The Democratic Nursing Organisation of South Africa has highlighted some key points in its submission to the White Paper on NHI. DENOSA’s full submission can be found by clicking here.
 
The need to employ more health professionals at Community Health Centres (CHCs), reopening of previously closed nursing colleges, and inclusion of Essential Equipment list for facilities as well as the need for the Office of Health Standards Compliance (OHSC) to work with provincial national core standard teams to ensure compliance of health facilities with the set targets are some of the areas that DENOSA highlighted in its submission.  
 
DENOSA remains steadfast in its position that National Health Insurance is a game-changer in the country’s health, and that it must be supported by all those who wish for equal access to quality healthcare for all South Africans, regardless of their socio-economic status. Our proposals is the inclusion all other services as part of mobile services and secured and well-capacitated 24 hour services especially dispensing of medication and pathology.
 
Our on-going concern, especially at primary healthcare level like in the country’s CHCs, is that the shortage of health professionals like nurses needs to be addressed through a quick turn-around plan so that, as first entry points for patients, they are more efficient and responsive to the needs of patients. DENOSA recommends strongly that nurses who will be leading the Primary Health Care Re-engineering teams should be supported extensively within the relevant prescripts of the law. These allocations to the municipality ward based teams should be done without compromising their conditions of service, safety and scope of practice.
 
On the urgent need to employ nurses in facilities, DENOSA is concerned that provinces such as Free State have not been able employ community service nurses despite this plan to improve the country’s healthcare. As a result, nurses are sitting at home doing nothing when they are greatly needed whereas CHCs suffer severe shortages and overcrowding.
 
The urgent need to employ nurses is also equal to the need to review Occupation Specific Dispensation (OSD) so that nurses are paid according to experience and specialty, and that this mechanism will retain more nurses within the NHI-funded universally accessible health system. Most nurses are leaving the profession for either overseas or other areas besides practicing nursing, because OSD was not reviewed in its fifth year in 2012 as it was agreed. 
 
Among our inputs to the White Paper, we propose that full-time positions represented by PHC nurses and managers be made available as part of the teams establishing NHI work streams.  
 
On the management of foreign nationals like asylum seekers, refugees and illegal immigrants, DENOSA need more clarity on the responsibility of a nurse when an illegal immigrant arrives in need of health service but is not registered, and we proposed that health centres be opened at the points of care to provide to non-registered illegal immigrants and then be linked to relevant officials thereafter, without exposing nurses to unnecessary threats and conflicts with WHO decree that every person has a right to life and healthcare.    
 
As part of trying to change the country’s healthcare system from a curative one to a more preventative one through NHI, DENOSA also proposes that wellness centres and programmes be expanded to included tax rebates and discount on food items as a way to promote healthy living among South Africans.