Annually, about 100 million people globally are forced into extreme poverty because of out-of-pocket expenditures on health. World Universal Health Coverage (UHC) Day takes place on 12 December every year.
This global day follows hot on the heels of the passing of the National Health Insurance (NHI) Bill by the National Council of Provinces in South Africa, despite many legitimate concerns over the Bill.
We want to see the right to health – including mental health – realised for all in South Africa. This is a fundamental human right. We need enabling legislation for UHC. However, there are other paths to realising quality UHC in South Africa besides the current NHI Bill.” – Shayni Geffen, Project Leader: Advocacy and Awareness at the South African Federation for Mental Health (SAFMH).
In addition to the extensive, well-documented concerns about the NHI Bill, SAFMH has mental health-specific concerns too. These include:
- The conditional grant budget line item for mental health needs to be revisited (pg. 58; 8.7). This amount is not congruent with the proposed recommendations from a Mental Health Investment Case Report[1] done in 2021 to sufficiently strengthen mental health services and integration. An adequate conditional grant for mental health is necessary to correct the injustices of the past regarding mental health service allocation and investing in scaling up mental health care in the country.
- There is no commitment to an explicit priority setting exercise for the NHI packages of care. Currently, the Bill states the Health Minister will ultimately determine health care benefits that will be reimbursed through the NHI Fund, as well as the service coverage. We advocate that the decisions related to the amounts and types of resources be made available, eligible populations, and specific rules for allocation are informed by an economic analysis to maximise value and achieve social goals.
- We are unsure what approach will be used to inform priority setting. We advocate that any priority setting should be informed by a needs-based approach rather than a current service use approach. Considerations around burden of disease, our human rights obligations and treatment gaps should drive the prioritisation of health services and associated budgets. These metrics alone provide good evidence for investing in mental health care.
While debates around the NHI will continue and perhaps even intensify in the lead-up to the 2024 elections, this should not stunt the immediate implementation of known, uncontroversial rights-based and evidence-based actions desperately needed to improve our health system performance. There are other paths to quality UHC besides the NHI.
We will continue to advocate for evidence-based, cost-effective mental health services, like those outlined in the Mental Health Policy Framework 2023 – 2028. These can be implemented TODAY to improve the mental wellbeing of all in South Africa.” Shayni Geffen.
For media enquiries, please contact:
Michel’le Donnelly – Project Leader: Advocacy & Awareness
CELL: +27 (0)79 799 6533
EMAIL: michel’le@safmh.org
