National Health Insurance: Medtech sector points out concerns with Act, immediate and urgent pressures on the industry, commits to continued engagement for workable NHI

The SA Medical Technology Industry Association (SAMED) says the promulgation of the NHI Bill into law marks a crucial juncture for South Africa’s health sector and for the entire country.

SAMED, which represents over 170 companies whose medical devices and diagnostic equipment are vital to healthcare provision, commits to continued engagement in the evolving policy development. It reaffirms its support for universal healthcare and a workable NHI that helps to transform the health system and manage current fragmentation and inequities.

The medtech industry has participated in NHI policy making since the early stages and the NHI Green Paper. During this time, it has established solid relationships and communication channels with government, regulatory role-players and business networks. Years of this positive engagement have been encapsulated in the public-private MEDTECH Master Plan that was launched earlier in May.

These considerations inform SAMED’s response to last week’s (15 May) promulgation of the NHI Act:

  • Government must address issues that are paramount for both the medtech industry and for uninterrupted provision of quality health services. The newly promulgated NHI Act does not have adequate policies to facilitate the establishment of frameworks for fundamental administrative functions. These include human resources and information and communication infrastructure necessary for processing millions of claims, invoices and payments.
  • These administrative elements are absolutely necessary for the efficient procurement, reimbursement and independent health technology assessment. Until these consequential amendments are made, SAMED cannot support the implementation of the NHI Act in its current form.
  • SAMED has addressed these topics on numerous occasions through written and direct submissions to parliament and other relevant role players, as well as provided extensive information and documentation.
  • Having invested commitment, goodwill and resources during the NHI policy-making and revision phases, SAMED has demonstrated that it is more than willing to work with government. The association believes the priorities it highlights in this statement could easily be addressed with better collaboration, management and concentrating the individual and joint focus on the South African patient.
  • SAMED welcomes President Cyril Ramaphosa’s indication on 19 May that he is giving thought to a mechanism that will allow for more engagement and collaboration with business, labour and other social partners.

Currently, a sizable segment of the medtech industry – regrettably most of them small and medium enterprises – are under severe financial pressure with their invoices not being paid due to the public sector’s administrative incapacity.

This has contributed to a ballooning outstanding government debt of over R1 billion now being owed to about 40 SAMED member companies. The total debt is far bigger. This systemic challenge has persisted for over 15 years despite efforts to resolve it because it affects patient care. SAMED is urging that attention be given to settling these payments despite the national focus being on elections to ensure that the supplier companies are paid and healthcare continues without disruptions.

In summary: SAMED fully supports universal healthcare and the objectives of the NHI Act but not its implementation in the current form. This version of the Act is not workable due to inadequate structures for implementation. SAMED will continue to advocate for public-private collaboration that can result in robust and fit-for-purpose medtech policies to allow for continuous and sustainable provision of medtech that is needed by South African patients.