Draft rules for universal healthcare slammed

South Africa's Health Minister Aaron Motsoaledi's unveiling on Friday of the first set of draft regulations for the National Health Insurance (NHI) Act has already sparked discontent inside and outside the healthcare sector, notes Legalbrief. Despite various objections and legal challenges, this long-debated piece of legislation was signed into law by President Cyril Ramaphosa in May 2024. A Sunday Tribune report says 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 Board of Healthcare Funders (BHF) has 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. MD of BHF Dr Katlego Mothudi is quoted in the Sunday Tribune as saying: ‘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 added the organisation intended to thoroughly review the regulations before submitting a detailed argument. In tandem with BHF's response, the Hospital Association of SA (Hasa), the country’s largest hospital group, has also initiated a legal challenge against the NHI. 

According to a Business Day report, Business Unity SA (Busa) challenged the authority of the Minister to issue regulations before the Act had been brought into effect. ‘According to our knowledge, the NHI Act is not effective because it has not been proclaimed by the President (and) therefore does not empower the Minister to make regulations yet,’ said Busa CEO Khulekani Mathe. Publishing regulations in isolation from an agreed on, workable NHI framework risked undermining the objective of universal health coverage, said Busa. Health Department Deputy DG for NHI Nicholas Crisp said the draft regulations had been gazetted ‘so that when the relevant sections of the Act are promulgated the regulations are ready’.

Full Business Day report

Full Sunday Tribune report