The senior command structure of the SA National Defence Force (SANDF), specifically those tasked with military healthcare, will be keeping a weather eye on next month’s public hearings into the proposed National Health Insurance (NHI) bill.
The military is aware of NHI as evidenced by the Department of Defence’s (DoD) annual performance plan for the current calendar year. It states, in part, “implementation of NHI will affect the SANDF once the rollout begins as the NHI is prescriptive of what is required of a health facility to be registered and also provides a clear indication as to what government believes the minimum standard of a health facility should be for patients making use of public health infrastructure”.
“While the SANDF is not a public health service provider, it could be argued members of the population entitled to a military health service should at least be provided with the minimum standards prescribed at an even higher standard for which appropriate funding is not available,” according to the performance plan.
Comprehensive health is listed in the performance plan as priority five of the DoD’s budget prioritisation framework in line with a Cabinet mandate paper setting out a strategic framework for budget priorities as per the National Development Plan. It comes after job creation and small business development; economic and community infrastructure; land reform and education and is followed by service delivery and finally, an integrated plan to fight crime and ensure territorial integrity.
The SA Military Health Service (SAMHS) via its national footprint of three military hospitals in Bloemfontein, Cape Town and Thaba Tshwane as well as sickbays at major bases, has the baseline objective of more than 2.1 million “healthcare activities” a year, according to the performance plan. This was surpassed in 2015/16, 2026/17 and again in 2017/18 when 6.6 million “activities” were provided. These are provided only for serving SANDF members and their immediate dependents as well as military pensioners and veterans.
SAnews has it that objectives of the NHI Bill include universal access to quality healthcare services, in accordance with section 27 of the Constitution; establishing a National Health Insurance Fund and setting out its powers, functions and governance structures as well as to provide a framework for strategic purchasing of healthcare services by the fund on behalf of users.