South Africa

NHI will be signed into law soon – Ramaphosa

President Cyril Ramaphosa said he will sign the National Health Insurance (NHI) Bill into law soon, despite threats of legal challenges from organised business over concerns about its constitutionality. 

Ramaphosa said this during his State of the Nation Address for 2024, where he joked that he was looking around for a pen to sign the Bill. 

“While our health system has had a great impact on people’s lives, we are working to improve both the quality of healthcare and equality of access,” Ramaphosa said. 

Parliament’s National Council of Provinces approved the Bill in December. It referred it to the president, who can either assent to it or ask lawmakers to amend it if deemed legally or technically flawed.

“We plan to incrementally implement the NHI, dealing with issues like health system financing, the health workforce, medical products, vaccines and technologies, and health information systems,” he said.

This is despite calls from Business Unity South Africa (BUSA) and Business for South Africa (B4SA) for the President to refer the Bill back to Parliament for amendment. 

BUSA and B4SA are preparing to submit a petition to Ramaphosa to this effect. 

The business groups said the NHI, in its current form, is unworkable, unimplementable, unaffordable, and unconstitutional. 

“Our concerns, recommendations, research, data, and inputs, as well as those made by a wide range of experts and affected stakeholders, have been ignored by the Parliamentary Portfolio Committee on Health and the NCOP,” Martin Kingston, B4SA Steering Committee Chair, said. 

BUSA and B4SA have threatened legal action against the government over the NHI should it become law in its current form. 

“No amendments were made at all, including those suggested by the Department of Health itself, which is deeply concerning for our country and democracy,” Kingston said. 

“If it goes forward as it is currently being proposed, then no doubt, not only ourselves but several other stakeholders from civil society and the private sector will engage with that process.”

“There will be litigation, which serves nobody any useful purpose.”

He added that the effects of passing this Bill are devastating. 

“It will materially delay access to universal health coverage, lead to disinvestment in the healthcare sector, further damage our already fragile economy, and create significant risks for the country in terms of the quality, management, and governance of healthcare.”

BUSA and B4SA were clear that they were not against the creation of NHI but were against the implementation of it in its current form. 


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