23 May 2021

NHI: Tracking the bill through Parliament


The NHI Bill was introduced to Parliament in August 2019 and is currently under consideration by the National Assembly’s Portfolio Committee on Health.

You can track the processing of the Bill here


18 May 2021: National Health Insurance (NHI) Bill: public hearings day 1

19 May 2021: National Health Insurance (NHI) Bill: public hearings day 2

20 May 2021: National Health Insurance (NHI) Bill: public hearings day 3

26 May 2021: National Health Insurance (NHI) Bill: public hearings day 4

01 June 2021: National Health Insurance (NHI) Bill: public hearings day 5

02 June 2021: National Health Insurance (NHI) Bill: public hearings day 6

15 June 2021: National Health Insurance (NHI) Bill: public hearings day 7

22 June 2021: National Health Insurance (NHI) Bill: public hearings day 8

23 June 2021: National Health Insurance (NHI) Bill: public hearings day 9

29 June 2021: National Health Insurance (NHI) Bill: public hearings day 10

30 June 2021: National Health Insurance (NHI) Bill: public hearings day 11

13 July 2021: National Health Insurance (NHI) Bill: public hearings day 12

14 July 2021: National Health Insurance (NHI) Bill: public hearings day 13

20 July 2021: National Health Insurance (NHI) Bill: public hearings day 14

21 July 2021: National Health Insurance (NHI) Bill: public hearings day 15

27 July 2021: National Health Insurance (NHI) Bill: public hearings day 16

28 July 2021: National Health Insurance (NHI) Bill: public hearings day 17

31 August 2021: National Health Insurance (NHI) Bill: public hearings day 18

10 September 2021: National Health Insurance (NHI) Bill: public hearings day 19, with Deputy Minister

According to the government, the NHI aims to achieve the following principles:

-The right to access health care: The NHI would ensure access to health care, as it was considered to be an important service which the State must be able to provide.

-Social Solidarity: The NHI would provide financial risk pooling to enable cross-subsidisation between young and old, rich and poor, as well as the healthy and the sick. This would mean people taking care of each other as South Africans. The solidarity principle would also serve as a guide towards the development of the NHI.

-Equity:  The NHI would ensure a fair and just health care system for all. Those who were ill should get services first.

-Health Care As A Public Good:  Health care should be seen as a social investment and not as a commodity of trade to be sold for profit.

-Affordability:  Health services should be procured at a reasonable cost. Should the cost be prohibitive, this could lead to the NHI not being able to offer health care to the whole country.

-Efficiency: Health care resources should be allocated and utilized in a manner that optimised value for money. The HLP had made it very clear that resources allocated to the NHI should be used appropriately.

-Effectiveness:  The health care interventions covered by the NHI would result in desired and expected outcomes in everyday settings. South Africans traveling through the country and in a need of health care, would see that the same treatment one would receive in Dzidane would not be inferior to the treatment received in the Western Cape.

-Appropriateness:  Health care services would be delivered at appropriate levels of care through innovative service delivery models and would be tailored to local needs. The health care services should take into account the cultural and social requirements within a particular area.

Meanwhile, there are some concerns about how the NHI will be funded and implemented.

The Portfolio Committee invited stakeholders and interested parties to submit written submissions on the Bill from 30 August to 29 December 2019.

At the same time, public hearings on the bill were carried out in Mpumalanga from 25-28 October 2018, in the Northern Cape from 1-4 November 2018, in Limpopo from 15-18 November 2018, in KwaZulu-Natal from 22-25 November 2018 and the Eastern Cape from 29 November-02 December. Hearings in the remaining provinces – Gauteng, Western Cape, Free State and North West - were concluded in 2020. See programme here

See the public hearing programmes here and here

Ahead of the public hearings, PMG interviewed the Committee Chairperson. Read the interview here

Watch the public hearings below:

Eastern Cape Public hearing: https://www.youtube.com/watch?v=WXqlxrKHOT4

KZN Public hearing: https://www.youtube.com/watch?v=mbg8wcG71PI

Limpopo Public Hearing: https://www.youtube.com/watch?v=8CBfJRoLhMo&t=22s

Northern Cape Public Hearing:  https://www.youtube.com/watch?v=kv0LkIj74Rw

Mpumalanga Public Hearing: https://www.youtube.com/watch?v=bgPYRrBFwxQ

Free State Public Hearing: https://www.youtube.com/watch?v=mUF3C1QS6hQ

North West Public Hearing: https://www.youtube.com/watch?v=ESMM9ZLj6XA

Western Cape Public Hearing: https://www.youtube.com/watch?v=Aq1QRfTCO1I

The Bill was long in the making as ideas to reform healthcare financing in South Africa are not new and date as far back as the late 1920s. We traced the historical timeline of the Bill (only looking at the democratic dispensation) and highlighted key dates and events.

You can also review the relevant policy documents and submissions at the NHI Library (source: Collaboration for Health Systems Analysis and Innovation (CHESAI))

Find the August 2019 NHI District Pilot Evaluation Report here


Here is a sample of the written submissions:


Section 27 and TAC Submission

HSF Submission

Medecins Sans Frontieres (Doctors without Borders) Submission

SA Medical Association Submission

Outa Submission

Dullah Omar Institute


You can look back at some of the previous and recent parliamentary meetings on the NHI:

16 March 1998: White Paper on transformation of the health system in South Africa: hearings

25 June 2002: Social Health Insurance Policy Development: briefing

7 June 2005: Social Health Insurance: Department briefing

16 August 2011: National Health Insurance Green Paper; Safety and Security in public hospitals: Departmental briefings

23 August 2011: National Health Insurance follow up, Childhood Cancer Foundation on challenges & solutions, Directorate of Radiation Control progress report

24 July 2013: National Health Insurance Pilot Project: progress report from Department of Health; & challenge assessment by Department of Performance Monitoring and Evaluation

26 February 2014: Preparations for National Health Insurance (NHI) pilot districts: briefing by Minister of Health

21 August 2015: National Health Insurance (NHI) Pilot Districts: progress report by Minister of Health

7 November 2018: High Level Panel Recommendations for Health Sector: Prof Shisana briefing

6 June 2018: Hospitals: Western Cape & Gauteng Departments of Health

13 June 2018: Hospitals: Northern Cape, Limpopo, Free State, KZN Departments of Health

12 June 2018: Hospitals: Mpumalanga, Eastern Cape & Gauteng Departments of Health


Parliament Media Statements

Health Committee Concludes First Phase of Public Participation on NHI Bill (25 Feb 2020 11:48am)

Quality Healthcare Before Profit, Say Gauteng Residents at Hearings on NHI Bill (24 Feb 2020 12:55pm)

Mogale City Residents Call for the Immediate Implementation of NHI (23 Feb 2020 11:18am)

Tshwane Residents Support NHI Bill for the Purposes of Achievement of Equal Access to Healthcare Services for All (22 Feb 2020 10:08am)

Soshanguve Kicks off Gauteng Province’s Public Hearings on NHI (20 Feb 2020 2:13pm)

Health Committee to Undertake Final NHI Hearings in Gauteng (17 Feb 2020 3:10pm)

Views for and Against the NHI Bill Reached Equilibrium in the Central Karoo and Garden Route Districts (9 Feb 2020 4:53pm)

Cape Metro Residents Come out in Numbers to Voice Their Opinions on NHI (6 Feb 2020 8:54pm)

Residents of the City of Cape Town Metro Express Optimism about the NHI (6 Feb 2020 5:40pm)

Committee Hears That NHI Is Much Needed in the West Coast District (5 Feb 2020 12:50pm)

North West’s Rustenburg Residents Express Mixed Views on NHI (1 Feb 2020 9:09am)

People of the Free State Have High Hopes on NHI (31 Jan 2020 9:44am)

Mangaung Residents Call for Resolution of Impediments to Better Healthcare (30 Jan 2020 10:11am)

Bloemfontein Residents Want NHI, but Call for Urgent Fixing of Healthcare System (28 Jan 2020 10:14am)

Nelson Mandela Bay Residents Support NHI Bill (4 Dec 2019 4:43pm)

Implementation of NHI Should Have Started Yesterday’ (4 Dec 2019 10:14am)

Eastern Cape Residents Call for Urgent Implementation of NHI (3 Dec 2019 2:20pm)

Committee Chairperson Appreciates Hard Work and Dedication of All Role-Players on NHI Bill Public Hearings (2 Dec 2019 2:50pm)

Committee on Health Commends the People of KZN for Meaningful Participation on NHI Bill (25 Nov 2019 9:07pm)

Health Committee Pleased with Sunday Nhi Public Hearings Turnout (24 Nov 2019 4:45pm)

NHI Bill Receives Thumbs up in Limpopo Province (21 Nov 2019 1:00pm)

Limpopo Province Overwhelmingly Welcomes NHI Bill (18 Nov 2019 9:25pm)

NHI Bill Receives Thumbs up in Limpopo’s Thulamela Local Municipality (16 Nov 2019 11:31am)

Committee Concludes Public Hearings on NHI Bill in the Northern Cape (5 Nov 2019 9:51am)

Upington Communities Urge Committee to Accelerate NHI Bill Law Making Process (4 Nov 2019 12:28pm)

Residents of Upington Calls for a Speedy Implementation of the NHI (4 Nov 2019 1:53pm)

De Aar Communities Say NHI Bill Must Address Poor Health Facilities (4 Nov 2019 1:47pm)

Public Hearings on NHI Move to Dawid Kruiper Local Municipality in Upington (2 Nov 2019 6:10pm)

Sol Plaatjie Residents Hope That NHI Will Close the Gap Between the Rich and the Poor (2 Nov 2019 11:10am)

People with Disabilities Have High Hopes for NHI in Gert Sibande District Municipality (29 Oct 2019 2:45pm)

Traditional Healers of Thembisile Hani Local Municipality Call for Inclusive NHI (28 Oct 2019 7:10am)

Traditional Healers in Thembisile Hani Municipality Say NHI Bill Is Silent about Them (28 Oct 2019 3:39pm)

Mpumalanga’s Nkomazi Residents Support NHI Bill (28 Oct 2019 1:25pm)

NHI Raises Hopes of Bushbuckridge Residents (28 Oct 2019 12:30pm)

Bushbuckridge People Urge Committee to Accelerate Nhi Law Making Process (27 Oct 2019 6:28am)

Nkomazi Residents Welcome NHI Bill (25 Oct 2019 10:02pm)



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