Johannesburg 14 May 2024 – Business Leadership South Africa (BLSA) expresses its concern, in the strongest possible terms, about news that President Cyril Ramaphosa will sign the National Health Insurance (NHI) Bill into law on Wednesday 15 May 2024 and, in doing so, discount the significant public comment on the proposed Bill which has found it to be unworkable, economically damaging and contrary to the precepts of the South African Constitution.

BLSA CEO, Busisiwe Mavuso, said: “Public consultation cannot just be a matter of procedure, but must include proper consideration of the input received, as spelled out in the Promotion of Administrative Justice Act. It is hard to believe that there has been proper consideration when draft legislation is finalised without change after a comment period.

“In this period of heightened electioneering, political campaigns are a distraction to the business of running the country, particularly at a crucial time for us to make progress on the major challenges facing our economy. The government is rushing populist policy through parliament, which can only be seen to be an electioneering ploy, as the significant and meaningful public input into the Bill and its socioeconomic ramifications have not been considered.

“This move is destructive for many stakeholders and relationships, at a time when partnerships between government and business are critical to building confidence globally that South Africa is an investible destination.  The law will never work, simply because there is no capacity to implement it, and as soon as it is signed it will be embroiled in litigation on several fronts, including its constitutionality.”

BLSA fully supports the call for universal access to quality health care for all South Africans. However, this poorly conceived Bill will obstruct – not facilitate – access to quality healthcare for citizens in our country. The legislation inflicts serious damage to both the private and public health systems through government’s attempts to set up a single payer fund to acquire all significant health services in the country, and effectively destroy the private health system in the process, without any plan on how capacity will be created in the public health service. It has already affected investment in the sector and given businesspeople — South Africa’s tax base — pause for thought about whether they will be able to rely on the South African health system in the future. BLSA has found that health professionals, who are globally mobile, are deeply concerned about their futures in South Africa due to several consequences which will result from government enacting the Bill.

South Africa’s constitutional framework makes consultation a key part of the development of laws. The Constitutional Court has in the past struck down legislation because of a failure of the state to comply with its constitutional obligations to include the public in development of legislation.

This is not just a cost to those who spend time and money on providing comment, but also to the government. When laws are ambiguous or unconstitutional, they will inevitably end up being challenged in court, requiring government to pay for legal processes. Many of these lead to amendments. It could all be avoided by properly engaging with public input and getting the legislation right in the first place.

“South Africa needs good laws, ones that benefit from the input of those affected by them. Laws should also be subject to a socioeconomic impact assessment, in line with the socioeconomic impact assessment system managed by the presidency. But these assessments, when undertaken, are often perfunctory and a missed opportunity to improve laws and regulations to maximise the public benefit. We need an engaged government, who genuinely considers the inputs its stakeholders provide, and acts where there is an opportunity to improve legislation. That is what the Constitution envisages because it is how we get to become a country that realises its potential,” said Mavuso.

 

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