The National Health Insurance (NHI), for which membership will be compulsory, is a funding scheme that aims to address healthcare inequity in South Africa. The scheme will do this by creating a fund that the government will use to buy healthcare services at set fees from accredited public and private health providers. The NHI Bill was passed in the National Assembly in June 2023. It has to go to the National Council of Provinces for approval.
Health professionals at government hospitals are allowed to apply to do extra work in the private sector so long as it doesn’t interfere with their public sector work. Internationally this is referred to as ‘dual practice’.
Some health workers abuse this system by doing both jobs at the same time, allowing them to double up on paychecks. The result is that doctors who are paid by taxpayers to work in government hospitals full-time spend large amounts of the working day treating private sector patients instead.
The problem is particularly widespread among specialist doctors, who are some of the most well paid and crucial members of the government healthcare system.