By Lehlohonolo Lehana.
President Cyril Ramaphosa will on Thursday, 22 August preside over the signing of the second Presidential Health Compact at the Union Buildings in Tshwane.
The Presidential Health Compact is an initiative launched by Ramaphosa in 2019, which established a “framework of cooperation” between critical sectors in South Africa to significantly influence good health outcomes.
Government and organised business were supposed to sign the Second Presidential Health Compact last week, intended to foster collaboration between the public and private sectors.
But this was postponed for a week after SA’s largest private sector organisation, Business Unity South Africa (Busa), announced it would not sign the accord because the latest version explicitly endorses the NHI Act in its current form, which business organisations, civil society and health organisations including some political groups oppose.
This is despite the fact that business organisations, along with a broad sweep of civil society and health organisations, endorsed a previous version of the accord that was drafted before the NHI Act was passed and signed just before the May general elections.
The law, which seeks to create, over time, a single government-controlled healthcare insurance system, eventually ousting private health insurance, has yet to be implemented.
However, the presidency appears to be set to sign the compact regardless of the objections.
Presidency has since published the list of the signatories, which includes representatives from government, business, civil society, labour and academia.
Only one business representative is listed, however, and it excludes BUSA, SAMA and the HPCSA.
The signatories to the health compact are:
• The President of the Republic of South Africa
• The Minister of Health
• The Minister of Science and Innovation
• Independent Community Pharmacy Association (ICPA)
• South African National AIDS Council (SANAC)
• South African Medical Association Trade Union
• Democratic Nurses of South Africa (DENOSA)
• Congress of South African Trade Unions (COSATU)
• Campaigning for Cancer- Patient User Groups
• South African Medical Research Council (SAMRC)
• South African Pharmacy Council (SAPC)
• National Unitary Professional Association for African Traditional Health Practitioners of South Africa (NUPAATHPSA)
• Traditional Knowledge Systems and Allied Health
Business Unity South Africa (Busa) CEO Cas Coovadia said in a statement, “The draft of the compact that was shared with Busa promotes the NHI in its current form as the foundation underpinning healthcare reform. Busa does not agree with this, given the serious differences between us and government as to the appropriateness of the NHI Act, let alone its feasibility as a legislative instrument to underpin universal health coverage.
In addition, Coovadia said there has been no consultation on the new compact’s updated wording, which transforms it from a health-system-strengthening focus to a focus on implementing the NHI.
South African Medical Association (SAMA) said it had serious concerns about the NHI as an avenue for the government to achieve its healthcare goals and called for the scheme to be re-evaluated.
“While we share the government’s commitment to universal healthcare, we believe that the NHI, in its current form, may not adequately address the complexities of our health system and could inadvertently lead to unintended consequences that compromise both the public and private healthcare sectors,” it said.
For the Health Professions Council of south Africa (HPCSA), the compact is “nothing more than an attempt to lock in support for the NHI Act”, which it does not believe will be a viable or workable model for universal health coverage.
“Health professionals, including general practitioners, specialists, dentists, and allied workers, are the cornerstone of health provision in this country. Our primary concern is, and always will be, the well-being of patients.