ABSTRACT
Background. The launch of the National Health Insurance (NHI) White Paper in December 2015 heralded a new stage in South Africa's advancement towards universal health coverage. The 'contracting in' of private sector general practitioners (GPs); though only one component of the overall reformed system; is nevertheless crucial to address staff shortages and capacity; and also to realise the broader vision of a single unified; integrated system.Objective. To report on the views and experiences of GP providers tasked with implementing the reforms at one pilot site; Tshwane District in Gauteng Province; providing an insight into the practical challenges the NHI scheme faces in implementation.Methods. The study was qualitative in nature; using a combination of convenience and purposeful sampling to recruit participants. A thematic analysis of the data was conducted using Nvivo 10 software.Results. The overall experiences of the GPs exposed a number of problems with the pilot.These included frustration with lack of appropriate infrastructure and equipment in NHI facilities; difficulties integrating into the facilities and lack of professional autonomy; as well as unhappiness with contracting arrangements. Despite strong support for the idea of NHI; there was general scepticism that private doctors would embrace the scheme on the scale required.Conclusion. The study suggests that the current pilots are still a long way from the vision of a single; integrated health system. While it may be argued that the pilots are not themselves the completed NHI; the findings suggest that it will take much longer to establish than the timeline envisaged by government