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The National Education, Health and Allied Workers’ Union [NEHAWU] notes the statement released by the Public Service Association of South Africa (PSA) on the National Health Insurance Bill. This reactionary and historical white staff association of the Apartheid state apparatus purports to speak on behalf of the workers in claiming that “the NHI Bill may reverse the gains workers have made in respect of access to quality healthcare”.

To the extent that in some of the economic sectors workers historically secured social security rights (including health and retirement insurances) during the twilight years of the Apartheid regime is exclusively thanks to the gallant and militant struggles of the trade unions in the fold of the Congress of the South African Trade Unions (COSATU). The PSA has the audacity to talk about these workers’ gains when it was a lapdog entity of the oppressive and racist regime.

In itself, the PSA statement underscores the fact that it does not understand what the NHI is about and confirms its complete absence over the years during the open and genuine engagements on the NHI at NEDLAC and in parliamentary public hearings, as well as between government and the formations of the medical practitioners, medical aid insurance and private hospitals groups. From the early development of the National Health Insurance in South Africa Policy Paper (Green Paper) in 2011 eventually to the gazetting of the 2017 White Paper on the National Health Insurance, culminating with the NHI Bill, there have been extensive and robust public consultations and engagement processes. No serious workers’ association, purporting to genuinely represent the best interests of the workers can only start showing interest now on the NHI and calling on President Cyril Ramaphosa “for further discussions” when it was absent at the Presidential Health Summits in 2018 and 2023.

As NEHAWU, we reiterate our support for the enactment of the NHI Bill, which has been subject to rigorous scrutiny since it was introduced in Parliament in August 2019. The NHI Bill is about the rule of law, i.e. compliance with Section 27 (1) of the Constitution of the Republic of South Africa– which imposes an injunction on the state to ensure that “everyone has the right to have access to (a) health care services, including reproductive health care; (b) sufficient food and water, and (c) social security, including, if they are unable to support themselves and their dependants, appropriate social assistance.”

Of course, we can expect the PSA to be part of the line-up of its ilk of the historical Apartheid forces that are opposing transformation but pretending to support our transformatory Constitution. They are now hoping to block the NHI through the courts. For the PSA to claim that “government is using the introduction of the NHI to campaign for the 2024 elections” further exposes the reactionary and cynical nature of this association and those who are aligned to it politically and otherwise.

The ANC government received first an overwhelming support for the introduction of the NHI from the electoral mandate of 2009. The NHI featured in all the election cycles and electoral mandates since then, including the 2019 mandate for the sixth democratic government. NEHAWU is a proud pioneer and protagonist for the introduction of the NHI, which seeks to align our country with the world that is striving to achieve universal health coverage in terms the United Nation’s Sustainable Development Goals (SDG 3). We are therefore gearing ourselves to defend the NHI against the reactionary forces hell-bent on maintaining the Apartheid legacy of the exclusion of the majority.

The NHI aims to ensure that everyone can access quality health services without incurring financial hardship and seeks to create healthcare equity and to eliminate the prevailing and inherited disparities by providing essential health services to all individuals, regardless of their socioeconomic status or geographic locations. This is in line with the Freedom Charter’s call for “a preventative health scheme run by the state - free medical care and hospitalisation provided for all, with special care for mothers and young children”.

Let all those opposing the NHI like the PSA show the South African people how they think Section 27 of the Constitution can be fulfilled without a universal health coverage. Let them also show us how the private health industry would sustain itself without the tax rebates (Medical Scheme Fees Tax Credit), which are actually unconstitutional or without the extortionate out-of-pocket expenses on those who apparently have medical insurance. Let them show us how the private health industry can survive without the rampant profiteering and systemic corruptions exposed by the Competition Commission’s Health Market Inquiry (HMI).

Issued by NEHAWU Secretariat