The Select Committee on Health and Social Services engaged in a thorough review with the Department of Health concerning the National Health Insurance (NHI) Bill. During this engagement, the Minister of Health, Dr Joe Phaahla, informed the committee of the extensive public input received across all nine provinces.

According to Parliament of South Africa, Dr. Phaahla detailed that provincial legislatures had carried out 60 public hearings from 28 July to 30 October 2023. He reported that a broad range of organizations had presented substantive feedback, echoing sentiments previously directed to the Portfolio Committee on Health.

Dr. Nicholas Crisp, the Deputy Director-General of the department, conveyed to the committee that much of the public commentary highlighted a need for greater clarity regarding the bill’s financing. Issues were raised concerning the ambiguity over potential tax hikes, concerns over an increase in personal taxes further straining taxpayers, and trepidation about potential rises in value-added tax.

Dr. Crisp clarified that Clause 49 (2)(a) of the bill specifies its financing sources, including additional mobilized resources. He highlighted that South Africa’s current health expenditure stands at 8.5% of its gross domestic product (GDP)—with public and private sectors spending 4.2% and 4.3%, respectively. This expenditure is significantly higher than that of countries at similar levels of economic development.

Additionally, Clause 49 outlines a mandatory pre-payment system as a structural component for generating revenue for the NHI Fund.

The committee’s chairperson, Mr. Zoyisile Njadu, expressed concern that some public submissions were omitted from the department’s responses. The committee was firm in its stance that all feedback should be considered, including late submissions. Consequently, it reached an agreement with the department to convene an additional meeting to address the previously excluded responses.