Government’s ambitious National Health Insurance (NHI) scheme is bound to succeed and deal a blow to South Africa’s “racialised, two-tier health system sustained on the basis of uneven distribution of resources”, President Cyril Ramaphosa said on Friday.

Ramaphosa was speaking in Pretoria at a high-level NHI consultative meeting with representatives of various stakeholders in the country’s health care system.

“The NHI can and will be a success. We are a country that is spending R420-billion or 8.5% of domestic funding on health care. This is more than any other middle-income country, and it is very close to advanced economies such as the United Kingdom and Canada. We have decided to cover the whole country on an incremental basis,” Ramaphosa told the summit, attended by Health Minister Aaron Motsoaledi, Acting Gauteng Premier Panyaza Lesufi and several other dignitaries.

“This means from 2019, once the bill is passed, we will start to incrementally implement the NHI and by 2025 everyone will be covered. We are determined to work together to overcome our two-tiered health system, which is the major barrier to achieve a universal health system.”

Ramaphosa told health professionals in South Africa that the success of the ambitious plan, and the quality of service, lie in their hands.

“I wish to conclude by urging all our health professionals and general workers in the health sector to understand that the provision of quality health care – and thus the success of the NHI – is literally in their hands. I urge all of us gathered here to do our best to encourage South Africans to adopt more healthy lifestyles and avoid placing themselves at risk of contracting diseases,” he said.

Earlier this week, trade union Solidarity said its research has found that health practitioners in South Africa are very sceptical about government’s proposed NHI plan, with many considering migrating to other countries if the project is implemented.

The results of the research project by the Solidarity Research Institute "which determined the opinions and feelings of medical practitioners regarding the NHI”, were presented in Pretoria at the Solidarity Occupational Guild for Health Care Practitioner’s "crisis summit" on the proposed NHI.

Government insists the NHI  represents a substantial policy shift that will restructure healthcare and secure universal health coverage for all South Africans.

The NHI is described as “a financing system that will make sure that all citizens of South Africa, and legal long-term residents, are provided with access to comprehensive healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund".

The summit of Friday was part of the stakeholder engagement process on the transformation of the healthcare sector. Ramaphosa also had closed-door engagements with various players in the health sector, particularly community leaders, health professionals, nongovernmental organisations, trade unions and community organisations.