South African National Health Bills Outlined

The Department of Health has set a target of 2026 to have a new national health system rolled out in South Africa, in many ways akin to the UK’s NHS, with the goal being equal access to healthcare, regardless of socio-economic status.

The first set of enabling legislation paving the way for universal healthcare in South Africa has been gazetted by Cabinet, Health Minister Aaron Motsoaledi announced on Thursday.

Motsoaledi presented two bills to the media on Thursday that would lead to massive changes in the way public health and medical aid coverage are handled in the country: the National Health Insurance (NHI) Bill and the Medical Aid Schemes Amendment Bill.

The minister said that the essence of the NHI is that the “rich will subsidise the poor, the young will subsidise the old, and the healthy must subsidise the sick”.

“Currently, it’s the opposite. At present, the poor subsidise the rich, and we will attempt to show that.”

Only 10% of South Africans could afford what was being charged in private healthcare, he said.

Citizens, civil society and the private sector have three months in which to comment on the new bills, which can be found HERE.

Single purchaser

The NHI Bill seeks to establish a fund – the National Health Insurance Fund – to act as a public entity governed by the Public Finance Management Act.

The fund will be a single public purchaser and financier of health services in the country, to ensure “equitable and fair distribution” and will be a mandatory pre-payment health services system.

It will purchase health care services, medicines, health goods and health-related products from certified, accredited and contracted service providers on behalf of the public.

It will “pool funds to provide access to quality health services for all South Africans based on their health needs and irrespective of their socio-economic status”, the minister explained.

The aim is for everyone to have the same access to the same standard of healthcare regardless of income, what people can afford or how frequently they need the services.

‘Terrible twins’ of the current system

Motsoaledi said there couldn’t be one set of rules for the rich and another for the poor as both groups “have the same health needs”.

He acknowledged that the move would require a massive reorganisation of the current health system, both public and private.

The National Development Plan described the exorbitant costs of private healthcare and the poor quality of public healthcare as the “terrible twins” of the health system.

Many have argued the country needs an overhaul of its health service first before changing the way it is funded, he said.

Fixing public healthcare, however, won’t be a single event, but a continuous, ongoing process, and shouldn’t be a “big stick” with which to beat back the move to national healthcare, he said.

“We are very much alive to the problems of poor quality in the public health system,” he said.

Comparison to Europe

South Africa currently spends a total of 8.7% of its GDP on both public and private health, he said.

The private sector spends 4.5% of GDP on health but only provides care to 16% of the population.

The public sector spends 4.2% of GDP on health but provides care to other 84% of the population.

Motsoaledi noted similarities in terms of spending when comparing SA to European countries, but not when it comes to the provision of healthcare. “It looks like chalk and cheese. The reason is the way the money is divided”, he said.

On top of that, South Africa is an outlier when it comes to voluntary spending on private health insurance.

South Africa spends 42.2% of total health spending on private healthcare, the highest proportion in the world. The US meanwhile spends 32%. The world average is 4.1%.

School health the ‘heartbeat’ of the new system

The NHI Bill will seek to make amendments to 12 other existing acts of Parliament in order to pave the way for an effective national fund.

For the purposes of the briefing, Motsoaledi confined himself to two acts: the National Health Act of 2003 and the Mental Health Act of 2002.

The amendment to the National Health Act will essentially give the minister’s office more direct capability in intervening in ailing provincial health departments, as it did in the North West earlier this year.

The same would apply for mental health services.

School health has been identified as the “heartbeat” of the new system under the NHI, with 12 million children in school currently.

After screening 3.5 million school children, the department found that eyesight, hearing, oral health and speech were physical barriers to learning.

The NHI would intervene in the matter, allowing for free glasses, hearing aids, oral hygienists and speech therapists. Pilot projects will be launched this year.

“We cannot wait for kids to arrive in clinics already sick. We need to know what is going on with them because they are the future.”

Co-payments to be abolished

Motsoaledi also announced the new Medical Aid Schemes Amendment Bill that will change how private medical aids operate in South Africa.

The minister said changes were necessary to pave the way for the NHI.

“The first amendment is to abolish what has become known as co-payments.”

Citizens have paid in the last financial year a sum of R29bn in co-payments from “their own pockets”.

“The patient should not be burdened with the need to pay anything,” Motsoaledi said.

“Of course there are people who say this amendment is callous and aimed at destroying the medical aid system. I assure you this has been well thought through.”

No late joining fees

He also took exception to medical aid schemes holding in reserves close to R60bn.

There is a statutory requirement that the schemes hold 25% of income in reserves to cater for emergencies.

“Our bone of contention is that R60bn is equivalent to 33% of reserves and is unnecessary accumulation.”

The bill will also abolish penalty fees for late joiners. “Under the NHI, there will be no penalty for late joining.”

In most retirement cases, a spouse cannot continue with the scheme until they themselves register as the principal member.

To see the gazetted bill, click here.

The transition is expected to take approximately 15 years in three phases. Phase two began in 2017 and will end in 2022. In theory, the system should finally be ready by 2026, Motsoaledi said.


Sources: News24 via AllAfrica [1]. Image sources: [1].

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Cape Town Investigating Natural Gas as New Energy Supply

The Cape Town city council is spending almost R13 million assessing the viability of a natural gas distribution network‚ including converting existing power plants to run on gas.

The study is being funded by the US Trade and Development Agency‚ and is due to be completed by early 2019.

Mayor Patricia de Lille said on Friday that Cape Town wanted to pioneer a new approach for the role of cities in supplying energy.

“It is our intention to play a greater role in fostering a dynamic energy market‚ and this study will help us understand the role that gas can play in supporting such a market‚” she said.

“It is clear that gas can play a complementary role to renewables in helping us balance the load and reduce our carbon emissions.”

US consul-general Virginia Blaser‚ who signed the feasibility study agreement with De Lille‚ said it was part of a long-term partnership with the Western Cape and Cape Town‚ aimed at driving economic growth.

“I’m proud Americans are working with South Africans to find innovations‚ resources‚ and opportunities toward creative solutions in the region‚” she said.

The City of Cape Town aims to generate at least 300MW of electricity from natural gas or cleaner supply options by 2020‚ and decided last year to divest from fossil fuel assets and companies in favour of greener investments.

“We have also taken the minister of energy and the National Energy Regulator of South Africa to court to fight for our right to procure clean energy directly from independent power producers‚” said De Lille.

The gas study will be done by Featherwood Capital‚ which De Lille said had extensive knowledge of the North American and international liquefied natural gas and liquefied petroleum gas industries‚ as well as the natural gas transportation and distribution markets.


For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, and Remuneration needs, email, or call us on +27 21 763 4240.

Sources: Dave Chambers via TimesLIVE [1]. Image sources: Jessica Mulder on Unsplash [1].

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Sources: [1]. Image sources: [1].

Johannesburg is Making Household Recycling Mandatory From 1 July

In an effort to cut down on pollution and safeguard the environment, the City of Johannesburg will roll out a phased approach to make ‘separation at source‘ mandatory for households from 1 July.

Effectively this means that households will be required to separate certain recyclable materials from other waste before they are picked up for collection.

According to a statement released on Friday (8 June), the City said that the biggest challenge it currently faces is trying to change human behaviour and getting people to understand how they impact the environment in the way they deal with plastic.

Speaking to BusinessTech, city councillor Nico De Jager said that more details on the program will be communicated on 12 June – following which, the City plans to make the details of the roll out known to all residents.

“With mandatory we mean that it will be compulsory, and through the initial stages we will do education campaigns and issue warning letters to get residents to participate.”

“There are no penalties in place at the moment,” he added.

The announcement follows a noticeable push by both the private and public sectors to cut down on plastic and other pollution.

In May, environmental affairs minister Edna Molewa indicated that her department is looking at the possibility of reviewing legislation with a view of phasing out harmful plastic products including straws.

Earlier this week, both Pick n Pay and Woolworths also announced a number of initiatives to cut down on plastic packaging.

Recycling is a key component of modern waste reduction and is the third component of the “Reduce, Reuse, and Recycle” waste hierarchy. Thus, recycling aims at environmental sustainability by substituting raw material inputs into and redirecting waste outputs out of the economic system.

Recyclable materials include many kinds of glass, paper, and cardboard, metal, plastic, tires, textiles, and electronics. The composting or other reuse of biodegradable waste—such as food or garden waste—is also considered recycling. Materials to be recycled are either brought to a collection center or picked up from the curbside, then sorted, cleaned, and reprocessed into new materials destined for manufacturing.

Everyone should strive to do as much as they can in order to ensure a sustainable future, and reducing usage is even more important than recycling. To read more about the importance of household recycling, visit the Western Cape Government’s Household Recycling page, and this UK Recycling Guide site.


For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, and Remuneration needs, email, or call us on +27 21 763 4240.

Sources: BusinessTech [1], [2]. Image sources: ProjectManhattan [1].

SA Department of Energy Launches Appliance Energy Calculator Apps

The Department of Energy has launched a new mobile app that allows consumers to make in-store energy comparisons of different appliance models before buying them.

The Appliance Energy Calculator mobile app allows for consumers to enter the relevant information (easily sourced from the mandatory energy label on the appliance) into the app, which calculates the estimated running cost of the appliances of their choice, the department said in a statement on Friday (8 June).

It added that the app shows how much powers the appliance uses over a one and ten year period, and also estimates CO2 emissions of the appliance.

The launch of the app also accompanies a Standards and Labelling (S&L) programme, which aims to places energy labels on appliances that provide consumers with accurate and comparable information on their energy efficiency.

Appliances for which the display and use of the South African Energy Efficiency Label is compulsory include:

  • Washer-Dryer Combinations
  • Washing Machines
  • Tumble Dryers
  • Electric Ovens
  • Fridge-Freezer Combinations
  • Freezers
  • Electric Water Heaters (geysers)
  • Fridges
  • Dishwashers and
  • Air-Conditioners

TV and audio-visual equipment including decoders and set-top boxes do not need to display a label but must have a standby power usage of less than 1 Watt, and 3 Watts for set top boxes.

“Access to electricity for all South Africans remains a core objective of government and so is the efficient and effective use of this resource,” said energy minister Jeff Radebe.

“Because we cannot always control how citizens choose to use their electricity, it was imperative for us to implement measures that ensure that appliances sold in South Africa are regulated and energy efficient. We equally introduced instruments that assist consumers to make the right choices when purchasing appliances.”

The Appliance Energy Calculator app is currently available on the Google Play Store and Apple App Store, the department said. For desktops, a calculator is available here.


For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, and Remuneration needs, email, or call us on +27 21 763 4240.

Sources: BusinessTech [1]. Image sources: Karsten Würth on Unsplash [1].