THE Department of Health has pledged that South Africans will not pay more towards the National Health Insurance (NHI) than their medical aid contributions today, but MPs have questioned whether the government has the capacity to pull off its most ambitious project yet. The director-general, Malebona Matsoso, and other department officials presented the policy on the proposed NHI to the National Assembly's standing committee on appropriations yesterday. The officials provided some details on the government's ambitious project to provide improved access to quality health services for all people. Anban Pillay, the chief director of health economics at the department said the department would make sure NHI contributions would not be more than citizens were currently paying. He said the health system would be overhauled, with hospitals being redesignated. The draft bill on the Office of Health Standards Compliance was with the state law advisers and was expected to be tabled in parliament soon. The independent body would inspect and certify health facilities and act as an ombudsman. With public health facilities expected to be a cornerstone of the NHI, the department is struggling with a shortage of specialists, nurses and doctors. Last year, there were only 150 509 registered health professionals, mostly nurses. Numbers stagnated between 1996 and 2008 as the country continued to produce only 1 200 doctors a year while HIV/AIDS and tuberculosis drove the disease burden up. Matsoso said the present model for training specialists was "inappropriate" as trainees who did not pass stayed on in their positions, which in effect "blocked entry of other specialists". She said there was no replacement strategy and the posts were used to retain people. Matsoso said dedicated hospitals for training were required. She said the number of doctors produced had been unchanged for two years. Recruiting them abroad was not a solution. The success of the NHI would be determined by bringing competent people into the medical field, she said. The department was consulting specialists all over the world as it prepared to launch the NHI's pilot phase next year. MPs were not convinced. Enock Mbili of the ANC slammed the department "for using the space" to discuss problems instead of relaying concrete solutions. He said it was unacceptable that the department did not know how many doctors there were. Marius Swart of the DA questioned whether the department had sufficient capacity. He said "chucking more money into a bad system" was not the solution.

Michelle Pieterse: The Cape Times, 24 August 2011