IRR hails Constitutional Court judgment on NHI as key to maintaining access to healthcare

The Institute of Race Relations (IRR) says the Constitutional Court judgment striking down the certificate-of-need provisions in the National Health Insurance (NHI) Act is vindication of its 2023 parliamentary submission casting doubt on whether the Act would withstand constitutional scrutiny.

Says IRR strategic engagements manager Makone Maja: “Where the NHI Act sought to undermine them, this judgment takes a step in upholding and preserving the constitutional rights to access to healthcare and the ability of healthcare professionals to operate freely.”

As the Institute noted in its submission to parliament of 15 September 2023, legitimate concerns about the then NHI Bill, including how the fund would be shielded from corruption, government inefficiencies and the burdens of additional bureaucracy, as well as where the financial means to implement it would be derived from, fell on the ears of the evidently wilfully deaf majority of the Select Committee on Health and Social Services in the National Council of Provinces

The certification component, now struck down by the Constitutional Court, formed a key part of the IRR’s submission. The NHI Act required all health professionals to obtain a certificate-of-need in order to provide health services, enumerating a list of vague requirements which the director of general of health was to rely on in deciding whether to issue a certificate or not.

“As a result, roughly 20% of public hospitals would qualify to operate under the NHI, leaving fewer public resources at the disposal of South Africans in need of health services. Private sector options would also be limited and the overall access to health of South Africans thwarted,” says Maja.

These certificates are not a new concept; they are contained in the National Health Act of 2003, but are not in effect. However, the NHI sought to operationalise them. The Constitutional Court ruling renders them unworkable and unconstitutional.

Maja notes: “There is no question that the healthcare system needs overhauling. Institutional reforms in public healthcare need to target the poor standards of hygiene, deficient safety equipment, air conditioners, and water supplies, and the inadequate financial systems and controls that lead to resource shortages. The NHI does nothing to improve the operation of public health facilities in this manner.”

In its Better Health Bill, the IRR offers an alternative to the centralised healthcare that the NHI proposes. Unlike the NHI, the Better Health Bill widens access to healthcare and takes the regulatory restraints off the healthcare system to incentivise competition, efficiency and sectoral growth through the introduction of a care voucher system.

Maja concludes: “Under the Better Health Bill, citizens earning below a certain income threshold will receive taxpayer-funded vouchers that are redeemable for healthcare services at a healthcare facility of their choice including at privately owned organisations. In this way, choice is enhanced rather than compromised, competition which drives better and more affordable services is enabled and more people have access to better health.”

Media contact: Makone Maja, IRR Strategic Engagements Manager Tel: 079 418 6676 Email: makone@irr.org.za

Media enquiries: Michael Morris Tel: 066 302 1968 Email: michael@irr.org.za