The Minister of Health, Dr Aaron Motsoaledi, has confirmed that the department is proceeding with preparations for the implementation of the National Health Insurance (NHI) scheme, despite objections from opposition parties.
Tabling the department’s budget vote in a mini-plenary of the National Assembly, the Minister stated that one of the objectives of the 2025/26 budget is to lay a strong foundation for the improvement of the public health system in preparation for the NHI. As part of these preparations, he announced major allocations for healthcare infrastructure development to ensure clinics and hospitals are adequately equipped to meet the compliance requirements for implementing the scheme.
“One of the biggest problems that the public health system encountered and was severely criticised for is the health infrastructure. During the reporting period of the 2024/25 financial year, 47 existing clinics and community health centres, as well as 45 hospitals, were substantially revitalised, while 403 public health facilities were maintained, repaired or refurbished,” he said.
He also reported progress on new and replacement hospitals under construction, which he described as a significant step towards strengthening the public healthcare system and improving service delivery across provinces. These include the Limpopo Central Academic Hospital; Siloam District Hospital in Vhembe, Limpopo; Dihlabeng Regional Hospital in the Free State; Bambisana District Hospital and Zithulele District Hospital in the Eastern Cape; and the Bophelong Psychiatric Hospital in the North West.
“As you would know, our country has 10 central or academic hospitals. We are busy adding the 11th, which is the Limpopo Central Hospital. It is a flagship hospital for the province and the Health Sciences Faculty of the University of Limpopo. This hospital is at 26% of construction,” said the Minister.
Beyond current projects, Dr Motsoaledi said the department has prioritised building several strategically located hospital developments to strengthen South Africa’s public hospital network, especially in high-demand areas such as Gauteng and underserved regions. Seventeen major hospital projects have been identified and are in various stages of design and development.
ANC: NHI is a Vision Realised
Dr Sibongiseni Dhlomo (ANC), Chairperson of the Portfolio Committee on Health, expressed full support for the budget and the implementation of the NHI. He asserted that the NHI was not a new idea, but a long-standing vision of a united and healthier South Africa.
“The signing of the NHI Act in May last year marked a defining moment in realising the long-cherished vision of the ANC … The NHI Act embodies the dreams of our forebears. It is an inter-generational mandate that has been carried forward for centuries – now over 70 years – finally declaring in a legislative form,” he said.
Dr Dhlomo added that it was both a moral and legal responsibility of the state to ensure healthcare services are provided without discrimination, and that all people are treated with dignity and care.
MK Party Criticises Budget Priorities
Mr Moshome Motubatse (uMkhonto weSizwe Party) questioned the allocation of R850 million towards the NHI when, he claimed, 79% of health facilities were non-compliant with the scheme’s requirements. “We stand here not only to oppose the budget vote but also to reveal its shortcomings … We are being asked to approve a budget of R275.5 billion for health for the 25/26 financial year. However, when we count inflation, this budget increases by only one percent; effectively it represents a cut in real terms. This budget is not about progress, it is keeping a dying system on life support,” he said.
He also criticised the department for unfinished infrastructure projects and for redirecting R2.2 billion intended for infrastructure towards disaster relief in 2024.
DA Warns Against “Costly Distraction”
Dr Karl le Roux (DA) argued that the main problem in the public health sector is not funding, but “managerial incompetence and poor leadership at all levels of the health system and corruption. The Minister believes the NHI is a silver bullet to our challenges, but the NHI is not the only way nor is it the best way in which universal healthcare can be achieved.
He also warned that the implementation of the NHI legislation by a government that is riddled with incompetence, mismanagement and corruption at every level would be a complete disaster, not to mention the fact that it will destroy our excellent, yet unaffordable for most, private sector.
Dr le Roux further warned that NHI implementation, despite facing likely litigation over the next five to ten years, represents a harmful and costly distraction. He urged the department to shift its focus to immediate priorities.
“Leadership positions must be filled by people with the necessary skills, experience and ethics. Management must listen to clinicians on the ground about how services are improved, spend budget effectively and fight corruption – and use capacity and expertise of the private sector to help us achieve good quality universal healthcare,” he suggested.
EFF and IFP: Budget Does Not Meet the Moment
The Economic Freedom Fighters expressed doubt over the department’s infrastructure investment plans. “This budget fails to build and protect the public health system. It is far below what is required to address the structural collapse of healthcare infrastructure, to employ the thousands of healthcare workers sitting at home unemployed and to ensure that we provide quality healthcare to the poorest South Africans. Moreover, the growth of the budget is insufficient in contrast to inflation and population growth,” said the EFF’s Ms Naledi Chirwa.
She argued that the proposed NHI funds should be redirected to building more clinics and hospitals.
The Inkatha Freedom Party supported the budget but noted concerns about inflation and increased healthcare demands. “The increase is insufficient for the scale of reform that our country’s healthcare system needs,” said Ms Nompumelelo Mhlongo.
Sakhile Mokoena
10 July 2025
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