Health Minister Aaron Motsoaledi has unveiled the first set of draft regulations for the National Health Insurance (NHI) Act despite various objections and legal challenges pending.

This long-debated piece of legislation was signed into law by President Cyril Ramaphosa in May 2024. It aims to transform the healthcare landscape, although it has yet to be fully operationalised.

The newly published draft regulations specifically address section 55 of the NHI Act, outlining a proposed governance structure and the processes governing the pivotal NHI Fund.

This fund is set to serve as the sole purchaser of medical services on behalf of patients, with the ambitious goal of guaranteeing free access to healthcare services for all eligible individuals at the point of delivery.

The announcement has sparked a wave of discontent in the healthcare sector. The Board of Healthcare Funders (BHF) expressed disappointment over the Minister’s decision to proceed with the publication of the regulations when multiple court challenges are questioning the constitutionality of the NHI Act.

Managing Director BHF, Dr Katlego Mothudi said: "It is disappointing that, instead of working with the private healthcare sector to find sustainable ways to address the urgent healthcare needs of the country, the National Department of Health continues to forge ahead with the implementation of the unworkable, unaffordable and unconstitutional NHI Act."

Mothudi further added that the organisation intends to thoroughly review the regulations before submitting a detailed argument.

"In the meantime, we will continue to fight for progress towards achieving universal healthcare in South Africa through our NHI court action. All South Africans deserve access to quality healthcare, but the NHI as currently proposed will not achieve that."

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In tandem with BHF's response, the Hospital Association of South Africa (HASA), the country's largest hospital group, has also initiated a legal challenge against the NHI.

HASA's legal documents, filed in the North Gauteng High Court in Pretoria at the end of January, argue that the Act should be set aside due to concerns over its constitutionality and financial viability.

Central to HASA’s argument is that the NHI scheme contravenes Section 27 of the Constitution, which guarantees every South African the right to access healthcare services.

Furthermore, HASA contends that the government has not conducted a recent financial feasibility study on the implementation costs of the NHI, which raises serious concerns about the scheme’s affordability and potential funding shortfalls.

The association warned that continuing with the current plan could jeopardise the integrity of the healthcare system as a whole.

sinenhlanhla.masilela@iol.co.za

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