South Africa will increase spending on its National Health Insurance programme at an average annual rate of 36.6 percent, from R1.2-billion in 2018/19 to R3-billion in 2021/22, the National Treasury said on Wednesday.

In its 2019 budget review, the Treasury said the allocations for national health insurance would be continually reviewed in tandem with policy and legislative developments, and expenditure trends.

The NHI is a health financing system designed to pool funds to provide access to quality affordable personal health services for all South Africans irrespective of their socio-economic status.

It is being implemented in phases over a 14-year period that started in 2012 and will be established through the creation of a single fund that will buy services on behalf of the entire population.

The Treasury noted that many public health facilities in the county were in a dire state, in need of maintenance, refurbishment and, in some cases, replacement.

It said the health department’s 10-year infrastructure plan had identified geographic areas where new facilities were needed, and therefore accordingly planned to invest R23.5-billion over the medium term expenditure framework (MTEF) in health infrastructure.

The health facility revitalisation grant, transferred to provincial departments of health, was allocated R19.2-billion over the MTEF to fund an estimated 1,500 infrastructure projects, including new facilities, upgrades, refurbishments and maintenance.

The Treasury said allocations to hire more health professionals had been increased by a further R1.6-billion over the MTEF. Funds would now be transferred to provinces through a new human resource capacitation grant, rather than the national department contracting these professionals.

It noted that the number and value of claims lodged against provincial departments of health in recent years had risen disproportionately, from R28.6-billion in March 2015 to R80.4-billion in March 2018, putting enormous pressure on provincial health budgets.

Medico-legal claims had risen because of inadequate quality of care, weaknesses in administration including patient record management and legal capacity and increasingly litigious behaviour from law firms.

To address the apparent rise in unjustified or excessive claims, government would implement new measures including prioritising improvements in areas where claims of negligence were prevalent and referring possible fraudulent cases to the Special Investigations Unit.