Zweli Mkhize. Picture: BUSINESS DAY
Zweli Mkhize. Picture: BUSINESS DAY

Health minister Zweli Mkhize will on Friday unpack the details of the approved National Health Insurance (NHI) Bill, which is aimed at providing universal health coverage for South Africans

Jackson Mthembu, minister in the presidency for planning, monitoring & evaluation, announced on Thursday that cabinet had finally approved the controversial bill but did not provide any details on it.

Mkhize was set to brief the media on the bill ahead of his budget vote address in parliament on Friday morning.

The DA labelled cabinet’s approval “premature, irresponsible and simply disastrous”.

Cabinet approved the bill for release for public consultation over a three-month period from June 2018 to September 2018.  He said the input from that process has now been incorporated in the latest version of the bill.


The bill was mired in controversy towards the end of 2018, after a leaked Treasury letter exposed an alleged attempt by President Cyril Ramaphosa’s adviser, Olive Shisana, to make sweeping changes to its draft.

A revised version was rejected by cabinet in early December and then reconsidered in January.

The approved bill will now be subjected to another “rigorous” parliamentary process, Mthembu said.

The proposed legislation will have to be considered by both the National Assembly and the National Council of Provinces, and go through public consultation before it can be implemented.

Its main aim is to launch an NHI fund that will purchase health services on behalf of patients from public and private sector providers, which will be free at the point of care.

“Once the bill has been passed, the existing draft implementation plan will be amended accordingly to give effect to the transitional arrangement of rolling out NHI in phases,” Mthembu said. He said the transition period after the bill was passed would allow for the repeal of certain pieces of legislation to enable “alignment and coherence”.

A key aspect of the bill is the future role it envisages for medical schemes, which provide coverage to about 8.9-million people.

Various stakeholders have warned that the roll-out of NHI will not succeed if the poor management of public health-care facilities persists and if the shortage of doctors and other health professionals is not addressed.

Siviwe Gwarube, the DA’s spokesperson on health, said the party was aware that neither Mkhize nor his predecessor, Aaron Motsoaeledi, engaged provinces, which are responsible for providing health services, on the bill.

“The matter has not been discussed at the National Health Council, and provincial departments have not been engaged about the additional responsibilities that the implementation of the NHI in its current form will require from them,”  Gwarube said.

She said the bill in its current form has not been costed nor has its feasibility been tested.

“All what we know is that the previous minister, Dr Aaron Motsoaledi, admitted that the R259bn price tag for NHI was a guesstimate. We are also aware that the majority of NHI pilot projects have been a spectacular failure,” Gwarube said. She said the DA would oppose the bill in its current form.