The department of health and organisations litigating against the National Health Insurance (NHI) Act have agreed to halt court challenges pending a Constitutional Court judgment on parliament’s public participation process on the contested legislation.
In return, President Cyril Ramaphosa and health minister Aaron Motsoaledi have agreed not to proclaim or implement any sections of the NHI Act before the top court issues judgment on two cases challenging the process followed by MPs before the president signed the NHI bill into law.
Judge Brenda Neukircher of the high court in Pretoria made the agreement by the parties to stay litigation an order of the court on Tuesday. This means the NHI Act will not be implemented until the top court delivers judgment. It also means the government’s vision for universal health coverage, through NHI, will be put on ice.
Ramaphosa signed into the NHI Act into law on May 15 2024, days before the general elections that triggered challenges from the private sector.
The legal challenges — by trade union Solidarity, the Hospital Association of SA, SA Medical Association, Hospital Association of South Africa, South African Medical Association, Health Funders Association, SA Private Practitioners Forum and business lobby group Sakeliga — will be stayed pending an order of the top court.
The parties have also agreed not to legally challenge the act, without leave of the court on grounds of exceptional and necessary circumstances, until the apex court rules.
We have all agreed we will not proceed with any of the court cases on condition the department and the presidency do not proceed with the proclamation and implementation of the act until we hear from the Constitutional Court
— Dr Nicholas Crisp, health deputy director-general
“On the Constitutional Court handing down any final judgment dismissing both the public participation challenges, the stay shall be discharged and the presiding judge case-managing the applications will, on request from any of the parties, issue directions requiring the parties to make submissions on the further conduct of the applications,” the court order reads.
The effect of the court order also means the health department’s legal challenge to consolidate all NHI challenges has been postponed.
The ConCourt is due to hear the NHI litigation from May 5 to 7.
Health deputy director-general Dr Nicholas Crisp, speaking to Business Day, said depending on the outcomes of the top court, the department would decide on how to proceed with the consolidation litigation.
“We have all agreed we will not proceed with any of the court cases on condition the department and the presidency do not proceed with the proclamation and implementation of the act until we hear from the Constitutional Court,” he said.
Crisp agreed the effect of the litigations delay the government’s plans to implement the act.
“Though we cannot implement the NHI, aspects of the preparation which are important to the health system will continue and focus our energies on that matter until we get the outcomes of the Constitutional Court.”
Despite several litigations against the NHI Act, Crisp said the government pursues implementation to have a health system that can work for the public.
“We have a complicated health system that is spending on inordinate amount of money on a very inefficient way of paying for health care. Private and public health care are very complicated.
“We have more than 100 different funding streams for health care, consuming a huge amount of money that could be spent on patient care.”
Business Day
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