How much will it cost?
Projected amounts from National Treasury are currently set at R256bn.
Where will it come from?
Treasury has outlined several different revenue streams.
Such as?
General income tax …
Where will additional taxes come from if our economic growth rate remains at less than 2%?
Treasury has said we should not get involved in their mandate of determining what would be the fiscal options available.
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Because NHI funding is predicated on a certain economic growth rate, isn’t it?
Well, there are many countries that didn’t have a growth rate that was great. The UK implemented its NHS at a point when it had its lowest economic development.
Our tax base is hardly comparable to that of the UK, is it?
Now. But at that point the UK was not doing well, it was going through a recession effectively.
Hasn’t it been calculated that if our economic growth rate remains at less than 2%, as currently projected, the NHI funding shortfall will be more than R132bn?
If the country goes into a state, as you ’re suggesting, where there are just no funds, Treasury will obviously slow down the roll-out of NHI. Remember, NHI is not an event, it doesn’t happen on a day, it happens over several years. The president has made it clear this is a phased approach.
So if economic growth remains as it is, the NHI could be stillborn?
You ’d need to ask Treasury that question. They’ll inform us what the funding is going to be.
Doesn’t the NHI white paper say that health spending will have to double?
It will have to increase, that’s true. Whether double I don’t know.
Isn’t the reality that the health budget is being cut as we speak?
It hasn’t been cut …
By R700m according to the February budget?
Certain aspects were cut, but money was shifted to other areas, such as the NHI grant.
Can NHI be implemented when public health facilities are still so broken?
We’ve made it very clear the public health system quality would have to improve.
How?
If we start with the clinics, there is the ideal clinic project which identifies what is the minimum standard that every clinic should achieve in order to be ready for NHI. The minister has outlined in his budget speech how we will be dealing with hospitals.
How successful was the roll-out of NHI pilot schemes from 2013 to 2018?
They were not NHI pilots, they were about strengthening the health system in NHI pilot districts. And the projects were successful enough for us to roll them out across the country.
Why are we not seeing this improvement on the ground?
It depends where you go. There are certainly facilities like that, but there are also facilities that are providing an excellent service.
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