Business lobby group Sakeliga has pushed back against health minister Aaron Motsoaledi’s attempt to pause the constitutional challenges to the National Health Insurance (NHI) Act with a new, two-pronged legal attack of its own.
The controversial NHI Act, signed into law by President Cyril Ramaphosa in May 2024, aims to breathe life into the ANC’s vision for universal health coverage, in which a central NHI fund will purchase services for all eligible patients.
It seeks to reform SA’s deeply unequal health system, in which most of the population relies on public healthcare services of uneven quality while wealthier medical scheme members can obtain generally better-quality care in the private sector.
The NHI Act faces eight separate legal challenges from organisations representing doctors, medical schemes, private hospitals, trade union Solidarity, Sakeliga and the Western Cape government.
In August the minister asked the court to consolidate all the cases that had by that stage been launched in the high court and suspend all challenges to the constitutional validity of the legislation until the legal attacks on the president’s decision to sign the act had been resolved. The minister argued that consolidating the cases would be more efficient and save money.
The president’s assent to the legislation has been challenged by the Board of Healthcare Funders, which represents medical schemes, and the SA Private Practitioners Forum, representing specialists.
Sakeliga launched legal action against the NHI Act in August, shortly before the minister filed his stay and consolidate application, arguing the scheme was unaffordable and unfeasible in the current economic climate. It has now filed papers opposing the minister’s stay application, along with a conditional counter-application asking the court to interdict the state from implementing NHI if the minister succeeds in pausing the constitutional challenges to the act.
If the minister’s stay application were to be successful, it would suspend judicial scrutiny of the NHI Act while the controversial policy was implemented, said Sakeliga.
“This tactic amounts to an abuse of process by the state and a violation of constitutional accountability. It would shield the government’s deeply flawed NHI Act from judicial review while inflicting ongoing harm on the public, taxpayers, healthcare services and the economy,” it said in a statement on Wednesday.
“This conditional relief is necessary to avert ongoing constitutional and economic harm and to prevent the waste of public funds on a demonstrably unaffordable scheme,” it said.
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