Western Cape challenges NHI Act in Constitutional Court over public participation flaws

Western Cape Government (WCG) has filed papers with the Constitutional Court to challenge the validity of the recently signed National Health Insurance (NHI) Act, arguing the legislation is unconstitutional.

The province stated this has not gone through the public participation process.

Western Cape Premier Alan Winde and Provincial Health and Wellness Minister Mireille Wenger announced the legal action on Wednesday, asserting that the National Council of Provinces (NCOP) failed to adequately consult the people of the Western Cape, thereby violating their right to be heard in the lawmaking process.

The papers were filed on Tuesday.

“The NHI is likely one of the most significant and controversial statutes in South African democratic history, yet it was rushed through Parliament with blatant disregard for meaningful public input,” said Minister Wenger.

“We bring this challenge on behalf of the people of the Western Cape, who stand to be directly impacted by its implementation.”

Premier Winde added: “This is not just about the Western Cape. This is about defending a fundamental pillar of our democracy — that Parliament must listen. Public participation cannot be a tick-box exercise.”

The NHI Act, signed into law by President Cyril Ramaphosa in May 2024, aims to create a single-payer, state-run healthcare system intended to deliver equitable health services to all South Africans.

However, critics — including economists, healthcare professionals, and opposition parties — have flagged serious concerns about funding models, governance, centralisation of power, and threats to both private healthcare and provincial autonomy.

The Western Cape, governed by the Democratic Alliance (DA), has consistently opposed the NHI Bill.

In its court filing, the province argued that the NCOP ignored key submissions from provincial consultations and failed to address substantive concerns raised by stakeholders, including civil society and medical professionals.

The DA’s court challenge is not isolated. It forms part of a broader strategy by the party to push back against several high-impact ANC-led legislative reforms.

These include the Basic Education Laws Amendment (BELA) Bill, which proposes centralised control over language and admissions policies in schools — a move the DA argues undermines parental choice and provincial oversight.

Similarly, the party has fiercely opposed the Land Expropriation Bill, which enables land to be taken without compensation under certain conditions. The DA claims this threatens property rights and investor confidence in an already strained economy.

The Constitutional Court must now determine whether the public participation process on the NHI was constitutionally compliant.

If the court finds in favour of the WCG, the ruling could halt or even reverse the implementation of the NHI — a blow to the ANC’s flagship health policy.

kamogelo.moichela@iol.co.za

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