02-06-2025
WC the only province to raise objections to NHI Fund draft regulations
THE ANC in the province says the Western Cape Government's rejection of the draft National Health Insurance (NHI) regulations reflects a political choice to defend privilege rather than fix inequality.
The province is the only in the country to have raised objections to the draft governance regulations relating to the implementation of the NHI Fund.
Health MEC, Mireille Wenger said the Western Cape Cabinet had approved comments from the provincial department of Health and Wellness expressing 'strong objections to the draft governance regulations'.
The NHI is a centralised, national insurance fund designed to provide universal health coverage. It aims to ensure all South Africans have access to quality and affordable healthcare services, regardless of their socio-economic status.
The draft regulations seek to provide for the establishment of structures and processes for the governance of the fund.
It represents the first formal step towards establishing the NHI Fund, to centralise all healthcare funding under the national government, said Wenger.
'While the Western Cape Government supports the constitutional imperative to realise the provision of universal healthcare, it remains concerned that the NHI model in its current form - will weaken existing healthcare systems and reduce the ability of provinces to deliver responsive and accountable services to residents. The draft governance regulations provide for detailed matters pertaining to, amongst other things, the appointment of a board and CEO for the NHI fund.
'In terms of Section 55(1) of the NHI Act, the National Minister may only make regulations after consulting both the National Health Council - which includes all nine provincial health departments and the national department - and the NHI Fund. Should the Minister make regulations without consulting the fund, the regulations will be invalid. Should the Minister wish to proceed to issue the draft regulations without consulting the fund, it will first be necessary to amend the Act to remove the requirement for consultation with the fund.
'The Act specifies the matters on which the Minister is empowered to make regulations, however these do not specifically include 'governance' and hence could be ultra vires to the Act and invalid,' she said.
According to Wenger they were also concerned about the minister's powers to appoint and remove role players, 'without sufficient checks and balances to prevent maladministration'.
ANC leader of the opposition in the provincial legislature, Khalid Sayed said they supported the NHI and its full implementation.
"The ANC fully supports the implementation of the National Health Insurance as a bold step towards ensuring that no South African is denied access to quality healthcare due to their income or location.
'The Western Cape Government's rejection of the draft regulations reflects a political choice to defend privilege rather than fix inequality. Instead of fearmongering about governance, we should be working together to build a just and inclusive health system for all—rural or urban, rich or poor. The people of this province deserve better than two-tier healthcare. The ANC remains committed to making universal healthcare a reality," said Sayed.
National health department spokesperson Foster Mohale said the Western Cape was the only provincial government that had raised objections.
'Only Western Cape has raised objections. How does the Minister consult a Fund that does not exist on regulations that will allow for processes to bring it into existence? The regulations do not mandate any power for the Minister that is not already provided for in the Act. What they do is to require absolute transparency in that process. We hope that the Western Cape government has actually commented on the contents of the draft regulations so that their comments can be accessible to the public,' Mohale said.
Wenger said the Western Cape Government will submit its formal written comments on the draft regulations in due course.
