Doctors are celebrating the Pretoria High Court’s decision on Wednesday, declaring the legislation allowing the government to dictate where health professionals can practice unconstitutional. This victory comes from the efforts of Solidarity, the Alliance of South African Independent Practitioners Associations, the South African Private Practitioner Forum, and the Hospital Association of SA.
The ruling is a significant setback for the National Health Insurance (NHI), which depends on the certificate of need for central management, a core principle of the NHI Act. Judge A Millar ruled that sections 36 to 40 of the NHI Act are invalid “in their entirety”.
A blow to NHI concept
Former SA Medical Association chair, Dr Angelique Coetzee, expressed satisfaction with the ruling, saying this saga had been ongoing since 2003, and now we finally have a verdict declaring it unconstitutional. However, she added, this judgment is also a blow to the entire NHI concept, which relied heavily on the principle of central management.
Coetzee noted that this ruling means doctors can now practice where they choose, and NHI cannot be implemented in its current form. The legislation’s primary goal was to regulate the distribution of health establishments and control where doctors could work, requiring them to reapply for certificates every 20 years.
Collaborative efforts needed
The Hospital Association of SA welcomed the judgment but expressed disappointment that a legal challenge was necessary. Hasa emphasised the need for collaborative efforts to strengthen the health system and address the critical shortage of doctors and specialists in South Africa.
Organisation Undoing Tax Abuse CEO Wayne Duvenage voiced support for universal healthcare but criticised the lack of clarity on the NHI’s financial and administrative model. He disagreed with the Minister’s recent remarks about medical aid schemes, stating that those paying for medical aid reduce their burden on the state’s healthcare resources, which benefits poorer communities.