Acts Online
GT Shield

National Health Act, 2003 (Act No. 61 of 2003)


National Health Insurance Policy towards Universal Health Coverage

Chapter 7 : Financing of NHI

7.9 Governance of the NHI Fund


255. Appropriate governance mechanisms put into place for the NHI Fund, which will function as a Schedule 3A public entity. In this regard, the NHI Fund will be governed by the NHI Board that will exercise oversight over the entity. The NHI Board will report to the Minister of Health and will be accountable to Parliament. This will be an external oversight mechanism that will ensure that the NHI Fund is held accountable and that the interests of the general public are taken into account.


256. The NHI Board will not be a stakeholder representative body, but a Board with a specific mandate of ensuring that the NHIF is functional, effective and accountable. The composition of the NHI Board will be based on experts in relevant fields which may include: healthcare financing, health economics, public health, health policy and planning, monitoring and evaluation, epidemiology, statistics, health law, labour, actuarial sciences, taxation, social security, information technology and communication. The Board will also include civil society representatives. No one with a conflict of interest in the functions of the NHI Fund may be appointed to the NHI Board. As the NHI Fund will be tax funded, it is not appropriate to appoint members representing specific interest groups.76, k


257. The NHI Fund will report on at least a quarterly basis to the NHI Board and on an annual basis to Parliament. The Fund will also prepare and disseminate publicly an annual report, which will report on financial and non-financial performance, as audited by the Auditor General. Specific performance indicators will be developed against which the Fund will be routinely assessed. Through making information available and transparent, the NHI Fund will be held accountable by government as well as the general public.



k While some countries have established these Supervisory Boards or Committees with membership from government, employers and employees, it has been found that such a composition often does not serve the best interests of the population. In particular, having representation of specific interest groups has made these oversight committees “incapable of making hard choices or serving as an adequate and timely forum for decision making” (Savedoff and Gottret, 2008: 207). International experience indicates that “rather than by[securing] the interests of specific economic groups, representation is increasingly shaped by the desire to incorporate a wider range of social actors, increase transparency, and involve professionals with technical expertise” (Savedoff and Gottret, 2008: 206).