The Gauteng High Court in Pretoria has ordered President Cyril Ramaphosa to provide a comprehensive record explaining his decision to sign the National Health Insurance (NHI) Bill into law in May 2024.
Source: GCIS. President Cyril Ramaphosa at a bilateral meeting with President Karin Keller-Sutter of Switzerland on the margins of the first meeting of the G20 Finance Ministers and Central Governors in Cape Town in February 2025.
This ruling comes in response to legal challenges from the Board of Healthcare Funders (BHF) and the South African Private Practitioners Forum (SAPPF), who argue that the President failed to consider substantial constitutional and financial objections raised during the legislative process.
The court determined that the president's decision is subject to judicial review under Rule 53 of the Uniform Rules of Court, which mandates that the executive's decisions can be scrutinised for legality and rationality.
President Ramaphosa was given 10 calendar days to submit the full record of the proceedings that led to his assent to the NHI Bill. The court also dismissed the Presidency's argument that only the Constitutional Court had jurisdiction over the matter.
The BHF and SAPPF contend that the President ignored numerous submissions highlighting the NHI Bill's potential unconstitutionality and impracticality. They assert that the President should have referred the Bill back to Parliament for further consideration, as provided for under Section 79(1) of the Constitution.
The NHI Act aims to establish a single-payer system to provide universal healthcare in South Africa. However, it has faced significant opposition from various stakeholders, including medical schemes, healthcare professionals, and provincial governments, who argue that the Act is vague, unaffordable, and could undermine the private healthcare sector
