School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town.
S Afr Fam Pract (2004). 2023 Dec 15;65(1):e1-e8. doi: 10.4102/safp.v65i1.5768.
The participation of independent private general practitioners (GPs) is of fundamental importance to the successful implementation of key elements of the proposed National Health Insurance (NHI) reform, notably the contracting units for primary health care (CUPS). This study explored knowledge and perceptions of the NHI reforms of private GPs following the tabling of the NHI Bill in parliament in 2019.
An explorative qualitative research methodology was adopted. Using a semi-structured guide, nine solo private GPs, purposefully selected to represent the range of practices in the southern peninsula of Cape Town were interviewed in depth by B.L.P. over the period from January 2021 to March 2022.
The GPs indicated support for the values of greater equity outlined in the NHI proposals. However, they had little engagement on or knowledge of their potential future roles in NHI. Concerns over financial viability and design were underpinned by an overall mistrust in the public sector to implement and manage NHI.
The study concurs with previous research that private GPs are broadly in support of the principles of, and are potential allies, in advancing NHI. General practitioners need a platform to share their concerns and contribute as co-designers of NHI reforms. In the interim, steps to increase collaboration between private and public sectors at local and provincial level through, for example, referral processes may help to build the trust that is necessary between the sectors.Contribution: This study foregrounds the role of trust relationships in advancing NHI.
独立私人全科医生（GP）的参与对于成功实施拟议的国家健康保险（NHI）改革的关键要素至关重要，特别是初级保健承包单位（CUPS）。本研究探讨了在 2019 年议会提交 NHI 法案后，私人 GP 对 NHI 改革的知识和看法。
采用探索性定性研究方法。使用半结构化指南，B.L.P. 在 2021 年 1 月至 2022 年 3 月期间对来自开普敦半岛南部的 9 名独立私人 GP 进行了深入的个别访谈，这些 GP 是有目的地选择的，以代表各种实践范围。
GP 们表示支持 NHI 提案中概述的更大公平价值观。然而，他们对自己在 NHI 中的潜在未来角色参与度很低，也缺乏相关知识。对财务可行性和设计的担忧，是基于对公共部门实施和管理 NHI 的整体不信任。
本研究与之前的研究一致，即私人 GP 普遍支持 NHI 的原则，并且是推进 NHI 的潜在盟友。全科医生需要一个平台来分享他们的担忧，并作为 NHI 改革的共同设计者做出贡献。在此期间，通过例如转诊流程，增加私营和公共部门在地方和省级层面的合作的措施，可能有助于建立两个部门之间必要的信任关系。贡献：本研究突出了信任关系在推进 NHI 方面的作用。
