The National Education, Health and Allied Workers’ Union [NEHAWU] welcomes the conclusion of deliberations in the parliamentary committees and the scheduled debate on the National Health Insurance (NHI) Bill in the National Assembly on Tuesday, 13 June 2023.

From the early development of the National Health Insurance in South Africa Policy Paper (Green Paper) in 2011 eventually to the gazetting of the 2017 White Paper on the National Health Insurance, which were accompanied by extensive and robust public consultations and engagement processes, this development marks a progressive milestone in South Africa’s healthcare sector. This has been a long struggle towards ensuring that our society lays the foundation of building an essential service to secure dignity for all and social cohesion through the attainment of the universal health coverage, in line with the injunction in Section 27 of the Constitution.

The working class and the poor in general have endured and persevered through the HIV/AIDS epidemic and suffered still more in the subsequent COVID-19 pandemic, in the context of an unjust two-tiered healthcare system that is characterised by the maldistribution of resources. These epidemics compounded other severe burdens of the diseases afflicting our society, in which the worst brunt of these diseases is primarily borne by the working class and the rural-poor. 

NEHAWU therefore wishes the ANC and other progressive parties well in the debate and the long anticipated adoption of the bill by Parliament. We also urge parliamentarians to use these deliberations to contest reckless notions peddled by the detractors of the NHI who claim to subscribe to the vision of the universal health coverage whilst espousing positions that are inconsistent with this vision. The adoption of the bill and its assent by the President would require a practical commitment on the part of the National Treasury with the necessary allocation of resources to ensure a successful phased implementation process of the NHI. NEHAWU will continue to organise, educate and mobilise workers, communities and society at large in support of the implementation of the NHI.

We note the statement issued by the South African Medical Association (SAMA) rejecting the National Health Insurance (NHI) Bill. SAMA attended and participated in the 2nd Presidential Health Summit, held from 04 to 05 May 2023, and formed part of the stakeholders who developed the 2018 Presidential Health Compact.

The general thrust of these two Presidential initiatives focussed heavily on the framework and commitments towards the implementation of NHI. The question arises as to why did SAMA not present its rejection to the NHI during these stakeholder engagements? SAMA is an outlier in the fold of the international movement of medical associations that in both theory and practice support the universal health coverage.

SAMA’s objections particularly pertain to the abolishment of the current extortionate funding model that is propping up the profiteering private health industry. Unlike other progressive medical associations, who are actively engaged in the strengthening of the healthcare systems to ensure better clinical outcomes, SAMA fixated on the mechanisms of financial transactions, confusing what is regarded by our constitution as a right with business interests.  


Issued by NEHAWU Secretariat Zola Saphetha (General Secretary) at 082 558 5968; December Mavuso (Deputy General Secretary) at 082 558 5969; Lwazi Nkolonzi (NEHAWU National Spokesperson) at 081 558 2335 or email: