The High Court’s decision that requiring healthcare practitioners to obtain a certificate of need (CoN) is unconstitutional will not stop the Department of Health from implementing National Health Insurance (NHI), says Minister of Health Dr Joe Phaahla.
In June, the High Court in Pretoria found that sections 36 to 40 of the National Health Act were unconstitutional and invalid.
The sections forced healthcare practitioners to obtain a CoN from the health department to be able to set up a practice and provide health care in a specific area.
Read: Health department will seek to have ‘anti-NHI ruling’ set aside
Acting Judge Thembi Bokako said the CoN scheme permitted the director-general of health to view healthcare personnel as “inanimate pawns in pursuit of the state’s objectives”.
The department, on the other hand, believes the certification scheme will ensure that under-served communities get access to health services by making work in such areas a condition of obtaining a certificate.
The health department said it would seek a rescission of the judgment and challenge the matter in the Constitutional Court.
The department’s spokesperson, Foster Mohale, was quoted as saying that the ruling has “serious implications”, because “it will limit adequate access to healthcare services to the most vulnerable members of society and will have serious implications for the NHI and its implementation”.
Last week, DA MP Michéle Clarke asked Dr Phaahla whether his department intended to await the outcome of its appeal against the judgment before it continues with the establishment of NHI.
In his written response, the minister said the health department “has no intention” of discontinuing activities directed at preparing the health system for the establishment of NHI while awaiting the outcome of its appeal.
Dr Phaahla said the ruling was confined to sections 36 to 40 of the National Health Act. The court did not make any ruling on the 2017 NHI Policy or on activities related to the preparatory work towards the establishment of NHI.
He said the establishment of NHI was informed by the White Paper on NHI, which was approved by the Cabinet in June 2017. The White Paper recommended a phased approach towards the establishment of NHI.
The first two phases of NHI implementation entail initiatives to strengthen the health system to prepare for the full establishment of NHI at the end of the third phase, Dr Phaahla said.
Phase two entails finalising the legislative process for the establishment of the NHI Fund through the enactment of the National Health Insurance Act.
The NHI Bill is currently being deliberated in Parliament, and the department has no authority over the legislative process, Dr Phaahla said.
