Civil society organisation AfriForum on Wednesday served a summons on President Cyril Ramaphosa and Health Minister Dr Aaron Motsoaledi, as part of its legal action to challenge the constitutionality of the National Health Insurance (NHI) Act.

AfriForum has expressed criticism of the Act, since its signing in 2024.

AfriForum health spokesperson Louis Boshoff said considering South Africa’s current political and economic climate, the NHI was “completely unworkable”.

“…the worst thing that can happen to taxpayers is the allocation of funds – equivalent to 10% of South Africa’s gross domestic product – to a health system that will never function effectively,” he said.

AfriForum head of public relations Ernst van Zyl said the NHI Act contained provisions that “not only affect the constitutional rights of AfriForum’s members, but also those of the public in general”.

The organisation noted that although other institutions had already instituted legal proceedings against the Act, its legal action was the first of its kind against this law.

“AfriForum’s summons launches a comprehensive attack on the NHI Act and points to the unconstitutionality of several provisions therein. The action proceeding offers, among other things, the opportunity to provide expert testimony in court if there are disputes about the facts,” said Boshoff.

AfriForum's legal representative in the case Wian Spies said the organisation’s legal action was based on the premise that the NHI Act was “inconsistent with the Constitution and must therefore be declared invalid and referred back to Parliament”.

Spies explained that AfriForum objected to the dilution of provincial governments’ constitutional powers, the restriction of patients’ freedom of choice and the restriction of the clinical independence of health practitioners.

The organisation also objects to the “lack of rationality” of the NHI framework owing to what AfriForum says is its economic unworkability.

“The true cost of NHI will be much more than its mere rand value. The loss of, among other things, constitutional rights and patients’ freedom of choice will ultimately result in a much higher price being paid,” Boshoff stated.

Van Zyl claimed that all citizens and Afrikaners had been victims of the African National Congress’s ideological agenda.