to be postponed until other legislation affected by the NHI Bill has been synchronised with it. Realistically, that cannot be done until the Bill has been finalised and passed by Parliament.
The same will apply to any proposed amendments to the 1998 Medical Schemes Act. Although a draft Medical Schemes Amendment Bill was released in June 2018 for comment, its proposals appear not to be in line with the NHI Bill – tending to imply that it is being reworked and will therefore need to be released again for public input. It will then need to be tabled in Parliament and undergo the same process as any other Bill.
Against that backdrop, the NHI Bill’s passage through Parliament is likely to be long, arduous and fraught. It could take many years, begging the question: Has this has ever been explained to grassroots ANC members and supporters? If the party’s 2019 election manifesto is any indication, probably not.