Government ready for NHI legal showdown

 ·16 May 2024

Various business and medical groups, trade unions, civil rights organisations and political parties have reacted to the signing of the controversial National Health Insurance (NHI) Bill with warnings of legal action if the decision is not reversed.

However, Health Minister Joe Phaahla said that he expected opposition from groups with “vested interests” and government is ready to meet them in court.


Some of the organisations which have threatened litigation against the NHI include Business Unity South Africa (BUSA), the Democratic Alliance (DA), trade union Solidarity, civil rights group Afriforum, and business interest group Sakeliga.

Opponents argue that the NHI would damage the country’s healthcare system, hurt taxpayers, undermine investment confidence, and result in a mass exodus of doctors.

Shortly after President Cyril Ramaphosa signed the NHI in a public ceremony at the union buildings on 15 May, Solidarity was the first to show its hand.

“Solidarity’s legal battle against the destructive National Health Insurance Bill (NHI) began within the first hour after Pres. Cyril Ramaphosa signed the bill [and] as a first step, the government has been formally cautioned not to implement the NHI,” said the group in a statement.

Both the DA and BUSA have also said that they are exploring legal avenues.

“The NHI will not address the underlying issues in our healthcare system; it is financially unfeasible, an election gimmick, and will burden South Africans with increased taxes,” said DA MP Siviwe Gwarube.

“The potential for corruption is staggering, and the flawed parliamentary process further erodes public trust [ and] the DA will pursue all legal avenues to challenge the NHI and ensure that the rights of all South Africans are upheld,” Gwarube added.

BUSA CEO Cas Coovadia said that “our subsequent actions will be guided by our belief that it is essential that we get the NHI right through all means still at our disposal, including appropriate legal interventions,” as the group believes that “the legislation, in its current form, is unimplementable and damaging to the country’s healthcare sector, to the economy more broadly and to investor confidence.”

Business interest group Sakeliga published a statement following the bill’s signing, urging businesses and the public “to resist this attempted nationalisation of healthcare services and medical practitioners wherever possible.”

“We encourage support for organisations committed to challenging the NHI Act in various ways, including through litigation,” added CEO Piet le Roux.

‘Bring it on’ – Phaahla

In response to questions about the impending legal battles that the NHI faces, Phaahla said that he expected opposition due to “vested interests” and because the bill would force people out of “their comfort zones.”

“People are used to their comfort zones or doing things a certain way, but there are also vested interests,” said Phaahla.

“Some of the organisations, if you trace back historically, you will find that they benefited, not only in terms of the lack of radical transformation in the sector since democracy, but they benefited since before the [new] dispensation and have the comfort of benefiting even more in democratic South Africa.”

“So, anything that threatens that comfort is going to be a challenge to some of these organisations. We accept that. We are in a democratic country, the courts are part and parcel of a democratic country. We are talking about serious vested interests. We must be ready to go and present our case,” added the health minister.

Read: Ramaphosa shrugs off NHI critics – and that’s one of the biggest legal problems he faces

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