The Fund will have a Board and various governance structures as required by the Public Finance Management Act (PFMA) and the principles contained in King IV’s Report on Corporate Governance. The Board will have the responsibility of ensuring that there are institutionalised systems, policies and procedures that proactively prevent, detect, investigate and correct incidents/acts of fraud and corruption.
The transitional arrangements for the NHI for the period 2023-2026 include:
The NHI Fund will purchase services on behalf of all South Africans. All users will be able to access health care services without paying anything at the point of care, regardless of their socioeconomic status.
Suppliers of health products will remain private companies. The NHI Fund will determine the range of products (medicines, devices, etc) that are required to deliver the benefits that the Fund is paying for at any point in time and will set prices for those products that any contracted provider will pay to the suppliers. The large volumes create certainty for suppliers and help to reduce prices.
No, the Fund will NOT take the accumulated reserves of medical schemes since those belong to the members and not the schemes.
Yes. The NHI aims to make health care more accessible to all South Africans. Individuals will be able to access NHI-contracted GPs, clinics or hospitals closest to them, whether in the public or private sectors.
There are initiatives underway to improve the conditions of public facilities. The Department of Health has allocated R7.2 billion over three years to facilitate maintenance, refurbishment, upgrades, replacements of infrastructure or new infrastructure.
No, the NHI will not destroy the private sector. The private sector has different role players, and they are: 1. health care providers (like GPs, specialists, pharmacies and hospitals); 2. suppliers of goods (heath products like medicines, devices and diagnostic devices); funders (medical schemes) and 4. administrators. They have different roles to play in the NHI and they are described below.
The Fund will be implemented over phases and over many years. Regulations will be published to address the phased implementation of the NHI Fund and phased implementation of service benefits as the money is moved to the Fund. Medical schemes will be given notice on the type of services that they will no longer be able to cover.
Not at all. Contracting with NHI Fund gives the health care provider opportunity to offer health care services to a designated population (significantly more patients than currently). The provider will not have to worry about the patients’ affordability as the Fund would have paid a capitation fee for the designated population. Patients who consult with providers who are not contracted with NHI will pay cash for the providers’ services. Patients will only be able to use their medical schemes to pay for benefits not covered by the Fund with non-NHI contracted providers.