7 things we know about how NHI will work as revealed by health minister Zweli Mkhize

12 July 2019 - 13:23 By Katharine Child
Health minister Zweli Mkhize delivers his budget vote in parliament on Friday.
Health minister Zweli Mkhize delivers his budget vote in parliament on Friday.
Image: Government Communication Information Systems

The National Health Insurance (NHI) Bill has been approved by cabinet and sent to parliament for discussion, bringing it one step closer to becoming law. 

Here is what you need to know. 

The final draft of NHI Bill has not yet been tabled in parliament or made public, but health minister Zweli Mkhize revealed some details in his speech to parliament on Friday.

1. NHI will share all the money available for healthcare among ALL people, suggesting medical aid premiums will be added to a single government-run fund

Mkhize: "NHI is a way of providing good healthcare for all by sharing the money available for healthcare among all our people. The health benefits that you received will depend on how sick you are and not on how wealthy you are."

2. Services will be for everyone, suggesting hospitals will not be divided into public and private facilities

Mkhize: "Hospitals, clinics, doctors, specialists, dentists, nurses and all other health workers will also be available to provide services equally."

3. The health department wants more money from Treasury if NHI is to work

Mkhize said the funding shortfall for the health department must be corrected "without further delay".  

4. The health department has admitted there is a severe shortage of staff with more than 4,100 vacant doctors posts in hospitals - that must be resolved before NHI

Mkhize said there are 4,143 medical officers' (doctors') posts and 3,932 nurses' posts that are unfilled. He said there are plans to fill 2,689 doctors' posts and 2,371 nurses' posts.

He also said there were too many people working as administrators in provincial and national health rather than on the frontline. 

5. There is an app for that

The health minister said there is an app being developed for patients to report when medicines are out of stock at their clinic or hospitals.

6. Money for medicines must not be for salaries

Mkhize said budgets for medicines must be ring fenced, so it doesn't go to paying salaries. This has happened.

A study published in the Health System Review stated that health department staff costs between 2006 and 2015 exceeded inflation by 38%. By February this year health departments had accumulated R14bn in debt to suppliers because money for drugs and consumables like gloves and syringes had been shifted to pay for salaries.

7.  The health department wants to fix dilapidated hospitals for NHI to work

A team between National Treasury and health has been established to find "creative financing" to fix old hospitals and clinics and deliver new ones within five to seven years.

Mkhize said the money that had been allocated over the medium term to fix ageing hospitals and clinics was "grossly inadequate".


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