Although the study is based on a relatively big sample, it cannot be claimed that the sample is representative of the entire medical fraternity. The study has however identified three important factors that would play a role in the success of the NHI when it is implemented. The study also highlighted general perceptions of health workers on the envisaged benefits and shortcomings of the NHI. This is an important contribution against the background of a lack of research done in South Africa on the NHI. It is recommended that this study be replicated in the other provinces in South Africa, so that informed decisions and actions can be taken in the implementation of the NHI. It is further recommended that more rigorous statistical analyses be conducted in order to unearth information not highlighted in this study.
6.7 CONCLUSION
The purpose of this study was to make a contribution to the successful implementation of the proposed South African NHI by investigating critical success factors that would impact such implementation. The study identified the following factors that are critical for the successful implementation of the NHI in South Africa:
- the projected benefits for stakeholders and specifically medical aid funds; - projected benefits for the private sector servicing public hospitals and clinics;
and
The study also identified the following areas of concern to South Africa health workers with regard to the NHI. Healthcare workers appear uncomfortable with the lack of clarity on the NHI and strongly believe that the government is not effectively communicating the vision and mission of the NHI to all healthcare providers and key stakeholders. They believe that consultation with all relevant stakeholders about the merits and demerits of the NHI was inadequate. It is important to be cognisant that healthcare providers have no confidence in the management system and intensely perceive that South Africa lacks competent leaders in the public healthcare sector to address potential NHI challenges. Furthermore, they consider that the NHI is not financially sustainable to purchase health services for the entire population and that improvement and re-engineering of public hospitals is considered pertinent to NHI success. Healthcare workers believe that incentives in the form of claiming tax rebates would benefit healthcare providers in the private sector for rendering services in the public sector, and that the allocation of CPD points for rendering services in the public sector would be appropriate. A challenge to the proposed NHI success is whether the government could harness ethical leadership through effective governance. If the South African government enhances or improves in these areas/variables, the successful implementation (or, at least, acceptance) of the NHI will be significantly enhanced.
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