The Ministry of Health has just issued a strongly worded statement in
reaction to recent media reports claiming that, for one, presidential
adviser, Prof Olive Shisana, and the Minister
of Health, Dr Aaron Motsoaledi, appeared to have sidelined senior Department of
Health and Treasury officials in preparing a new version of the National Health
Insurance (NHI) Bill now due for submission to Cabinet next week.

At issue has
been primarily the nature and manner of coverage of the content of a four-page letter
from Treasury to the Presidency leaked to the media in mid-November. Main point
raised by the media from the letter contents was the allegation that various
provisions in the NHI Bill, previously agreed upon between government
departments, had been changed without consultation, or agreed-upon changes were
not implemented. It was also alleged in the letter reports that comments from
the public had not been taken into account.

“Clearly this is meant to cast serious aspersions on the credibility of
the process and in the instance try to delegitimise it in the mind of the
public,” the statement notes

“We have no doubt,” it adds later, “that enemies of NHI will do
everything possible to try to stop NHI from becoming a reality, failing which,
they will try to cast doubt and aspersions on the integrity of the process.”

The statement continues as follows (with minimal editing in the interest
of reading time and space):

Here are the facts (on the NHI Bill process):

Comments were received from a variety of stakeholders and citizens. As
is normal practice the Department of Health reviewed the comments and
considered theme in revising the NHI Bill. In addition to public comments,
further stakeholder consultations took place. This included a consultative
meeting in which the President himself engaged with over 300 participants at
the CSIR on 24th of August.

 It is at this consultative meeting that the President announced
that he is going to lead the NHI process as Head of State. The media did raise
questions about this. The Minister of Health explained that, he personally
requested the President to lead this process because ushering in NHI is a huge
seismic event which will need the guidance of the Head of State.

 Hence there is nothing sinister at all for The Presidency to get
involved in this NHI process.It is designed to be so. The President is the Head
of State and hence, The Presidency has a legal right and authority to oversee
government work – all government work including legislation.

After that consultative meeting (referred to above), the Minister went
around the country addressing civil society organisations, academic
institutions, deans of health science faculties, traditional leaders, labour
unions and professional medical associations about the NHI Bill, the medical
scheme amendment Bill and the report of former Chief Justice, Sandile Ngcobo’s
Public market inquiry into the cost of private healthcare.

There has been extensive consultation between National Treasury
and the Department of Health, which as planned were facilitated by the

 Sometimes, these consultations took place through exchange of
letters. There was hence nothing untoward with the letter written by National
Treasury on this matters. This type of exchange will continue to happen
unhindered as is normal practice between government departments in legislative
and policy making process.

What is sinister, however, is the leaking of such letters to the media
by some unscrupulous officials and then pretending that they uncovered some
hidden evil lurking in government departmental exchanges.

 The types of discussions within interdepartmental coordinating
structures like NHI War Rooms and Department of Health and National Treasury
Technical Task Teams are always robust to ensure rigor and coherences and will
always be welcome in government.

The responsibility of the Presidency is to bring departments together so
that various perspectives are taken into account before policy recommendations
are taken to Cabinet.

As the Ministry of Health, we will always welcome, support and
appreciate the role played by the Presidency in ushering in a new era of NHI.

Through the work of the War Room, the Department of Health and National
Treasury have been able to address the concerns and jointly plan the way
forward.  The same applies to submissions made by other government

 Furthermore, we note media commentary about documents submitted to
Cabinet. We wish to state that Cabinet is not a secret organisation. It is a
legitimate structure empowered by law to conduct the affairs of the state and
by the same laws, its documents are classified. As such contents may not be
released until authorised by Cabinet itself.

We wish to restate once again that the Presidency has a right to
facilitate, direct and unblock obstacles in the process of Legislation and
policy making.

We have no doubt that enemies of NHI will do everything possible to try
to stop NHI from becoming a reality, failing which, they will try to cast doubt
and aspersions on the integrity of the process.

We wish to reassure the nation that no law is being breached nor any
illegality or irregularity committed in the manner in which the legislative
process towards realisation of NHI is being conducted between the Department of
Health, its officials, the Treasury, The Presidency and the rest of government.

It is unfortunate that some anti-NHI individuals or entities have
decided to personalise, isolate and attack some hard working and dedicated
Presidential support staff, particularly Prof. Olive Shisana, employed to help
drive government priorities in the social sector, health included.

NHI is bigger than individuals. It is the ultimate expression of social
justice, fairness and as the former Director-General of the World Health
Organisation stated, it is an equaliser between the rich and the poor. We are
hence not surprised by the type and calibre of people who are working around
the clock to undermine NHI. Equalising between the rich and the poor is a revolution
that will automatically scare those who flourish under conditions of
inequality. It is expected that they will club together in a desperate bid to
stop this inevitable revolution whose time has arrived.

There is no single individual, be it an advisor, a Director-General or a
Minister who has the sole monopoly or right to determine the fate of NHI. That
is the sole preserve of Cabinet and ultimately the citizens of this country
through the Parliamentary process.

The allegation that we ignored calls to extend the period of public
participation beyond three months, is pure mischief. This issue was raised at
the consultative seminar held on the 24th of August 2018 and the Minister of
Health explained to the meeting why it will be undesirable to grant any
extension. Furthermore, he explained that whatever outstanding issue that could
not be raised through public participation within that period of 3 months will
still be achieved when Parliament conducts public hearings throughout the
length and breadth of our country. Such public hearings are still coming.

South Africa has been driving the introduction of NHI since 2009. Since
that period, there has been individuals and or organisations that always made
it their duty to find one reason or the other to argue that we are not ready
for it. We believe these individuals will go on forever and will stop at
nothing for decades to come to continue that line of argument. At no stage will
they ever declare we are ready.

One of the reasons always put forward is that the public healthcare
system needs to be fixed first. To musk their intentions we note that in recent
days they have now added the fixing of the private healthcare as a

Fixing the quality of the public healthcare system and dealing with the
exorbitant cost of private healthcare has always been our goal and is a strong
recommendation by the National Development Plan of the country. Government
fully endorsed this recommendation without any reservation. But this fixing of
the system has never been mutually exclusive with the implementation of NHI, in
fact they go hand in glove and reinforce each other. We shall never agree to be
put in a no-man’s land of chicken and egg situation.

We are doing everything in our power to resolve the challenges of
infrastructure, human resources and availability of health commodities.

Any individual or organisation who will use such challenges as a good
reason to delay NHI smacks of dishonesty and hypocrisy because the plans to
improve quality of healthcare have been unveiled at the consultative meeting of
24th August and consolidated and adopted at the Presidential
health summit held end of October 2018.

We are calling on all stakeholders and social partners to join hands
with us on this journey to usher in Universal Health Coverage where no one will
be left behind.


Ministry of Health


Popo Maja: Spokesperson. Ministry of Health.