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The Constitutional Court has declared a key section of the National Health Insurance (NHI) Act unconstitutional, which will give succour to the scheme’s opponents.

Earlier today, the Constitutional Court declared that the sections of the NHI Act, which would require doctors to secure a “certificate of need” (CoN) before they would be able to set up a practice in a certain area, was unconstitutional.

According to the NHI Act, medical providers would have to secure this certificate from the government before they could establish, expand, or continue operating in specific geographic areas.

That particular section of the NHI Act had already been declared “irrational, unconstitutional, and procedurally unfair” in 2024 and this Constitutional Court ruling confirmed it.

In a unanimous judgement the Constitutional Court confirmed the 2024 ruling as it was an unjustifiable limit on an individual’s right to choose a trade, occupation, or profession freely.

The issue of the CoN had been challenged by a trade union, Solidarity, and other organisations, including the Hospital Association of South Africa and the South African Private Practitioners’ Forum.

In a statement, Anton van der Bijl, the deputy CEO of Solidarity, said: “One of the NHI’s central pillars has collapsed today. The certificate of need was far more than merely an administrative instrument. It was an instrument of centralisation and state control. The government wanted to move health practitioners around like its own pawns on a chessboard to cover up its own failures. Today the court said that South Africans are not state property and professionals are not pawns of the government.”