Millionaire managers already hired for unconstitutional NHI Bill

Dear Editor

In response to a written question addressed to the Minister of Health, Joe Paahla, it was confirmed that there are several individuals in the upper salary bands, 13 to 16, of the Department of Health’s National Health Insurance (NHI) programme who already earn over R1.2 million per annum. The 2024/25 National Budget allocated funds to employ at least 28 people in these salary bands this year, with an average annual salary of R1.1 million.

Moreover, as far back as 2022, the Department requested that the NHI branch be “strengthened”. Consequently, the Minister of Public Service and Administration approved 44 more high-earning positions.

This prompted the DA’s questions regarding the necessity of such high salaries for these roles. The written questions specifically sought the job descriptions and compensation expectations. The Minister’s vague response has confirmed that many of the positions are redundant and wasteful, will contribute little value to the public service and will merely serve to diverted resources that could be more effectively used elsewhere.

One such position is:

“SPECIALIST ANALYST: KNOWLEDGE MANAGEMENT (X2 POSTS)

Chief Directorate: Health System Digital Information

SALARY : R1 073 187 per annum

DUTIES : Interrogate analytical outputs from the NHI-digital platform to identify best practices and lessons learnt to be shared. Facilitate a learning platform to disseminate key resources to NHI related community of practices. Prepare annual performance report for NHI Digital Platform. Facilitate and organise sessions to support data driven decision making to improve NHI contracting performance measures. Manage the monitoring and evaluation and research activities of the fund.”

Nearly R5 billion has already been allocated to the NHI programme for the medium term despite it not even being in existence yet.

Since the introduction of the NHI Bill, the government has remained elusive about its funding. But Minister Paahla in another response to a written question posed to him that taxes will have to be increased to fund the Bill. Conservative estimates of the projected financial impact of the NHI have already reached R859 billion per annum.

Funding will not magically appear once the bill becomes law as the Minister claims. Instead, government appears to be readying itself to march headfirst into what it knows will be a constitutional catastrophe and a humanitarian disaster.

The DA’s position is clear. We remain committed to the principle of universal access to healthcare for all citizens. But the NHI Bill is unconstitutional and will only serve to further erode an already ailing national public health sector.

Instead, our model, presented in the DA’s Manifesto and healthcare policy documents, outlines how sustainable access to healthcare can be achieved by fixing the current district management model through governance reform. By leveraging the strengths of the private sector in partnership with the public sector, a DA government will provide access to high quality healthcare for every South African, without increasing the tax burden.

While the President has been looking for his pen to sign it into law, the DA has sought legal counsel and stands ready to oppose this legislation that threatens to bar access to quality healthcare for South Africans.

Regards

Dr Dion George MP
DA Shadow Minister of Finance