Luvindao defends govt directive on public hospital use

Health minister Esperance Luvindao says billions of dollars in state funding continue to flow into private healthcare, where a small segment of the population receives top-quality treatment, while the overwhelming majority of Namibians depend on public hospitals that have long struggled with infrastructure and capacity constraints.

“For too long, we have accepted a two-tier system where services deemed insufficient for senior officials were deemed acceptable for the ordinary Namibian," Luvindao said in parliament.

“If public hospitals are not good enough for politicians, we must accept the indictment that they are not good enough for anyone,” Luvindao told MPs.

Speaking in the National Assembly this week, the minister provided an update on Vision April 2026.

She said the first phase, due to start in April, will target Windhoek Central Hospital, Katutura Intermediate Hospital, Rundu Intermediate Hospital, Keetmanshoop District Hospital, Oshakati Intermediate Hospital, the Walvis Bay–Swakopmund Hospital Complex and Onandjokwe Intermediate Hospital.

The health minister said government is the largest employer, with about 118 936 public servants covered under the Public Service Medical Aid Scheme (Psemas), and that approximately N$3.9 billion has been allocated to private medical practice.

She said more than 85% of the population, about 2.57 million people, rely exclusively on public health services funded through a N$12.27 billion allocation to the health ministry.

Vision April 2026, issued shortly after President Netumbo Nandi-Ndaitwah assumed office, requires political office bearers and senior public servants to seek healthcare at selected public facilities from 1 April 2026.

Luvindao described the directive as “a clarion call for equity” and a “good shot in the arm” needed to radically transform the public health system by closing the gap between decision-makers and the services they administer.

'Aggressive' overhaul

Luvindao said Vision April 2026 forms part of what she described as the most aggressive health-system strengthening programme since independence.

She said a nationwide readiness assessment completed in September 2025 informed a targeted investment strategy built on four pillars: human resources, medicines, equipment and infrastructure.

More than 2 000 additional health worker posts were funded during the 2025/26 mid-year budget review, with 66% already filled by mid-January and the remaining vacancies expected to be filled by March.

The ministry has shifted to direct procurement from manufacturers to stabilise medicine supply chains, aiming to achieve 95% stock availability.

Luvindao emphasised that Vision April 2026 will not be implemented as a rushed “big bang”.

Phase I, beginning on 1 April 2026, will apply only to political office bearers and senior public servants, including executive directors and heads of security services.

Services will initially be limited to seven public facilities assessed as ready, including Windhoek Central Hospital, Katutura Intermediate Hospital, Oshakati Intermediate Hospital and Onandjokwe Intermediate Hospital.

She said referral mechanisms to private providers would remain in place where specialised services are not yet available in the public sector.

“No one will be denied necessary care,” Luvindao said. “We are building capacity, but we are pragmatic.”

Accountability through use

Luvindao framed Vision April 2026 as a dignity-driven reform aimed at ensuring that the quality of care received by ordinary Namibians matches that available to the country’s leadership.

“This is about fixing the system by using it,” she stressed.

The minister said recruitment drives, equipment deliveries and improvements in the availability of medicine show tangible progress, insisting the policy is intended to expose weaknesses, force accountability and accelerate reform rather than punish patients.

Vision April 2026, Luvindao said, remains central to Namibia’s broader push toward universal health coverage and a system where access to care is determined by need rather than income or status.

Constitutional rights

Several lawmakers questioned whether civil servants would be compelled to abandon private healthcare altogether.

“When you say they are going to use these public facilities, it either means two things. You are either compelling them, or you are encouraging them,” AR leader Job Amupanda said.

Amupanda warned that forcing patients to bypass nearby private hospitals in emergencies would be impractical and legally vulnerable.

“Legally, you will not pass it. It will be challenged legally,” he said, adding that compelling patients could infringe constitutional rights.

“If anything is done to compel me to go to the public hospital… Article 13 is very clear… Is it supposed to take me to forego my fundamental human rights?”

Opposition leader McHenry Venaani questioned whether public facilities could adequately protect patient information.

“The minute that the president goes to the hospital, we will know all her diseases. So how do we ensure privacy that is lacking in our public institutions?” he asked.

One MP recounted how an ambulance arrived without proper equipment, leading to his brother's death after a snakebite.

Another MP said: “We love the dream. What we just don’t appreciate is announcements. Fix the roofs, fix the tiles… fix it. And we will then be able to go to the hospital and say, yes, it is now well.”