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On 8 September 2009 the Minister of Health signed a notice that appeared in the Government Gazette on 11 September 2009 (Government Notice No. 903 in Government Gazette No. 32564, dated 11 September 2009) establishing the "National Health Insurance Advisory Committee". This Committee is established pursuant to the Minister's powers afforded to him in section 91 of the National Health Act No. 61 of 2003.
The establishment of the Committee is an important indicator of the forthcoming National Health Insurance Scheme ("the NHIS"). The NHIS has received much attention since it was first mooted by the African National Congress during the general elections in South Africa in 2009. However, very little has been published about the NHIS by the current Government in any formal document. Therefore, the publication of the aforementioned notice is a significant step in the commitment by the current Government to the implementation of the NHIS.
The advisory committee is to be convened in order to advise the Minister of Health on the development of "policy and legislation relating to the introduction of a national health insurance system." In addition, the Committee is required to advise the Minister on issues concerning the development of policy, the drafting of legislation relating to the introduction of NHIS and the development of a detailed implementation plan to introduce the NHIS.
Importantly, the notice contains certain background information pertaining to the NHIS. Of relevance is the characterisation of the South African healthcare sector in its current form. The sector is characterised as fragmented and inequitable "due to the huge disparities that exist between the public and private health sectors with regards to the accessibility, funding and delivery of health services." As a result of this state of affairs, the delivery of healthcare is rendered unequally and disproportionately in so far as "the majority of the population relying on a public health care system that has a disproportionately lower amount of financial human resources at its disposal relative to the private sector." Therefore, the introduction of the NHIS is designed primarily to address a disproportionate existence between the public and private healthcare sectors with reference to human resources and financial strength. This is confirmed in section 1.2 of the Notice as the NHIS is to be introduced to address the imbalances of human resources and finances between the respective healthcare sectors in South Africa. Specifically, section 1.2 states that a NHIS is required to address the imbalances and to transform the health system "into an integrated, prepayment-based healthfinancing system that effectively promotes the progressive realisation of the right to healthcare for all." Section 1.2 finds an echo in section 27 of the Constitution of the Republic ofSouth Africa, 1996, which expressly provides for the access of all South Africans to adequate healthcare.
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