Parties prepare papers for court as Ramaphosa signs NHI bill into law

Medical aid schemes and businesses say they'll also go to war against 'flawed act'

President Cyril Ramaphosa gestures after signing into law the NHI bill.
President Cyril Ramaphosa gestures after signing into law the NHI bill.
Image: Siphiwe Sibeko/Reuters

Now that the controversial National Health Insurance bill has been enacted, political parties and other interested bodies are preparing to challenge its implementation all the way to the Constitutional Court.

This is what the DA and Mmusi Maimane's Bosa made clear just minutes after the NHI bill was signed into law by President Cyril Ramaphosa on Wednesday.

Ramaphosa, after years of delays, finally signed the bill into law, paving the way for the creation of a government-controlled NHI fund, to roll out what it says will be equal health care to rich and the poor in both public and private healthcare facilities.

Medical aid schemes and businesses have also stated their intentions to mount legal challenges against the “flawed act”.

But NHI has been welcomed by several labour unions.

At a briefing on the lawns of the Union Buildings, DA chief whip Siviwe Gwarube said the scheme was “nothing more than a political tool” and an attempt by the governing party to “put a Band-Aid over a gushing wound”. 

She said while the DA was a proponent of universal health care, there was “deliberate misinformation” on how NHI would work.

“There has been deliberate misinformation about what this bill seeks to do and what it will be able to do. In its current form, it will not be able to bring about quality health care for all South Africans.

“It is a lie that has been peddled, and it is simply not true. As the bill stands, all that it will be able to do is pool funds of about R300bn a year to be able to set up the NHI fund, but it's not going to deal with the systemic issues in the healthcare system. The system needs significant investment, which has not been done in 30 years and it needs to be capacitated. Vacancies need to filled, and none of these things have been done.”

Speaking on the party's constitutional concerns, Gwarube said the centralisation of the pool of funds, under the control of a minister, would open the fund to “significant corruption” as well as looting, as was the case with the Digital Vibes saga during the Covid epidemic, which forced former health minister Dr Zweli Mkhize to resign.

On the party's next steps, she said the DA had briefed its legal team and was compiling court papers.

“We knew that despite the inputs that were made by academics and industry experts, the ANC would ram the bill through parliament. And so, as has become customary, it's now up to us to effectively approach the courts and say 'this bill will in effect be the one thing that will stop people from getting quality health care’.”

Build One SA is also considering legal action “to stop the creation of a new ANC looting fund”.

Bosa maintains that the NHI has little to do with health services and much more to do with creating a new looting fund for ANC cadres

The party said while it recognised the challenges with the current healthcare system, the standard of public health care infringed on the dignity of a majority of the country's population. 

It said R250bn a year should be enough to fund quality health care for each and every South African, “but due to corruption, mismanagement and nepotism, much of this budget is wasted and as a result, millions of poor South Africans suffer”.

“Instead of fixing the well-funded public health system, the ANC has sought out an unaffordable scapegoat for its failures in health care. Even if it were a good idea, the fact is we cannot afford the NHI. The most affordable version of the NHI is estimated at R500bn a year.”

The movement proposed a range of alternatives to tackle the challenges, including sufficiently equipping hospitals, filling vacancies and holding medical aid schemes accountable for “abusive practices and extortionate funding models”.

“Bosa maintains that the NHI has little to do with health services and much more to do with creating a new looting fund for ANC cadres. The theft during the Covid-19 pandemic — ranging from PPE funds to 'Digital Vibes' — showed South Africans that there are no limits to how far the ANC will stoop to steal public funds from citizens.

“We cannot allow this new law to go unchallenged. Bosa is today conferring with lawyers to consider legal action to stop the NHI in its tracks,” the party said.