Ramaphosa dragged to court

Civil rights organisation AfriForum has served a summons on President Cyril Ramaphosa and Health Minister Aaron Motsoaledi.

This forms part of the group’s legal action challenging the constitutionality of the National Health Insurance (NHI) Act, which is facing several concurrent lawsuits.

The legislation was signed into law by the President in May 2024 and seeks to centralise control over South Africa’s healthcare financing in a single state-run fund.

This will essentially enable universal, free health coverage in South Africa, limiting the role of private healthcare providers in favour of public providers.

Even before its enactment, this plan has faced severe backlash, ranging from critiques of its lack of funding to concerns about the potential for corruption and mismanagement.

Since the Act was signed into law, much of this backlash has translated into legal action, with the legislation now facing around nine different court cases.

One such case is AfriForum’s, which argues that the NHI Act is unconstitutional and must therefore be declared invalid and referred back to Parliament.

AfriForum’s legal representative, Wian Spies, explained that the organisation’s legal challenge is based on the premise that the NHI Act is inconsistent with the Constitution. 

The organisation is arguing that the following aspects of the legislation, among others, constitute unconstitutionality –

• The dilution of provincial governments’ constitutional powers
• The restriction of patients’ freedom of choice
• The restriction of the clinical independence of health practitioners
• The lack of rationality of the NHI framework due to its economic unworkability

AfriForum’s head of public relations, Ernst van Zyl, said the NHI Act contains provisions that not only affect the constitutional rights of the organisation’s members, but also those of the public.

“All citizens and Afrikaners in particular have been victims of the ANC’s ideological agenda. NHI is another such case,” Van Zyl claimed. 

“The ANC has already received ample evidence that it will not improve people’s healthcare, but they continue to cling to it for ideological reasons. This is why AfriForum cannot allow this to continue.”

AfriForum’s spokesperson on health, Louis Boshoff, said given South Africa’s current political and eocnomic climate, NHI is completely unworkable.

Boshoff claimed that the worst thing that can happen to South African taxpayers is the allocation of funds – equivalent to around 10% of the country’s GDP – to a health system that “will never function effectively”.

The Health Department has estimated that NHI would require an additional R200 billion in annual tax revenue to fund.

Momentum Health Solutions has projected a far higher cost, estimating that the government would need between R900 billion and R1.3 trillion per year to provide each South African with the same quality of care as under the private health system.

However, Boshoff said the true cost of NHI will be much more than its rand value. “The loss of, among other things, constitutional rights and patients’ freedom of choice will ultimately result in a much higher price being paid,” he said.

AfriForum’s legal action

AfriForum announced that it had served a summons on the President and Health Minister during a media conference held at the abandoned Kempton Park Hospital in Gauteng.

The organisation claimed this dilapidated public hospital serves as a warning of what could await the country’s health sector should NHI be implemented.