Senior officials to use state hospitals from 2026 – Ngurare backs presidential directive

Prime minister Elijah Ngurare says the government will be implementing a presidential directive that will urge all senior government officials to use state healthcare facilities.

The Namibian Broadcasting Corporation (NBC) yesterday reported that president Netumbo Nandi-Ndaitwah has issued a directive to all senior state employees under the Public Service Medical Aid Scheme (Psemas) to use public healthcare facilities from April 2026.

Although the details of the plan are sketchy, Ngurare yesterday said the government is planning to upgrade public healthcare facilities to a standard at which the president could confidently use it.

He said civil servants currently invest billions of dollars in the private healthcare sector.

The government has one year to assess the feasibility of the transition from private to public healthcare, which is expected to cost N$16 million, the prime minister said.

Ngurare said the transition will create 31 000 jobs in the public healthcare sector.

“Her excellency rightly assessed the health system in the country and what the government spends on it.

“The question is whether what we’ve been investing has truly resulted in improvement.”

THE COST

Executive director of health and social services Ben Nangombe says the government has spent N$3 billion on over 200 000 civil servants in the private sector through the state-funded Psemas.

“We know Psemas is allocated an amount of more than N$3 billion, and you have the budget for the minister of health, which was N$12 million,” he says. Nangombe says the government is making significant strides in improving public healthcare and reducing dependency on private sector referrals at all 34 district hospitals countrywide.

“The state spends over N$100 million annually referring patients to private facilities for dialysis.

“In response, several public hospitals have been equipped with dialysis machines to provide in-house treatment,” he says.

Nangombe says key developments are the expansion of intensive care units (ICUs), dialysis centres, and the enhancement of neonatal care at all hospitals.

Before the Covid-19 pandemic, Namibia had only 20 ICU beds available in the public healthcare sector, but now has 200 beds.

“We have taken a policy decision, which is already being implemented, to ensure every district hospital is equipped with ICU facilities,” Nangombe says.

The additions aim to provide affordable treatment to patients across the country and reduce the cost of long-distance travel for private healthcare. Nangombe says the expansion of available services will include open heart and brain surgery, and will also lead to the creation of over 31 000 jobs in the healthcare industry.

“Approval was recently granted for the ministry to create an additional 11 134 positions on top of the existing 20 000 healthcare workers,” he says.

Additionally, 1 400 new positions have been created to support mission hospitals that receive subsidies from the health ministry.

“In 2023, we submitted a cost plan to strengthen Namibia’s health system at N$16 billion. That is what we are currently busy implementing, with a strong focus on infrastructure development of the district hospital in Windhoek,” Nangombe says. He says the question should not be whether the presidential directive would work, but rather how to ensure civil servants use public healthcare services.

“With ongoing improvement, these facilities will be more than capable of serving all Namibians, including senior government officials,” he says.

‘PSEMAS WILL CONTINUE’

Ministry of Finance and Social Grants Management spokesperson Wilson Shikoto yesterday said there are no conflicting directives with regards to Psemas.

“Therefore, there are currently no planned changes to Psemas – the medical aid scheme will continue,” he said.

The move has been welcomed by Landless People’s Movement (LPM) national youth league leader Duminga Ndala.

“It is commendable that civil servants have been given such directives, as it provides them with an opportunity to experience first-hand the challenges of the broken healthcare system that citizens have long been subjected to,” she says.

Ndala believes such an approach could serve as a catalyst for the swift improvement of healthcare in the country, as it would help the government realise the urgency of transforming the state healthcare system. She, however, cautions that such a directive cannot be made mandatory, as individuals have the right to choose the healthcare system they deem most suitable for their needs.

Ndala says the president and minister of health and social services Esperance Luvindao need to advocate the transformation of public healthcare by upgrading hospitals and clinics to world-class standards, addressing the doctor-patient ratio in clinics and hospitals, and ensuring hospitals are capacitated with the necessary resources to treat people.

‘IT’S ONLY FAIR’

The presidential directive was announced by Luvindao at the closing of an annual five-day strategic plan review and performance agreement workshop at Otjiwarongo last week.

The new health minister was quoted by NBC saying: “Very interesting. When I first heard her [the president] say this, I thought she might be joking. But then it was repeated, and I realised she was serious.

“By April 2026, senior government officials, myself included, will need to use state facilities for our healthcare. At first, I expected significant pushback, but then I thought, why? If we are doing our best, we should be open to using the same services as the public. It’s only fair.”

She said when implemented, this move will align with the ministry’s service charter, mission, and goals.

Swanu of Namibia president Evilastus Kaaronda says if the principle is to encourage civil servants to use state hospitals it is a great move.

However, he warns that any forced directive should not be allowed in a democratic country like Namibia.

“No one should impose any directives on anyone. But if it is a way of encouragement to revive the lost confidence from the public in regards to hospitals, it is a very good thing. But we must beef up capacity first,” he says.

He cautions that in the current state, the health sector lacks capacity to handle high volumes, citing that it could result in risking people’s health.

It would be irresponsible for the president to give such a directive without capacitating the health sector first, Kaaronda says.