NPPF Healthcare Sector Update – September 2025
Dear Colleagues
Please be updated on some of the recent developments in the sector with specific reference to the cost study and where it fits into the bigger scheme of things:
1.Cost Study: Nearly there
It remains imperative to establish an ethical tariff that reflects the true cost of running a practice in Namibia. This tariff must be embedded within a new statutory framework (see attached draft concept for its proposed structure of the Medical Control Board).
The recent extension brought us very close to the required statistical threshold but not yet where we must be. On HealthMan’s recommendation, a further extension is now underway to ensure we reach the critical threshold necessary for a valid and representative study.
At this stage, HealthMan still urgently requires TEN (10) participants from EACH of the following groups:
• General Practitioners
• Specialists (except Ophthalmologists, Radiologists and Pathologists)
• Audiologists/Speech Therapists,
• Physiotherapists,
• Occupational Therapist,
• Clinical Psychologists,
• Radiographers.
IMPORTANT: Practitioners who are unable to complete the survey forms are encouraged instead to submit their financial statements already provided to NAMRA for 2023/2024 or 2024/2025. These may be emailed directly to HealthMan at surveys@healthman.co.za
2. NAMAF Engagement: Conditionality Reaffirmed
While NAMAF initially indicated willingness to participate in the cost study and to support the establishment of a Medical Control Board, they have since revised their position and reverted back to a voluntary engagement framework (see point 4 in attached document).
While NAMAF’s outreach is appreciated and the principles supported - NPPF has formally confirmed that precondition for further cooperation is the fee reimbursement for practice number registrations and the creation of a statutory medical control board. Past experiences showed that NAMAF’s “voluntary engagement” are fund centred and result in mere dictates to practitioners.
3.ICD 10 / NAPPI Code Enforcement: Legal Clarification
The NPPF has noted NAMAF’s recent circulars regarding ICD 10 and NAPPI coding. It is important to clarify that, under the current legislative framework, NAMAF does not have statutory authority to compel practitioners to apply these coding systems. While such tools may be useful for claims processing, their compulsory use can only be established through formal regulation by the Ministry of Health and Social Services or another competent statutory body.
Because ICD 10 coding inherently involves disclosure of diagnostic information, patient confidentiality safeguards must be grounded in statute. Until such a framework is enacted, NAMAF’s circulars should be regarded as advisory rather than binding. The NPPF will continue to uphold the principle that any requirements affecting clinical practice and patient data must rest on a clear statutory mandate.
4.NAMFISA Complaints: Regulatory Oversight in Question
Despite efforts to maintain cordial relations with medical funds, several issues remain unresolved. Formal complaints regarding RMA and NAMMED persistence on maintaining untenable positions have therefore been submitted to NAMFISA, with the aim of securing regulatory intervention and resolution. These complaints reflect ongoing concern over fund practices outside the statutory framework and their impact on practitioner sustainability.
5.Ministry of Finance: Disputes Over Oversight Authority
Disagreements persist between the NPPF and NAMFISA regarding the latter’s role in endorsing NAMAF’s ultra vires actions—particularly NAMAF’s assumption of a clinical governance role without statutory mandate. These actions have direct implications for practitioners and raise serious questions about regulatory boundaries and accountability.
The NPPF has submitted an appeal to the Ministry of Finance already in February 2025 concerning NAMFISA’s endorsement of NAMAF’s practices, while allegedly blocking alternative funding options and obstructing the development of a proper regulatory framework.
There was also a request for an update from the Honourable Minister on alleged fraud within the PSEMAS administrative system.
6.Health Care Advocacy Group: Building Statutory Balance
The private healthcare sector continues to operate within a judicial vacuum—one that NAMAF has filled with a narrow emphasis on affordability at the expense of clinical integrity. To correct this imbalance, broader sector involvement is essential.
Although the NPPF currently accommodates only individual membership, it has previously been approached by associations seeking to join its advocacy for healthcare reform. At present, strategic synergies are being explored with the Namibian Association of Private Health Facilities (NAPH) to establish a Memorandum of Understanding (MOU) aimed at advancing sector reform and ensuring the sustainability of private healthcare.
The Psychiatric Association of Namibia and the Namibian Society of Physiotherapy already maintain close ties with the NPPF and actively support the envisaged reforms through their contributions. Their engagement is highly valuable and significantly shapes ongoing sector efforts.
An open invitation is extended to other professional associations wishing to join this collective advocacy and strengthen the call for statutory reforms to safeguard the future of private healthcare.
7. Appreciation
We extend our sincere thanks to all practitioners and associations for their unwavering support and meaningful contributions in addressing the challenges of the private healthcare funding system. Your active participation in the cost study strengthens not only this process but the sustainability of the entire sector.
Kind regards
NPPF TEAM
Dr Jürgen Hoffmann
CEO: NAMIBIA PRIVATE PRACTITIONERS FORUM
Cell: 081 1242884
Email: nppfmanagement@gmail.com
