Finance Minister Enoch Godongwana says Health Minister Aaron Motsoaledi is expected to come with document spelling out how much is needed for the implementation of the National Health Insurance policy. Picture: Armand Hough / Independent Newspapers
THE ball is in the court of Health Minister Aaron Motsoaledi to come up with the amount that will cost the implementation of the National health Insurance (NHI) policy.
This was the word from Finance Minister Enoch Godongwana when asked about funding for the NHI in the 2025 budget, which was postponed to March 12.
Godongwana said the provision made in the budget was for the preparation for the implementation of the NHI.
“What is expected and agreed is that Minister Motsoaledi must submit a document saying how he is going to roll out the implementation of the NHI so that all of us can be able to engage with it and understand the full cost of the implementation over what period,” he said.
Godongwana said the immediate task was to upgrade health facilities and improve things such as the record keeping in the department.
“We now agree infrastructure must be upgraded substantially to be able to comply with NHI. That is where we are in terms of costs.”
In its Budget Review document, the National Treasury said as part of strengthening the health system and preparing for the NHI policy, the Department of Health will fund the development of a patient information system, a centralised chronic medicine dispensing and distribution system, and a facility medicine stock surveillance system.
Godongwana and the department’s position on the NHI are in line with what President Cyril Ramaphosa said in his State of the Nation Address, ensuring that they will proceed with the preparatory work for the establishment of the NHI.
Ramaphosa spoke about developing the first phase of a single electronic health record, preparatory work to establish Ministerial Advisory Committees on health technologies and health care benefits, and an accreditation framework for health service providers.
“Our most immediate priority is to strengthen the health system and improve the quality of care. A vital part of this is the modernisation, improvement, and maintenance of existing health facilities and construction of new hospitals and clinics,” he said.
According to Godongwana, his budget speech was to touch on the commencement of upgrade work at two hospitals.
He was apparently referring to the provisional allocations from the Budget Facility for Infrastructure (BFI) and new allocations for Siloam District Hospital and Tygerberg Hospital equipment through a public-private partnership in 2027/28.
The two health facilities are mentioned in the 2025 budget document.
The National Treasury proposed conditional grants for NHI allocations to the tune of R8.5 billion and R1.4 billion for the two hospitals in the medium-term expenditure framework.
“Sustained allocations for direct and indirect infrastructure grants, including potential additional funding through the BFI, as outlined in the 2024 MTBPS, will focus on new or replacement buildings, upgrades, rehabilitation, and maintenance.
“The total infrastructure allocation is R37.4 billion over the MTEF period, including provisional allocations from the BFI and new allocations for Siloam District Hospital and Tygerberg Hospital equipment through a public-private partnership in 2027/28.
“It remains important to improve efficiency in expenditure, including in the areas of commuted overtime, public procurement and price benchmarking.”
Meanwhile, the budget is proposing that the department be allocated an overall R941.5 billion over the MTEF period to support the equitable provision of public health services, including free primary healthcare.
“About 44.7% of this allocation is directed to funding district health services, particularly primary healthcare facilities such as clinics and community health centres, which also provide outreach services.
“This level of care is recognised as the most efficient and effective due to its focus on disease prevention and proximity to communities.”
The National Treasury said that almost 98% of the proposed budget was allocated to provinces, amounting to about R922.7 billion.
“Employee compensation accounts for 64.1% of the provincial total to maintain an adequate number of healthcare personnel, especially doctors and nurses.”
mayibongwe.maqhina@inl.co.za