UFH Psychology Department presents response on NHI Bill to Parliamentary Portfolio Committee

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In 2012 government launched the National Health Insurance (NHI) Bill and invited public comments. In 2019, the University of Fort Hare’s Department of Psychology filed a submission that highlighted issues of mental health. 

On Wednesday, 2 June Psychology lecturer, Lucille Hendricks presented the submission before the parliamentary Portfolio Committee on Health in the National Assembly. 
The UFH Submission in a nutshell: by Lucille Hendricks: The NHI Bill promotes universal health coverage for all South African citizens as essential However, there are concerns regarding the bill in its current form which require urgent change in order to make high-quality universal health coverage a reality.
Issues regarding access to healthcare affect every citizen in the republic. Specific concerns regarding the fund that the bill proposes establishing and the implications for access to mental healthcare, in particular, was highlighted in our departmental submission as not having received enough attention in the bill’s benefits. 
As a department focusing on Counselling Psychology with a strong community psychology ethos, we train students to work within communities where contextual issues are the focus and where psychological understanding and community context is given preference. 
We further aim to redress the inequalities of the past by servicing vulnerable groups who historically would not have had access to psychological services, with our focus primarily on preventative strategies. Prior to the Covid-19 pandemic, hospitals and clinics were dealing with overwhelming numbers of trauma and illness cases, many of which could have been prevented and dealt with at an early stage through preventative psychosocial interventions. 
During the pandemic these numbers have increased exponentially, highlighting the need and desire for community-based mental health services. Mental health professionals should be available and accessible by all citizens as specialist services to which physicians and other primary healthcare providers can refer. This accessibility to these specialists is, however, not expressly addressed in the NHI Benefits.
It is our opinion that general mental health should be more effectively integrated into the NHI Bill and that assurance to equitable access to health services for all people be prioritized. We recommend that mental health experts such as Counselling Psychologists be appointed in the advisory structures of the NHI such as the Benefits Advisory Committee and Health Diagnostic related groups.
Furthermore, we recommend that the area of preventative work receives appropriate funding and support within the fund benefits (the ramifications of these psychological stressors and events have a negative impact on families, communities and greater society). 
In our submission, we also indicated that we could not support any limitations on population coverage as proposed in the Bill, as it violates human rights to basic health care. Universal health care should be available to all who in need, regardless of their status within the country. 
We note that there are no national mental health programs developed and implemented in our local contexts, as appose to the other priority health programmes such as HIV, and TB dots, for example, and this requires immediate attention. Furthermore, Mental Health needs to be explicitly mentioned in the Bill as there is a tendency to focus primarily on physical health resulting in the disregard of mental wellbeing in the development of healthcare plans. 
In a society where trauma, suicide, violence, depression, sexual abuse, substance abuse, unemployed and poverty has become a norm, it is imperative that one recognizes the value and contribution of preventative psychosocial and psychological work. 
The NHI Bill needs to appropriately budget for mental health services under primary health care. Historically, when budget cuts are introduced, mental health programs are the first to be considered, indicating the lack of investment in mental wellbeing for South African citizens and this needs to change and be addressed in the Bill. As a department, and as mental health professionals, we fully support the overall purpose of the Bill to “achieve sustainable and affordable universal access to quality health care services” (S2). Report submitted and presented on behalf of the Department of Psychology Staff (2021) 
To view the presentation: https://www.youtube.com/ watch?v=UonzI6iSwoI