Order of battle set for NGV legal battle


The National Health Insurance (NHI) is unaffordable, unsustainable, unenforceable, illegal and unnecessary. It’s not about health care, but power.

Solidarity less than an hour after pres. Cyril Ramaphosa signed the NGV Act on Wednesday, starting a legal process. The first step is a reminder that gives Ramaphosa until next Thursday to repeal the law. “If this is not going to happen, as expected, the government can expect that court documents will be served on him soon after,” says Dr. Dirk Hermann, managing director of Solidarity.

In its draft court documents, Solidarity demands that the NGV Act be declared illegal because it is contrary to the Constitution, among other things because it does not provide for a clear funding model and is vague about which services will be paid for.

According to Solidarity, the NHI Act also leads to uncertainty among millions of South Africans about how it will affect the levels of access to healthcare they currently enjoy. There is further uncertainty about the role of medical funds and whether any private medical institution or healthcare provider that does not contract with the NGV fund will be prohibited from providing healthcare services to the public.

Another reason for concern is the extensive powers granted to the minister of health and the infringement of the constitutional principle of separation of powers. Other constitutional rights that are unfairly infringed on include the right to human dignity, the right to life, the right to freedom and security of the person, the right to freedom of association as well as the right to freedom of trade, occupation and profession and labor rights .

“Solidarity expects hundreds of health practitioners to support his court case. We have the support of doctors, specialists, nurses, pharmacists and many more. We are overwhelmed by the support. The resistance to the NGV is huge. We also expect a stream of parties to enter the litigation battle. This could become the biggest legal battle in South Africa’s history. Political parties, civil organizations such as AfriForum, business organisations, medical associations and medical funds have already indicated that they will go to court.”

‘By no means free’

The NGV will cost approximately R660 billion when fully implemented. If the current health budget, adjusted according to the passage of time, is subtracted from it, this is an additional cost of R296 billion.

“Already heavily taxed taxpayers are going to have to pay. Ordinary salary earners will bear the heaviest burden. The government is reckless and populist. Expectations are created that cannot be met. This is the seed of medical anarchism.

“There is no question of greater access to better medical care. This outcome is simply going to be equal access to poor medical care. It is a looting pot where looters go to feast on taxpayers’ money while sick people sit in queues, waiting for a referral. It’s a sick system that must be stopped.”

‘It’s about power’

According to Hermann, it is not about medical care for the government, but about power.

“All power must be centralized in the government. The pendulum has now swung to first denial, then disillusionment and now anger from civil society and the private sector. Medical funds were at first positive and thought there were commercial opportunities, then they were neutral and now some of them are starting to come out openly against the NGV.

“The NGV wants to centralize all health care in South Africa. The NGV is not simply a funding model, but a comprehensive state-controlled health model that is set up for failure. They want to prescribe where doctors practise, which doctor you may go to, which medicine must be prescribed and want to purchase everything centrally.”

Central control of the state has already had catastrophic consequences, Hermann points out. “What we cannot afford at all are alternate pills or alternate surgeries. It is about life and death. The NGV will result in all medical care being weakened.”

Ramaphosa and populists like Panyaza Lesufi are creating expectations about the NGV which cannot be met, says Hermann. “The reality is that the state has nowhere near the ability to manage such a complex system. All medical purchases will be made centrally by the state. It’s going to be a new loot pot. Taxpayers are going to pay billions that will be looted by looters.”

Solidarity also took the unusual step of informing Ramaphosa that legal costs would be recovered against his person “because he was fully aware that the law is irrational and unaffordable, which will lead to great disadvantage of the South African health sector”.