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DENOSA KZN statement on the state of readiness of the province for NHI 

Media statement 

Tuesday, 16 July 2019

Following the announcement of a 10-Point Plan as part of the process of rolling out National Health Insurance (NHI) by Health Minister in his Budget Vote in Parliament on Friday, the Democratic Nursing Organisation of South Africa (DENOSA) in KwaZulu-Natal is not convinced that the province is ready for NHI yet, given the slow pace of solving the current outstanding critical issues that have a direct impact on the patient experience in public health facilities.

While Minister of Health, Dr Zweli Mkhize, highlighted the need to address the issue of staff shortage and shortage of resources in facilities, the reality is that these challenges have been experienced by the province for a long time and there appears not to be any political will to address them. 

DENOSA in the province understands that the NHI is about financing the healthcare service in the country, but we are always the first people to point out that such healthcare service is not going to be rendered in the sky, but will be provided by the same current health facilities, unless government's hope will rest on the few well-resourced facilities in the private healthcare sector. 

More critical to our concerns is the abandonment of the current solution to the shortage of nurses within the healthcare system in the province, where hundreds of newly-qualified nurses cannot be absorbed by the health system, despite a glaring shortage in our facilities. As a result, the provincial government is considering releasing these nurses to other provinces and to the private sector, thereby dashing any immediate hope of addressing the chronic shortage in health facilities.

Furthermore, gaps that have been identified during the pilot phase of NHI in the province, such as Ideal Clinics, Family Teams and Schools Health Programme, have not been addressed and poor resources are at the core of their ineffectiveness.

Many clinics have scored poorly from assessments, which are done twice a year, on critical areas like resuscitation equipment and only 11 percent of clinics are ready for NHI in the eThekwini District, and staffing norms (WISN) are not used when hiring staff. 

The integrity of infrastructure scored not more than 27 percent in clinics, and the response of EMS to emergencies is only at 39 percent while a whopping 43 percent of clinics have non-functional ablution facilities. 

While there were areas of improvement on infrastructure in some districts, which is a positive sign, the challenges of human resource and shortage of equipment far outweigh the positives in this regard.


Issued by DENOSA in KwaZulu-Natal

For more information, contact:

Mandla Shabangu, Provincial Secretary

Mobile: 071 643 3369