In the wake of the unprecedented exposure given to the proposed National Health Insurance (NHI) system and all its elements in the last 12 months – and specifically the many explanations and deliberations presented in the wake of the July release of the NHI Bill itself to Parliament – results of a survey into healthcare workers’ knowledge of, insight into and opinion of the system over the same time period have shown a marginal increase in their knowledge of but a significant drop in their positivity about NHI.

Almost 80% (79.7%) of the respondents in the Solidarity Health workers NHI Survey report released yesterday were negative or sceptical about the NHI, compared to 71.9% in 2018 – 20.8% indicating that they had already acted on plans to emigrate and a further 41.6% saying they would take steps to emigrate when the NHI was implemented.

Invitations to take part in the study, the Solidarity researchers explain in their report introduction, were sent to 7 443 healthcare practitioners, and 651 respondents completed the online questionnaire: “This is a feedback figure of almost 9% and is adequate to yield valid and reliable results,” they note, adding that a wide field of medical professions was covered with a view to generalising the results of the study beyond Solidarity’s member base used in the 2018 survey.

“This will give Solidarity as a pressure group and trade union greater clarity and strategic insight on how to inform, support and protect its members and fellow South Africans on aspects regarding the NHI.”

Returning to the findings, despite being better informed – 56, 3% having adequate knowledge as opposed 46% in last year’s survey – only 2.6%, as against 3.8% in the 2018 survey, were positive or optimistic about the NHI.

“More than 60% of them,” the report continues, “were convinced that the NHI would not be able to improve the quality of service delivery, and most of them indicated that they would not want to work under the NHI.”

Concerns expressed in this regard included healthcare sector “destabilisation”  factors: such as  shortages of specialists, doctors, nursing staff and other health workers, financial management of the NHI, purchasing and distribution of medicines and equipment, and Maintenance of infrastructure and equipment.

SOURCE: Nicolien Welthagen, Senior Research Psychologist: Solidarity Research Institute

*The full report can be downloaded at