Issued by: Ministry of Health
IMPLEMENTATION OF THE NATIONAL HEALTH SYSTEM FOR UNIVERSAL PRIMARY HEALTH CARE AS OF APRIL 1, 1996
In January 1995 a Committee of Inquiry was appointed to investigate the possibility of a National Health Insurance System and how it could be financed. The Committee had to develop a plan for the provision of health care services at the primary level of care, based on the following policy objectives:
Extensive consultations were held on the plan and it was subsequently submitted to Cabinet for approval. Cabinet approved implementation of part 1 of the plan as of April 1, 1996.
The report is divided into two parts. Part I is to be implemen- ted as of April 1, 1996. Part II, which consists of regulatory reform of the private health sector, will require legislation and in some cases, drafting amendments to regulations before implementation.
The following components of the National Health System for Universal Primary Health Care (NHS) are ready for implementation:
Public primary health care facilities, e.g. clinics, community health care centres and local authority clinics will provide services free of charge. This will be phased in. KwaZulu-Natal and Northern Province have already started. Other provinces will start on the 1st of April, and it should be fully implemented by the 1st of July.
This also accommodates the local authorities who at our meeting expressed their support but indicated that their financial year starts on 1 July 1996.
Services are, however, not free at the hospital except for children and pregnant mothers.
Medicines on the Essential Drugs List (EDL) for Primary Care will be available free of charge in the public sector as from April 1, 1996.
This will of course be meaningless unless the facilities are accessible country wide. The clinic upgrading and building programme will see 343 new clinics finished this year and 58 being upgraded to address this.
It will, however, take us up to 10 years to achieve full access to quality health care country wide.
The government will be introducing a new grading system as promised which will significantly increase the salaries of all health workers especially nurses, doctors and other professionals.
We are also filling the fully funded vacant posts especially at the primary health care level to ease the workload of health personnel.
The improved salaries and working conditions hopefully will attract the doctors back into the public sector so that we do not rely on foreign doctors for ever.
During 1996/7 this will be funded out of our budget which is now R17,2 billion, excluding the salary increases which will be implemented on 1st July, 1996.
The implementation of this plan will be monitored to measure the impact on health services, the health status of the nation and the long term financial implications.
The regulatory reforms in the private sector will not be implemented on April 1, 1996. Discussions are currently being finalised and draft legislation in this regard is being prepared. Some of these reforms will be incorporated into the proposed National Health Bill.
26 March 1996