NHI still 'viable and on track' despite Constitutional Court setback, says Motsoaledi
Minister of Health Aaron Motsoaledi says that South Africa’s National Health Insurance (NHI) programme will continue
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Minister of Health Aaron Motsoaledi says that South Africa’s National Health Insurance (NHI) programme will continue despite a recent Constitutional Court ruling that struck down key provisions of the National Health Act’s Certificate of Need system.
The Constitutional Court has ruled that the “Certificate of Need” (CON) provisions in the Health Care Act - which control where doctors work - are unconstitutional. These provisions require doctors to obtain a CON before they can work at a specific location.
In a written reply to questions from ActionSA MP Dr Tebogo Kgosietsile Letlape, Motsoaledi said the judgment does not stop or invalidate the NHI programme.
He said the government is studying the ruling and will ensure that future health policies comply with the Constitution, while maintaining its goal of universal health coverage.
"The judgment does not halt or invalidate the broader programme of health system transformation, nor does it affect the viability or phased implementation of the National Health Insurance (NHI). Universal Health Coverage remains a vital national imperative to rectify South Africa’s deeply unequal dual healthcare system," Motsoaledi said.
"The Certificate of Need (CoN) provisions were originally conceived as a planning and regulatory instrument to address deep structural and geographic inequities, where healthcare resources remain heavily concentrated in affluent urban centres to the detriment of rural and historically underserved communities. While the mechanism has been struck down, the underlying problem of inequitable resource distribution remains."
The minister added that the government will now explore alternative, constitutionally compliant ways to address unequal access to healthcare across the country.
He said the aim remains to improve the distribution of health services, particularly in underserved and rural areas, even after the Constitutional Court struck down the Certificate of Need provisions.
"The insinuation that the government is pursuing 'centralised state control' is rejected," he said.
"The Department’s interventions are guided entirely by Section 27 of the Constitution, which places a mandatory obligation on the State to take reasonable legislative and other measures, within available resources, to progressively realise the right of access to healthcare services for all South Africans. The judgment does not diminish this constitutional obligation."
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