Health Department dismisses NHI collapse claims after ConCourt ruling

The National Department of Health says the Constitutional Court’s ruling on sections of the National Health Act does not invalidate the National Health Insurance Act, despite claims from opposition parties and lobby groups that the judgement represents a setback for the policy. 

On Monday, the apex court declared sections 36 to 40 of the National Health Act unconstitutional, upholding an earlier ruling by the Pretoria High Court.

The court found that the provisions unjustifiably limited the right of healthcare professionals to choose a trade, occupation or profession.

The contested sections relate to the proposed Certificate of Need system, which would have allowed the government to determine where healthcare practitioners may work and what services they may provide.

(1/5) Judgment on 18 May 2026 at 09h00: Sections 36 to 40 of the National Health Act 61 of 2003 are unconstitutional and are consequently severed from the Act.

— Constitutional Court (@ConCourtSA) May 18, 2026

In response, the Health Department stressed that the provisions in question were enacted more than two decades ago and have never been implemented.

Health Department spokesperson Foster Mohale said the ruling has no direct bearing on the NHI Act.

“While noting this judgement, it is important to clarify that the judgement is not relating to the National Health Insurance Act. The sections in question were passed by Parliament 23 years ago and have never been brought into effect. Therefore, there is no direct impact on the NHI Act, as some would think in the political circles and public sector have rushed to mislead the public on.”

The Constitutional Court Judgement handed on Monday, 18 May, declared that sections 36 to 40 of the National Health Act 61 of 2003 are inconsistent with the Constitution and invalid in that they are irrational and unjustifiably limit the right to choose a trade, occupation… pic.twitter.com/bK4wKOC75b

— National Department of Health (@HealthZA) May 18, 2026

Trade union Solidarity, which brought the case alongside several healthcare bodies, welcomed the ruling, describing it as a major victory against state control in healthcare.

Solidarity Deputy Chief Executive, Anton van der Bijl, said the Certificate of Need framework was central to the NHI proposal.

“The government wanted to move health practitioners around like pawns on a chessboard to cover up its own failures. Today the court said South Africans are not state property and professionals are not pawns of the government.”

Solidarity triumphs as central pillar of NHI collapses

Solidarity celebrates the Constitutional Court’s ruling today on the Certificate of Need and considers it a huge victory for healthcare practitioners and the broader public.

According to this ruling, parts of the National… pic.twitter.com/8OPJxXLEDm

— Solidariteit (@solidariteit) May 18, 2026

The Freedom Front Plus also welcomed the judgment, calling it a “major blow” to the NHI and arguing that government should focus on improving existing healthcare facilities rather than centralising control.

ActionSA described the ruling as a “landmark victory” against state overreach, saying the country’s healthcare crisis is rooted in corruption, failing infrastructure and poor governance.

Meanwhile, several legal challenges against the NHI remain before the courts, including cases challenging it’s constitutionality and the public participation process followed before it was signed into law.

Government maintains that preparations for the rollout of the NHI will continue, pending the outcome of ongoing litigation, as part of its goal of achieving universal healthcare coverage.