The ruling confirms that the president can be held accountable for revealing the reasons why he signs legislation, such as NHI, into law.
In the first court judgement about the National Health Insurance (NHI), the North Gauteng High Court ruled that President Cyril Ramaphosa must explain how he decided to sign the NHI Bill into law in May last year.
The Board of Healthcare Funders (BHF), which brought the application, says the ruling confirms that the president’s decision to assent to and sign the NHI Bill into law is subject to review in the High Court.
“In addition, the judgement obligates the president to provide his full record of proceedings that led to his decision to sign the NHI Bill into law in line with Rule 53 of the Uniform Rules of the Court. The High Court directed President Ramaphosa to furnish this record within ten calendar days of today’s ruling.”
The BHF, a non-profit company that works in the best interest of effective and sustainable healthcare for all, with members in seven African countries, welcomed today’s judgement, saying it is a victory for the rule of law and a step towards exposing the unconstitutional aspects of the NHI Act.
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Ruling is important milestone in challenging NHI Act
“This ruling marks an important milestone in the BHF’s ongoing legal challenge against the NHI Act. It reaffirms the constitutional principle that all public power is subject to the rule of law and that no office-bearer, including the president, is above judicial scrutiny,” the BHF said in a statement.
The BHF based its main review application on the president failing to fulfil his constitutional duty under section 79(1) of the constitution by not referring the NHI Bill back to parliament despite receiving numerous submissions, including several from the BHF.
“Instead, the president proceeded to sign the NHI Bill into law in May 2024, setting in motion legislation that we contend is vague, unaffordable and ultimately unworkable,” the NHF said.
Before the main review application could proceed, the president and the minister of health, Dr Aaron Motsoaledi, filed notices raising two questions of law:
- Can only the Constitutional Court decide if the president has failed to fulfil a legislative obligation?
- Can the president’s assent and signature of a Bill be reviewed, and if so, is the president obligated to provide the BHF (as the applicant) with his record of decision?
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Ruling confirms court jurisdiction to review signing of Act
The BHF says today’s judgement confirmed that the High Court does have jurisdiction to hear its main review application. “The court decision also affirms the BHF’s right as the applicant to receive the full record of the president’s decision-making process.
“We believe the record will demonstrate that the president ignored compelling legal and policy objections submitted by multiple stakeholders across civil society, business and the healthcare sector. We view the notices the president and the minister filed as clear attempts to delay the progression of the main review application.
“The court’s decision to dismiss those preliminary objections and compel the president to produce the record of decision is therefore a meaningful step forward in our pursuit of accountability and constitutionally sound governance.”
The BHF said it remains steadfast in its commitment to achieving universal health coverage. “However, we believe that this goal must be pursued through a practical and inclusive multi-payer model that preserves the strengths of both the public and private healthcare sectors.”
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“The NHI Act, as it currently stands, threatens to erode healthcare access for millions, including the over 9.7 million lives currently covered by medical schemes that include two-thirds from previously disadvantaged communities.”
The BHF said it remains committed to working with all stakeholders who are committed to developing an affordable, workable and constitutionally compliant framework to achieve quality universal healthcare for all.
