Business Unity South Africa (Busa) on Thursday maintained that "structured, formal and urgent engagement" with government is needed on the Health Compact and the proposed National Health Insurance (NHI) Act to ensure healthcare reform and universal health coverage without negatively affecting the economy and the existing skills in the private healthcare sector. 

Busa said the engagement should include the Presidency, National Treasury and the Department of Health. 

Busa has not signed the new version of the Presidential Health Compact, saying it was “unilaterally” amended by government, and that it had transformed its “original intent and objectives into an explicit pledge of support for the NHI Act”. 

“While reference was made to NHI in the previous version of the Compact, it was only mentioned in the context of longer-term developments. Busa has always supported a collaborative, workable NHI rather than the current single-fund model which is both unaffordable and unimplementable. It's disappointing that the initiative has been altered to endorse an NHI framework that many stakeholders, including ourselves, do not support because it is unworkable,” stated Busa.

It also claimed that the changes to the Health Compact were made without consultation. 

Deputy President Paul Mashatile will, in his capacity as Acting President, lead the signing by multiple stakeholders of the Second Presidential Health Compact at the Union Buildings, Pretoria on Thursday.

President Cyril Ramaphosa appointed Mashatile as Acting President, based on medical advice that he allow an eye infection to clear.

The Presidency said immediately after the Health Compact signing, Mashatile would receive Letters of Credence from Heads of Mission and Ambassadors-Designate of 11 countries.

Busa stressed it had consistently supported the goals of the Presidential Health Compact since its inception in 2018, and that it remained committed to such projects and objectives.