HFA welcomes Minister Godongwana’s call for collaboration on NHI and

urges an urgent focus on primary healthcare, the backbone to achieving UHC

The Health Funders Association (HFA) welcomes Minister of Finance Enoch Godongwana’s call for the various legal challenges to the National Health Insurance (NHI) Act to be addressed through engagement, collaboration and possible settlement, rather than lengthy court processes.

Speaking in Parliament this week, the Minister noted legal action may delay progress, and urged parties to “meet, and craft a settlement”.

HFA has consistently supported and advocated for constructive, solutions-driven approaches to health reform. As a representative organisation for medical schemes and medical scheme administrators, collectively representing 45% of all medical scheme members, HFA is committed to working with government, healthcare professionals, organised labour and all stakeholders to strengthen South Africa’s health system.

HFA’s decision to pursue legal action against the NHI Act was not taken lightly and followed years of making constructive inputs (along with many other stakeholders), which were ignored. Litigation was undertaken as a last resort, out of concern for the sustainability and stability of South Africa’s health system. 

“HFA fully supports the goal of NHI and is committed to building a more equitable health system,” said Thoneshan Naidoo, CEO of the Health Funders Association. “However, we must be realistic about what will work in practice. To achieve Universal Health Coverage (UHC), we need a plan that is implementable, financially sustainable, and leverage what is already working well in both the public and private sectors.”

Throughout the development of the NHI Act, HFA submitted detailed recommendations for collaborative and sustainable interventions that would strengthen the health system and accelerate the achievement of UHC in a more constructive and equitable manner than is currently outlined in the Act.

In addition, HFA has developed and submitted a comprehensive proposal outlining an alternative path to UHC — one that can be implemented more quickly and efficiently than the current trajectory. This approach proposes a hybrid, multi-fund model that builds on the NHI Fund, incorporates global best practice, and preserves what is already effective within South Africa’s healthcare system.

“Our proposal uses the existing available tools to expand access faster — while ensuring reforms that protect households from financial ruin, improve quality and avoids disruption that would leave people worse off,” adds Naidoo.

HFA believes that the path to UHC must prioritise the urgent expansion of good quality primary and preventive healthcare, through both the public and private sectors, as this is the most effective way to improve population health outcomes. This would act as a stepping-stone to NHI, while reducing out-of-pocket spending and relieving pressure on public hospitals.

“HFA is ready to engage in good faith,” concluded Naidoo. “Collaboration and utilising the excellence that exists in both the public and private sectors is how we can build a health system that works for everyone.”