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South Africans have until 6 June to submit comments on the proposed regulations for the governance of the National Health Insurance (NHI) Fund.
As per the NHI Act which was signed into law in May of 2024, the NHI Fund is the vehicle through which universal health coverage is to be achieved in the country. Among the functions of the Fund is to purchase health services on behalf of NHI users, set the rates for these services and ensure that service providers have the necessary registration or accreditation.
The draft regulations on the NHI Fund’s governance sets out the structures and individuals responsible for managing and overseeing the Fund’s operations to ensure accountability, transparency, efficiency and integrity.
The Role of the Minister of Health
The Minister of Health will appoint an ad hoc advisory panel based on members’ expertise and experience in relevant fields. The panel’s mission is to provide independent expert advice to guide the Funds’ decision-making, ensuring transparency, accountability, and align with national health priorities
The Board of the NHI Fund will be established after the Minister of Health submits the candidates recommended by the Ad Hoc Committee to Cabinet for approval, and in line with criteria set out in the NHI Act. The board is responsible for overseeing the strategic direction, financial management and the overall performance of the Fund.
The CEO of the NHI Fund should be appointed by the Board through a merit-based selection process, following a transparent recruitment procedure. The CEO is responsible for managing the day-to-day operations of the Fund, implementing its strategic objectives and ensuring the effective delivery of health services under the NHI system.
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The health minister plays a key role in overseeing and ensuring the overall policy and legislative framework of the NHI Fund, but will not be responsible for operational control.
The minister will determine which health services are covered under the NHI with the advice from the Benefits Advisory Committee – which will be appointed by the minister.
He provides political and strategic oversight to ensure the alignment of the Fund with national health policy and facilitate coordination between the Fund and the health system.
The Minister of Health will be responsible for recommending appointments to key governance structures such as the Board and for tabling reports on the Fund’s performance to Parliament.
Clarity on NHI Fund governance
Dr Nicholas Crisp, deputy director-general for NHI in the Department of Health explains that the Board will be legally responsible for managing and overseeing the financial affairs of the Fund as required in the Public Finance Management Act (PFMA). He says the NHI Act provides for 11 members appointed with a technical skills mix.
“The regulation of the NHI Fund governance describes how board members and two of the advisory committees will be nominated. This process is very public and very transparent. When the minister signs the letters of appointment for the Board members there will have been extensive public insight into who is appointed. If the minister and cabinet deviates from any step there is an obligation to provide public reasons for such deviations,” Crisp explains.
Crisps says the draft regulations do not establish the Fund, but aim to appoint a Board and the Advisory Committees that will be responsible for developing and implementing the administration of the Fund.
“The entity will only be established when that capacity exists. The public should remember that the NHI must be gradually phased in using a progressive and programmatic approach based on financial resource availability,” he says.
Submission of comments
Have your say by submitting written representations and comments by 6 June.
These are to be submitted by completing the online public comment survey at Https://www.health.gov.za/NHI/ or
Post to: The Director -General, Department of National Health, Private Bag X828, Pretoria 0001. Or these can be hand delivered at Reception, Dr AB Xuma building, 1112 Voortrekker Road, Pretoria Downlands 351-JR, Pretoria, 0083.
Submissions can also be emailed to regcomments@health.gov.za. – Health-e News
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