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A coalition of the country’s top health-care professionals and organisations have proposed what they say is a “pragmatic route” to achieving universal access to equitable, quality and affordable healthcare in South Africa.
In a detailed statement on Wednesday, the Universal Healthcare Access Coalition (UHAC), said its approach was gaining support amongst healthcare professionals, workers and patient advocacy organisations.
This, as the government sticks to its guns on continuing with the “unimplementable” and “unfixable” National Health Insurance (NHI) Act.
The Coalition said its proposed framework for healthcare reform is practical, evidence-based, capable of more immediate implementation and critically, is designed to work within the country’s fiscal constraints rather than raising the tax burden on citizens.
Responding to President Cyril Ramaphosa’s statement during SONA that the government would proceed with the preparatory work this year, UHAC steering committee member Dr Aslam Dasoo, said this signalled that the crumbling state of healthcare would continue “while government tries to figure out how to fund and implement an unworkable NHI”.
He said SONA effectively promised little more than policy stagnation and an untenable status quo.
“The UHAC has developed a concrete, workable reform pathway to address the very evident failures in the public and private healthcare systems and achieve a high-performing system of universal access and coverage in South Africa,” said Dr Dasoo.
According to the statement, the UHAC represents the majority of South Africa’s healthcare and related professionals and industry organisations, with more than 25 representative organisations as signatories to the proposed healthcare reform framework, and support growing.
The group was formed following the President’s invitation in September 2024 for specific proposals of workable solutions to advance quality, affordable healthcare for all in South Africa.
Another steering committee member and chairperson of the SA Medical Association, Dr Mvuyisi Mzukwa, said the NHI does not materially depart from the weaknesses of the current system but instead centralises control without resolving fundamental problems.
“The Act as it stands is unworkable, lacking a clear implementation pathway and timeframes.
“Crucially, the NHI model of a single tax-financed fund to provide healthcare access and cover for the entire population is unfeasible and unattainable in the country’s current and foreseeable economic future.”
“UHAC proposes a mixed funding model of medical scheme contributions and general taxes, with some re-alignment of existing taxes, which better aligns with the country’s fiscal constraints and will ensure long-term sustainability,” Dr Mzukwa said.
Dr Simon Strachan, the CEO of the SA Private Practitioners Forum (SAPPF), said the coalition’s proposal draws on research and the recommendations of various commissions and related enquiries over the last three decades, updated and designed to account for the absence of healthcare reform over the last 20 years.
“The public system is failing due to institutionalised corruption enabled by flawed governance structures.
“Needed reforms to the private system, most recently outlined by the Health Market Inquiry in 2019, have inexplicably been put on indefinite hold – an apparent consequence of the irrational and counterproductive perspective that medical schemes would no longer exist.
Interested parties can find more information on UHAC and the proposals at https://progressivehealthforum.net/uhac/
