Neelam Rahim | neelam@radioislam.co.za
3-minute read
10 May 2025 | 13:09 CAT

With no concrete outcomes to any of the legal challenges against the NHI at this stage, the future of the Act is uncertain. (Photo: Rosetta Msimango / Spotlight)

A legal showdown is brewing over South Africa’s contentious National Health Insurance (NHI) Act. The High Court has ordered President Cyril Ramaphosa to disclose the full record of decision-making that led him to sign the bill into law—a move hailed by health stakeholders as a crucial first step toward accountability.

Dr Simon Strachan, spokesperson for the South African Health Professionals Collaboration (SAHPC), welcomed the court’s ruling, calling it “a small win in what is going to be a long road.” Strachan argued that the President failed in his constitutional duty to scrutinize the bill for irregularities, despite years of submissions highlighting its flaws—even from the State Law Advisor and Parliamentary Legal Advisor.

“What we’ve asked the court is to prove or disprove whether the President fulfilled his obligation,” Strachan told Radio Islam International. “This ruling allows for clarity on what process was followed and why the bill was assented to.”

Critics argue the Act unjustifiably restricts citizens’ rights—particularly their ability to choose how to access healthcare. “The vehicle, in this case the NHI, does not achieve the intended objective of universal healthcare. It’s based on outdated costing and lacks clear implementation strategies,” Strachan explained.

While government asserts the NHI is key to achieving universal health coverage, stakeholders contend that the model is flawed and alternative, more viable mechanisms exist.

In response to eroding trust between the state and healthcare providers, a new coalition—Universal Healthcare Access Coalition (UHAC)—has emerged. Spearheaded by the South African Private Practitioners Forum and the South African Medical Association, UHAC unites 37 organisations including hospitals, medical funders and patient advocacy groups.

Strachan noted, “We’ve created a strategic proposal for health reform that has been shared with the President and Health Department. Through UHAC, we’re building a platform for all voices—providers, patients, and business—to co-create a workable path to equitable healthcare.”

As legal and political tensions mount, the future of NHI now hangs on transparency, meaningful consultation, and whether government will engage with growing calls for reform.

Listen to the full interview on The Daily Round-Up with Moulana Junaid Kharsany and Dr Simon Strachan here.