Wednesday, 9 July 2025
House Chairperson
Minister, Aaron Motsoaledi
Deputy Minister, Joe Phaahla
Distinguished guests
Honourable Members,
The signing of the NHI Act by President Cyril Ramaphosa in May last year marked a defining moment in realising a long-cherished vision of the African National Congress, which dates back as far as 1943, through the African Claims, where our forebears envisioned a just and equitable system that caters to all without discrimination. That vision found resonance in 1955 when the Congress of the People in Kliptown adopted the Freedom Charter, which boldly declared:
“A preventive health scheme shall be run by the state; Free medical care and hospitalisation shall be provided for all, with special care for mothers and young children”.
This is an illustration of how the concept of the NHI is not a new one. The signing of the NHI into law represented the long-awaited restoration of a vision for a united and healthier South Africa. The NHI Act embodies the dreams of Alfred Xuma, Charlotte Maxeke, Oliver Tambo, Lilian Ngoyi and all our forebears. It is an intergenerational mandate that has been carried forward for centuries and is now, over 80 years later, finally declared in legislative form.
Honourable Members,
As we celebrate the 70th anniversary of the Freedom Charter, we are reminded of how its essence has shaped our democratic dispensation through fundamental clauses which declare that:
- All National Groups (not just some but ALL) shall have Equal Rights!
- All Shall Enjoy Equal Human Rights!
These values are the bedrock on which our Constitution was founded, which culminated in the Bill of Rights and Section 27 of the Constitution, which declared that
“Everyone has the right to have access to health care services”.
Therefore, it is both the moral and legal responsibility of the state not to discriminate in the provision of health but to ensure all in need are treated with dignity and care. This is also aligned with our African identity as captured in the spirit of Ubuntu, which teaches us to treat the next person with respect and humanity because Umntu Ngumntu Ngabantu, meaning I am because you are. As the ANC, this is what has informed our conceptualization and approach to the NHI and our aspirations for Universal Health Coverage.
Honourable Members,
High-quality and compliant infrastructure is an integral part of transforming our healthcare system. We therefore welcome the allocation of R7.2 billion to the health facilities revitalisation grants, as well as the combined R3 billion earmarked for the Limpopo Central Academic Hospital and Siloam District Hospital.
Our clinics and hospitals must not merely exist; they must be equipped and maintained to ideal standards. We therefore support the 2025/26 target of 2,800 primary healthcare facilities achieving ideal clinic standards, as well as the maintenance, repair, and refurbishment of up to 550 public health facilities annually.
Honourable Members,
We commend the work of the Section 59 report, which was led by Advocate Tembeka Ngcukaitobi, on allegations of unfair racial discrimination and procedural unfairness by medical schemes. The findings revealed that black healthcare professionals were more likely to be investigated, found guilty and penalised by medical aid schemes.
In 2022, Medical Aid Schemes collected R218 billion, where the lion’s share of the fund went to:
- Private institutions with R77 billion (35%)
- Specialists R59 billion (27%)
- Pharmaceuticals R33 billion (15%)
- R18.9 billion (8.6%) was paid to administration – people who provide no health care
- GPs and Black GPs who were followed for possible fraud, wastage and corruption received only R5.3 billion (5.2%) of the cake.
A situation like this would not have arisen in a country like the People’s Republic of Cuba – a country that values all human lives and has universal health coverage. The report endorses the correctness of the NHI Act.
Minister, the final report of the Section 59 investigation, together with the Health Marketing Inquiry, must support you against those who are taking the government to court on the NHI Act. Both reports debunk the myth that says, “Fix the public sector and leave the private health sector alone”, as they expose the deep structural and systemic challenges within the private healthcare sector.
Minister, we are also encouraged by the fact that you promptly made yourself available to be briefed as soon as the report was finalised. This is a testament to the responsiveness of the ANC-led government in addressing matters that hinder the transformation of our healthcare system. I also appreciate that through my discussion with you, you will be available to table the report to the Portfolio Committee on Health for this coming Friday, 11 July 2025. It might also be imperative for you to be accompanied by the Council for Medical Schemes, as some of the Section 59 investigation reports are applicable to them.
Being the largest representative body, the South African Medical Association was expected to represent doctors, including black GPs, but became a bystander instead of leading this process that brought this damming report about certain medical aid schemes. The South African Medical Association has failed to champion the interests of its members.
House Chairperson,
South Africans must understand that when some political parties reject this budget, in reality, it means they are rejecting the payment of salaries to doctors, nurses, and other health professionals who tirelessly care for our people daily. Professionals who rely on this income to support themselves and their families. By rejecting this budget, these political parties will be saying we must not make funds available to address the unemployment of doctors and other healthcare professionals. Rejecting this budget means rejecting the procurement of much-needed medication, as well as the upgrading and construction of health infrastructure that will strengthen the provision of quality and dignified care to our people. To reject this budget is to reject the people of this republic and the right to better health care.
As the ANC, we stand with South Africans and support this budget towards the realisation of a united, quality, and equitable healthcare system, where no one is left behind.
Thank you.