Black Sash Media Statements

Sash welcomes Green Paper on NHI - BLACK SASH, 11 August 2011

For immediate release: Thursday, 11 August 2011

The Black Sash welcomes the clarity provided today by the Health Minister and his department on the long awaited draft policy for National Health Insurance. We broadly welcome the intention to improve the quality of our public healthcare service and we commend the government on tabling what we believe is potentially one of the most significant social policies since the roll out of social grants.

Healthcare is a fundamental human right but our very high infant and maternal mortality statistics indicate that we have serious challenges that need urgent attention. At the same time, we acknowledge the complexity of the project that is being proposed and the enormity of the expenditure involved. For this reason, we welcome the substantial 3-month period set aside by Minister Aaron Motsoaledi for “intense public consultation”. We also commend him for his commitment to careful piloting and a 15 year implementation plan that is not limited by politically-driven short-term imperatives nor by medium-term fiscal constraints.

The Black Sash has heard countless heartbreaking testimonies of families that have been stripped of their income by simply trying to get care for their sick loved ones. In the context of our unacceptable poverty and inequality, it is imperative that we confront the harsh reality of our unequal healthcare system. Currently, 44% of all money spent on healthcare in South Africa is spent in the private sector by 16% of the population, many of whom are struggling to afford the escalating costs of private care. This leaves the vast majority of South Africans (84%) making do within the public sector on 43% of the total money spent on health. The balance of 13% is spent by mainly poor citizens without medical aids on supplementary private care. The new system has to create a more just division of resources. We are, however, encouraged that the proposals do not appear to be designed to set up a wall between private and public healthcare providers but rather to draw on a range of resources to more equitably meet the healthcare needs of all South Africans.  

We agree with government that in order for the NHI to succeed, there needs to be a dramatic improvement in the quality of service in public hospitals. This was made abundantly clear during the nine provincial healthcare consultations conducted by the Black Sash over the past 18 months. Most of the 460 leaders from CBO’s, NGO’s, human rights and health organisations that we spoke to also insisted that health facilities needed to be accountable and proposed better monitoring systems, including by the community itself.   

The Black Sash is encouraged that the community leaders we consulted support the fundamental commitment that healthcare should be available to all; and that access to care should not be dependent on a patient's ability to pay. We look forward to studying the proposed financial mechanisms to achieve this. At its best, the NHI will follow in the tradition of other redistributive social security schemes that make inroads against inequality and poverty in South Africa. 

Read the full National Synthesis Report on the Black Sash Provincial Health Consultations and the individual Provincial Reports. And find out more about our Community Monitoring and Advocacy Project or CMAP.

For interview requests, please contact:

Elroy Paulus

Black Sash Advocacy Programme Manager

Cell: 072-382 8175

Email: This email address is being protected from spambots. You need JavaScript enabled to view it. 


Nkosikhulule Nyembezi

Black Sash Advocacy Programme Manager

Cell: 082-429 4719

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.