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ActionSA welcomes the decision by President Cyril Ramaphosa to delay the proclamation of the National Health Insurance (NHI) Act. This is a necessary and responsible step, however, we differ in our approach and argue that Parliament should be the one ensuring that National Health Insurance must be constitutionally sound, procedurally fair,  practically implementable and fully funded.

The fact that multiple parties have approached the courts over concerns relating to the public participation process underscores the seriousness of the issues at hand. While government insists that preparatory work continues and that implementation timelines remain unaffected, the reality is that the NHI in its current form raises profound concerns about governance, funding, centralisation of power, and the potentially devastating impact on both public and private healthcare systems.

We believe Parliament should be the primary forum for resolving legislative deficiencies. If the public participation process was flawed, or if substantive concerns remain unaddressed, it is Parliament’s constitutional duty to revisit the legislation, ensure proper consultation, and make the necessary amendments. Relying on litigation to correct avoidable procedural and policy failures is an indictment on our legislative processes and how this Bill was handled.

Healthcare reform is a matter of life and dignity – South Africans deserve a health system that expands improved access without collapsing what already works. Reform must be guided by evidence, sustainability, and meaningful stakeholder engagement – not ideological rigidity.

ActionSA reiterates its commitment to universal healthcare coverage. However, we will continue to oppose any framework that concentrates unchecked power in a single fund, lacks clear financing mechanisms, and fails to prioritise fixing frontline service delivery failures in our existing public health system.

Issued by ActionSA Member of Parliament Kgosi Letlape