Despite a recent High Court ruling declaring some sections of the National Health Act unconstitutional, Health Minister Joe Phaahla says this won’t impede plans to roll out the National Health Insurance (NHI) scheme, and that the government will continue work on its implementation.
In June, the High Court found that sections 36 to 40 of the NHA were unconstitutional (the sections refer to provisions for issuing health establishments with a “certificate of need”).
BusinessTech reports that according to the controversial laws, doctors and health practitioners cannot start a practice or provide health services without a certificate. Health professionals argue that this violates fundamental rights, as it gives the state power to prevent them from working.
The government defends this, saying the certification scheme is necessary to ensure “vulnerable communities get access to health services” by making work in such areas a condition of obtaining a certificate.
After the Health Department and other government officials listed as respondents in the case failed to participate in proceedings, the High Court ruled in favour of the applicants. The department is now appealing the ruling and wants to take the matter to the Constitutional Court.
In a written parliamentary Q&A this past week, Phaahla said the department would not wait for a legal outcome and would continue laying the groundwork for the health scheme.
“The ruling … confines itself to declaring provisions of the National Health Act in Sections 36 to 40 not compliant with Section 172(1) of the Constitution. The ruling has not made any reference or ruling on other Sections outside Sections 36 to 40 of the National Health Act.
“Neither has the High Court made any ruling on the 2017 NHI Policy or activities related to the preparatory work towards the establishment of NHI,” he said.
He said the NHI Bill is currently being deliberated in Parliament, and the department has no authority over the legislative processes in Parliament.
The government’s pursuit of the NHI continues despite criticism from the private health sector, medical aids, and warnings from Treasury and the Department of Health itself.
Private healthcare groups believe that the scheme is unsustainable and unmanageable, considering the failure of public healthcare, while there are also concerns over an exodus of healthcare professionals who refuse to be subject to the scheme’s harsh conditions, as evidenced by the court ruling the department is appealing.
Medical aids are also fighting for their continuation – the NHI scheme envisions a healthcare system with the state entirely in control and little to no room for private healthcare funding.
Treasury’s warnings come from a financing standpoint – there is simply no money to feed into the scheme without raising taxes.
Finally, the Department of Health has raised red flags over the scheme’s administration, conceding that it is vulnerable to maladministration and mismanagement.
BusinessTech article – Court ruling won’t stop NHI plans for South Africa: minister (Open access)
See more from MedicalBrief archives:
Scathing ruling against state’s bid to control where doctors work
Solidarity: Judgment reserved in application to have NHI ‘certificate of need’ declared invalid
Court application to challenge constitutionality of ‘certificate of need’
Submissions: NHI Bill has serious constitutional and human rights implications
Brickbats and bouquets for NHI and Medical Schemes Bills