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04 June 2024 | Story Dr Larisse Prinsen | Photo Supplied
Dr Larisse Prinsen
Dr Larisse Prinsen is Senior Lecturer in the Department of Public Law at the University of the Free State (UFS).

Opinion article by Dr Larisse Prinsen, Department of Public Law, Faculty of Law, University of the Free State


On 15 May 2024, the National Health Insurance (NHI) Bill was signed into law by President Ramaphosa during a public ceremony. This did not come as a surprise as Minister in the Presidency, Khumbudzo Ntshavheni, had already stated in January that enactment would take place before the 2024 elections. Universal access to health care is an ANC promise, after all, which has led to some calling this public display – as well as the remarks made before the signing – electioneering, considering the closeness of the election to be held at the end of the month.

Now that the Bill has become an Act, however, its actual real-life implementation may be stalled for some time. As the President himself stated during the signing ceremony, the Act is to be implemented in stages. This could potentially take many years if the example of the previous, pivotal piece of health-related legislation, the National Health Act – which took more than a decade to become fully operational – is anything to go by. Each stage of implementation will also bring the potential for a slew of unique legal challenges for the Act and its implementation.

Legislation that could combat the implementation of the NHI Act

There is also the issue of the missing money bill. An Act such as the NHI Act, which has massive financial and economic ramifications, should be accompanied by a money bill drafted by the National Treasury, setting out the financial aspects of the primary Act. So far, no money bill has been drafted, which pauses the implementation of the NHI Act. Should the implementation of the NHI proceed without clarification of the rand-and-cent aspects, legal challenges may be brought.

Further pieces of legislation that could possibly be used to combat the implementation of the NHI Act include the Consumer Protection Act, which aims to establish and protect consumer rights, such as the right to quality goods and services and to select the supplier of your choice; the Competition Act, which fights against restrictive practices and the abuse of a dominant position; or the Protection of Personal Information Act, which may have implications for the large gathering of personal information that will be necessary for the NHI system to be workable. Another notable piece of legislation to consider is the Promotion of Administrative Justice Act.

Various constitutional challenges

Various constitutional challenges are also rumoured to be in the pipeline, with Solidarity, the Democratic Alliance, the Health Funders Association, the South African Medical Association, the Board of Healthcare Funders, the South African Health Professionals Collaboration, as well as Business Unity South Africa all having previously suggested that they may consider, or outright declaring that they will take legal action against the Act as soon as Ramaphosa’s ‘special pen’ touches paper.

The NHI Act may be constitutionally challenged on various grounds. To start with, there are concerns regarding the rule of law’s requirement that the law be clear, unambiguous, and not vague. The lack of clarity on the benefits and cover provided by the NHI scheme has raised many issues. Not only is the ‘what will be covered?’ but also the ‘who will be covered?’ unclear. This not only constitutes legislative vagueness, but this uncertainty also makes it almost impossible to apply our system of checks and balances whereby a determination may be made whether the State is truly adhering to its mandate in Section 27 of the Constitution to take progressive steps to realise the rights enshrined in the Bill of RightsLitigation may also be instituted based on arguments that Section 33 of the NHI Act, which may lead to the demise of medical aid schemes, is unconstitutional and that it limits the constitutional provision of access to health-care services. In terms of the limitation clause of the Constitution, a limitation is only justified when, among other requirements, there are no less restrictive measures by which the purpose of the limitation may be achieved. Challenges could also be brought against the NHI Act based on nonadherence to requirements of procedural fairness and the principles of participatory democracy, as the consultation processes preceding the enactment have largely been labelled as mere lip service to consultation requirements without having seriously considered the various concerns, objections, submissions, and comments, and even blatantly dismissing them. Other possible causes of action are related to the infringement of the right to autonomy, privacy, association, freedom of expression, as well as freedom of trade, occupation, and profession.

Law and health care intersect

As the ink dries on the NHI Act, the stage is set for many legal dramas to unfold, indicating that the Act’s destiny will be decided by a gavel rather than a pen. While the ceremonial signing marked a historical milestone in the attempt to promote equality in South Africa, the road to implementation is fraught with challenges. With no accompanying money bill in sight and a landscape ripe for constitutional scrutiny, the Act's journey forward is likely to be tumultuous. As stakeholders gear up to challenge its provisions on various fronts – from procedural fairness to constitutional rights – the NHI Act is poised to become a battleground where the nuances of law and health care intersect. As the curtains rise on this legal saga, the true test of the Act's viability and constitutionality awaits.

More institutional experts can be found at: https://www.ufs.ac.za/media/leading-researchers

News Archive

Parking at UFS for visitors
2007-11-10

UFS creates more parking for visitors

In its effort to make it easier for visitors to park on the Main Campus of the University of the Free State (UFS) in Bloemfontein, two paid parking areas will be put into operation as from Monday, 5 November 2007.

These parking areas are part of a comprehensive new parking strategy of the UFS, which is being implemented since September 2007. As part of the strategy, areas of the central campus have been reserved for staff and visitors and hundreds of new parking areas were developed for students at the entrance in Wynand Mouton Avenue (at the Faculty of Health Sciences) and the entrance in DF Malherbe Avenue (at the Agriculture Building).

“The paid parking areas for visitors, which are as close as possible to the busy and largely closed-off central campus, were created as an additional service to visitors,” said Ms Edma Pelzer, Director of Physical Resources at the UFS.

According to Ms Pelzer, persons who attend meetings, seminars or short courses, visiting colleagues, consultants, service providers, family of students and staff members, clients, etc. can make use of this parking.

“We have found that it is often difficult for visitors to obtain parking in or close to the central campus. Now they will have a choice to either park in the visitors parking areas at a minimal fee or to park in any of the open unreserved parking areas on campus,” said Ms Pelzer.

The areas, which will be closed off behind booms on weekdays from 06:00 until 18:00, are situated to the eastern side of the “Red Square”, east of the CR Swart and Idalia Loots Buildings and west of Campus Avenue North between the Psychology and the Flippie Groenewoud Buildings.


Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za  
2 November 2007

Parking for visitors: Important notice:

As from Monday 5 November 2007 two paid parking areas on the UFS Campus will be put into operation. The areas will be closed off behind booms on weekdays from 06:00 until 18:00. These will be manned and R3 per hour will be charged.
 

The following areas are involved:

  • P3: The area to the east of the “Red Square”, east of the CR Swart and Idalia Loots Buildings.

     
  • P6: The area to the east of Campus Avenue North between the Psychology and Flippie Groenewoud Buildings.

    The friendly co-operation of users of motor vehicles on campus is requested to allow this implementation to proceed as smoothly as possible.

Parking for visitors: More information

The strategy to create paid parking areas for visitors

The decision to reserve areas in the central campus areas for the convenience of visitors was taken as part of the comprehensive new parking strategy of the UFS approved by the Executive Management in May 2007 and which is being implemented since September.

All visitors need not park in these areas. Visitors may park for free on any open (unreserved) parking bay on campus. These paid parking areas for visitors, as close as possible to the busy and largely closed-off central campus, have been created as an additional service to visitors.

The strategy to close off parts of the central campus for staff members and visitors was implemented after sufficient alternative parking areas had been developed for students.

What is meant by the term “visitors”?

It includes all persons who are not students of staff members of the UFS and who visit the campus for one reason or another. Persons who attend meetings, seminars or short courses, visiting colleagues, consultants, service providers, family of students and staff members, et cetera are included.

As at present, it will, of course, be possible to make special arrangements with Protection Services to make it possible for VIP visitors to park as near as possible to their destinations.

No student or staff member will be actively prevented from parking in the area. They will, however, be discouraged by the fact that R3 per hour will be charged without exception.

The visitors’ parking area and access to it

  • P3: The area to the east of the “Red Square”, east of the CR Swart and Idalia Loots Buildings. The area is within easy walking distance for visitors to, among others, the following buildings: George du Toit Administration Building, Theology Building, Idalia Loots Building, CR Swart Building, Johannes Brill Building, Van der Merwe Scholz Hall.

    The area is conveniently accessible from the following entrances: Nelson Mandela Drive, Groenewoud Street and Wynand Mouton Drive.

     
  • P6: The area to the west of Campus Avenue North, between the Psychology and Flippie Groenewoud Buildings. The area is within easy walking distance for visitors to all the academic buildings in the central campus, such as the Chemistry Building, Stef Coetzee Building, the Geography Building, et cetera and located directly opposite the general information point on the Thakaneng Bridge.

    The area is conveniently accessible from the following entrances: Fürstenburg Road and DF Malherbe Avenue (at the Agriculture Building).

     

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