NHI: Tracking the Bill through Parliament
The NHI Bill was introduced to Parliament in August 2019 and is currently under consideration by the National Assembly’s Portfolio Committee on Health.
You can track the processing of the Bill here
The committee commenced this leg of the public participation process on the NHI Bill on 18 May 2021. The virtual oral public hearings provide an opportunity for stakeholders who had expressed interest to make oral presentations on their written submissions.
Stakeholders who have been participating in the public hearings include professional associations, civil society organisations, faith-based organisations, researchers, lobby groups, academics, traditional healers, public health entities, statutory bodies, government departments, sector experts, healthcare funders, medical aid schemes, healthcare administrators, hospital groups, political organisations, labour unions and other interested stakeholders.
The virtual public hearings follow on from provincial public hearings, which took place between 25 October 2019 and 24 February 2020. These included visits to 33 district municipalities across all nine provinces (three to four district municipalities per province). The public hearings took place from Friday afternoon to Monday evening so as to allow maximum participation. There were 11 564 attendees at the public hearings and 961 submissions were made, which represented 8.3 percent of those in attendance.
About 135 stakeholders had expressed interest to make oral presentations. To date, a total of 100 organisations/ stakeholders have orally presented their written submissions to the committee. (source: parliament.gov.za)
31 August 2021: National Health Insurance (NHI) Bill: public hearings day 18
01 December 2021: NHI Bill: public hearings
25 January 2022: National Health Insurance (NHI) Bill: public hearings day 22
26 January 2022: National Health Insurance (NHI) Bill: public hearings day 23
28 January 2022: National Health Insurance (NHI) Bill: public hearings day 24
08 February 2022: National Health Insurance (NHI) Bill: public hearings day 25
09 February 2022: National Health Insurance (NHI) Bill: public hearings day 26
15 February 2022: National Health Insurance (NHI) Bill: public hearings day 27
16 February 2022: National Health Insurance (NHI) Bill: public hearings day 28
23 February 2022: National Health Insurance (NHI) Bill: public hearings day 29
29 March 2022: NHI Bill: Department response to public hearings
01 June 2022: National Health Insurance (NHI) Bill: deliberations
08 June 2022: National Health Insurance (NHI) Bill: deliberations
23 August 2022: National Health Insurance (NHI) Bill: deliberations
07 September 2022: National Health Insurance (NHI) Bill: deliberations
14 September 2022: National Health Insurance (NHI) Bill: deliberations
21 September 2022: National Health Insurance (NHI) Bill: Clause 42 to 47 deliberations
Health Justice Initiative NHI Library: https://nhi.healthjusticeinitiative.org.za/
Analysis (SAMRC, CHAI, UCT and UWC)
Thematic analysis of the challenges and options for the Portfolio Committee on Health in reviewing the National Health Insurance Bill - The SA Medical Journal 30 May 2022
Too much ministerial power for NHI (PART THREE) — challenges and options for the portfolio committee. Daily Maverick 2022-04-11
Health Bill (PART TWO). NHI will stand or fall on Parliament’s approach to corruption, says civil society bodies. Daily Maverick. 2022-04-3.
Whither NHI? (PART ONE) Summary of views on the proposed health funding model presented to Parliament. Daily Maverick. 2022-03-23.
Mixed views and scepticism continue to obstruct pathway of NHI Bill. Daily Maverick. 2022-03-01.
Parliament’s health committee faces range of options after 100,000-plus submissions received. Daily Maverick. 2021-09-08.
According to the government, the NHI aims to achieve the following principles:
-The right to access health care: The NHI would ensure access to health care, as it was considered to be an important service which the State must be able to provide.
-Social Solidarity: The NHI would provide financial risk pooling to enable cross-subsidisation between young and old, rich and poor, as well as the healthy and the sick. This would mean people taking care of each other as South Africans. The solidarity principle would also serve as a guide towards the development of the NHI.
-Equity: The NHI would ensure a fair and just health care system for all. Those who were ill should get services first.
-Health Care As A Public Good: Health care should be seen as a social investment and not as a commodity of trade to be sold for profit.
-Affordability: Health services should be procured at a reasonable cost. Should the cost be prohibitive, this could lead to the NHI not being able to offer health care to the whole country.
-Efficiency: Health care resources should be allocated and utilized in a manner that optimised value for money. The HLP had made it very clear that resources allocated to the NHI should be used appropriately.
-Effectiveness: The health care interventions covered by the NHI would result in desired and expected outcomes in everyday settings. South Africans traveling through the country and in a need of health care, would see that the same treatment one would receive in Dzidane would not be inferior to the treatment received in the Western Cape.
-Appropriateness: Health care services would be delivered at appropriate levels of care through innovative service delivery models and would be tailored to local needs. The health care services should take into account the cultural and social requirements within a particular area.
Meanwhile, there are some concerns about how the NHI will be funded and implemented.
The Portfolio Committee invited stakeholders and interested parties to submit written submissions on the Bill from 30 August to 29 December 2019.
Public hearings on the bill were carried out in Mpumalanga from 25-28 October 2019, in the Northern Cape from 1-4 November 2019, in Limpopo from 15-18 November 2018, in KwaZulu-Natal from 22-25 November 2019 and the Eastern Cape from 29 November-02 December 2019. Hearings in the remaining provinces – Gauteng, Western Cape, Free State and North West - were concluded in 2020. See programme here
Ahead of the provincial public hearings, PMG interviewed the Committee Chairperson. Read the interview here
Watch the public hearings below:
Eastern Cape Public hearing: https://www.youtube.com/watch?v=WXqlxrKHOT4
KZN Public hearing: https://www.youtube.com/watch?v=mbg8wcG71PI
Limpopo Public Hearing: https://www.youtube.com/watch?v=8CBfJRoLhMo&t=22s
Northern Cape Public Hearing: https://www.youtube.com/watch?v=kv0LkIj74Rw
Mpumalanga Public Hearing: https://www.youtube.com/watch?v=bgPYRrBFwxQ
Free State Public Hearing: https://www.youtube.com/watch?v=mUF3C1QS6hQ
North West Public Hearing: https://www.youtube.com/watch?v=ESMM9ZLj6XA
Western Cape Public Hearing: https://www.youtube.com/watch?v=Aq1QRfTCO1I
The Bill was long in the making as ideas to reform healthcare financing in South Africa are not new and date as far back as the late 1920s. We traced the historical timeline of the Bill (only looking at the democratic dispensation) and highlighted key dates and events.
You can also review the relevant policy documents and submissions at the NHI Library (source: Collaboration for Health Systems Analysis and Innovation (CHESAI))
Find the August 2019 NHI District Pilot Evaluation Report here
You can look back at some of the previous and recent parliamentary meetings on the NHI:
25 June 2002: Social Health Insurance Policy Development: briefing
7 June 2005: Social Health Insurance: Department briefing
Parliament Media Statements
Health Committee Concludes First Phase of Public Participation on NHI Bill (25 Feb 2020 11:48am)
Quality Healthcare Before Profit, Say Gauteng Residents at Hearings on NHI Bill (24 Feb 2020 12:55pm)
Mogale City Residents Call for the Immediate Implementation of NHI (23 Feb 2020 11:18am)
Soshanguve Kicks off Gauteng Province’s Public Hearings on NHI (20 Feb 2020 2:13pm)
Health Committee to Undertake Final NHI Hearings in Gauteng (17 Feb 2020 3:10pm)
Cape Metro Residents Come out in Numbers to Voice Their Opinions on NHI (6 Feb 2020 8:54pm)
Residents of the City of Cape Town Metro Express Optimism about the NHI (6 Feb 2020 5:40pm)
Committee Hears That NHI Is Much Needed in the West Coast District (5 Feb 2020 12:50pm)
North West’s Rustenburg Residents Express Mixed Views on NHI (1 Feb 2020 9:09am)
People of the Free State Have High Hopes on NHI (31 Jan 2020 9:44am)
Mangaung Residents Call for Resolution of Impediments to Better Healthcare (30 Jan 2020 10:11am)
Bloemfontein Residents Want NHI, but Call for Urgent Fixing of Healthcare System (28 Jan 2020 10:14am)
Nelson Mandela Bay Residents Support NHI Bill (4 Dec 2019 4:43pm)
Implementation of NHI Should Have Started Yesterday’ (4 Dec 2019 10:14am)
Eastern Cape Residents Call for Urgent Implementation of NHI (3 Dec 2019 2:20pm)
Health Committee Pleased with Sunday Nhi Public Hearings Turnout (24 Nov 2019 4:45pm)
NHI Bill Receives Thumbs up in Limpopo Province (21 Nov 2019 1:00pm)
Limpopo Province Overwhelmingly Welcomes NHI Bill (18 Nov 2019 9:25pm)
NHI Bill Receives Thumbs up in Limpopo’s Thulamela Local Municipality (16 Nov 2019 11:31am)
Committee Concludes Public Hearings on NHI Bill in the Northern Cape (5 Nov 2019 9:51am)
Upington Communities Urge Committee to Accelerate NHI Bill Law Making Process (4 Nov 2019 12:28pm)
Residents of Upington Calls for a Speedy Implementation of the NHI (4 Nov 2019 1:53pm)
De Aar Communities Say NHI Bill Must Address Poor Health Facilities (4 Nov 2019 1:47pm)
Public Hearings on NHI Move to Dawid Kruiper Local Municipality in Upington (2 Nov 2019 6:10pm)
Traditional Healers of Thembisile Hani Local Municipality Call for Inclusive NHI (28 Oct 2019 7:10am)
Mpumalanga’s Nkomazi Residents Support NHI Bill (28 Oct 2019 1:25pm)
NHI Raises Hopes of Bushbuckridge Residents (28 Oct 2019 12:30pm)
Bushbuckridge People Urge Committee to Accelerate Nhi Law Making Process (27 Oct 2019 6:28am)
Nkomazi Residents Welcome NHI Bill (25 Oct 2019 10:02pm)
About this blog
"That week in Parliament" is a series of blog posts in which the important Parliamentary events of the week are discussed.