The South African Medical Association (SAMA) will meet health minister Aaron Motsoaledi to discuss the future of National Health Insurance (NHI) after finance ministerEnoch Godongwanalast week urged the parties litigating over the NHI Act to negotiate a settlement instead. SAMA is South Africa’s largest doctors’ organisation, and one of eight organisations that have separately taken legal action against the act, which was signed into law by President Cyril Ramaphosa in May 2024 but has yet to be brought into effect. “As recently as January 15 2026, SAMA met with the minister of health on separate matters, and both parties agreed to schedule a dedicated engagement on the NHI,” SAMA said in a statement on Tuesday.
“[R]eal progress on NHI can only be achieved through continued, meaningful engagement with government and key stakeholders who are integral to the healthcare ecosystem.” SAMA said it hadturned to the courtsas a last resort, after its efforts to engage through the legislative process, including submissions to parliament, petitions to the National Council of Provinces and correspondence with the president, had failed to elicit a “meaningful response”. When asked whether Motsoaledi would like to seek an out-of-court settlement on NHI, health spokesperson Foster Mohale reiterated comments made to the media last week: “The minister has noted the remarks on the NHI made by the finance minister in parliament [last week] as a proposal to all the stakeholders. Thus, if a need arises, he will engage him [Godongwana] through the relevant channels they normally use to discuss issues of government, including funding.” SAMA said it was committed to working with the government to ensure that “the reconfigured NHI achieves its goal of universal health coverage in a sustainable and equitable manner”.
Its position is in contrast to those of theother organisationschallenging the NHI Act. Those bodies showed little appetite for dropping their cases and voiced scepticism about the government’s willingness to negotiate. NHI is the ANC’s plan for achieving universal health coverage and aims to ensure all eligible patients have access to a health system that provides care that is free at the point of delivery, regardless of a person’s socioeconomic status.
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The act proposes establishing a central NHI Fund that will buy health services on behalf of patients from accredited public and private providers. In addition to SAMA, legal action has been taken by trade unionSolidarity; theBoard of Healthcare Funders(BHF) and theHealth Funders Association (HFA), representing medical schemes; the South African Private Practitioners’ Forum (SAPPF) representing specialists; the Hospital Association of South Africa (Hasa), representing private hospitals; and business lobby group Sakeliga.
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