Western Cape Government again urges President not to sign NHI Bill into law

Joint Media Release: Western Cape Government again urges President not to sign NHI Bill into law until major Constitutional amendments are made

Premier Alan Winde and Western Cape Minister of Health and Wellness, Professor Nomafrench Mbombo, again urge President Cyril Ramaphosa to not sign the National Health Insurance (NHI) Bill into law.

“The Western Cape Government (WCG) remains deeply concerned with the Bill in its current form. It requires substantial amendments. We believe that the Bill as it stands currently is unconstitutional and will prove to be unaffordable and impractical. We firmly believe that it will not achieve its purpose of Universal Health Coverage (UHC), which our citizens deserve. I appeal to the President to refer the Bill back to Parliament for reconsideration, in terms of Section 79 of the Constitution,” said Premier Winde.

In accordance with Section 27(2) of the Constitution, the State must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of the right of access to healthcare services.

Premier Winde noted that national government does not appear to have done this.

The Premier and Minister Mbombo wrote to the President to raise their concerns on 8 December 2023 and 24 January 2024. There has to date been no response from him or his office.

It is for this reason that we have written once again to the President, urging him not to assent to this Bill.

Minister Mbombo stressed, “With the NHI Bill signaling the most significant change to the healthcare system since the promulgation of the National Health Act, it is crucial that a piece of legislation of this nature reflects all stakeholders’ inputs and creates a system that is unified and strategically aligned.

“Unfortunately, this is not the case with the NHI in its current form. For us to truly achieve UHC, we do believe that the current health system needs to be completely overhauled as we are currently trying to run an imperfect system perfectly.  However, it requires that we create a system where all stakeholders work together.”

While the National Government will have to draft and implement various pieces of legislation and policies in order to give effect to NHI, it is important that the framework as provided in the Bill is correct and does not contain policy gaps that create uncertainty.

In addition to the uncertainty this Bill will create when signed into law, provincial health departments are having to contend with immense fiscal constraints caused in large part by the budget cuts that have had to be made due to the public sector wage bill increase. It is, therefore, incomprehensible how the national government intends funding this unaffordable piece of legislation.