GOVERNMENT is marching ahead with the implementation of the National Health Insurance scheme and there "is no turning back" as this is "no joke" or "pipe dream" but a looming worldwide phenomenon.

This was emphasised by Minister of Health Aaron Motsoaledi in Pretoria yesterday when he announced the roll out of the R1billion NHI pilot project in ten districts in nine provinces next month.

The testing grounds for the project are:

• OR Tambo district in Eastern Cape;
• Gert Sibande in Mpumalanga;
• Vhembe in Limpopo;
• Pixley Ka Seme in Northern Cape;
• Umzinyathi and UMgungundlovu in KwaZulu-Natal;
• Eden in Western Cape;
• Dr Kenneth Kaunda in North West;
• Thabo Mofutsanyane in Free State,
• Tshwane in Gauteng.

With two districts chosen by the department as testing areas for the project - and, owing to the province's high population and high burden of diseases - KwaZulu-Natal has - on its own accord - added Amajuba district to the pilot project sites list.

Motsoaledi said KwaZulu-Natal was able to add another district because of its ability to manage finances very well. He said his department would assist the provinces where necessary to ensure successful implementation of the pilot project.

With public consultations on the green paper on NHI completed last December, the minister said the first phase of the pilot scheme to be rolled out over the next five years would entail the strengthening of health systems, improving service delivery platforms as well as policy and legislative reform.

"The focus of all these interventions is to ensure that South Africans have access to quality health services, experience the reduction in the burden of disease, particularly that borne by women and children," he said.

The key progress indicators to pave the way for the roll out of the pilot include 4500 of the 5000 nurses and community health care workers being placed in municipal wards, translating to ten nurses per municipal ward. All of them had been trained by November.

For the school-based primary healthcare services, database on school nurses had been established by September last year and benefitting schools had been identified by October.

Health infrastructure grants for public hospital infrastructure equipment as well as for the refurbishment and equipping of 122 nursing colleges - first 72 nursing colleges to be refurbished by the end of 2011-2012 financial year - established by November last year.

A total of 1967 infrastructure projects are currently at different stages of implementation and 49 nursing college infrastructure projects are currently under way.

To address staffing issues, the human resources strategy was finalised and launched by the end of October and a number of training faculties have already taken up the request to increase medical students intakes this year.

Motsoaledi said he would soon meet doctors in private practice to strike a deal with them to work at least four hours in local clinics and be paid by government to relieve doctors in state hospitals.

To bolster the implementation of the pilot scheme, the European Union has pledged R1,26billion for primary healthcare and, through its ambassador Nils Johnsons, the EU has commended the South African government for its intervention to strengthen health systems.