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Speaker 1: The NHS NHI. I think the National Health Insurance Scheme

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Speaker 1: is kind of in limbo at the moment because the

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Speaker 1: President has committed to not putting into legislation any provisions

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Speaker 1: of the NHI Act until there is legal certainty, because

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Speaker 1: there are significant challenges to various aspects of the Act

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Speaker 1: on which the Constitutional Court has still to rule. So

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Speaker 1: it is sound I think that the government says, Okay,

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Speaker 1: we've got this act. We're committed to making it real

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Speaker 1: in practice, but we're not going to proceed procedurally until

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Speaker 1: we have legal But don't worry, we are still very

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Speaker 1: committed to it. Neil Kirby is head of healthcare and

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Speaker 1: Life Sciences at Worksmen's Attorneys. Neil Good, afternoon, I go ASTERNJA.

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Speaker 1: Limbo is a reasonable description of where we are with

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Speaker 1: the NHI, is it?

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Speaker 2: Yeah? I think limbo is not a bad idea. It's

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Speaker 2: not a legal term, but it's certainly one that.

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Speaker 1: I'm not a legal person, so I don't know how.

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Speaker 2: Fair enough. Yeah, As you said, there are a number

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Speaker 2: of significant legal challenges to the National Health Insurance Act

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Speaker 2: at this point in time. We're in various courts. In fact,

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Speaker 2: conceivably we're in the Hard Court, the Supreme Court and

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Speaker 2: the Constitutional Court, and where we are currently is that

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Speaker 2: there have been a number of challenges brought in the

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Speaker 2: Constitutional Court that needs to be resolved. The Constitutional Court

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Speaker 2: in turn has said to as look, I think this

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Speaker 2: is important. We're in court in night and the fifth

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Speaker 2: and as a result, in order to secure some degree

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Speaker 2: of legal certainty, both in terms of process and also

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Speaker 2: on the merits, there was an undertaking by both the

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Speaker 2: Minister of Health and the President not to bring into

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Speaker 2: force any of the provisions of the Act. Just as

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Speaker 2: a footnote to that comment, the National Health Insurance Act

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Speaker 2: is law. It's an act. It's been passed by two

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Speaker 2: houses of Parliament. So it's not as if it's not

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Speaker 2: around or it's something that is in some degree abstract.

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Speaker 2: It is law that the prerogative lives with the President

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Speaker 2: to bring into sections of the National Health Insurance Act

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Speaker 2: into force by proclamation and the government aread.

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Speaker 1: But it is sound. It seems to me, as an

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Speaker 1: outside non legal observer what Ramopausa is doing because it

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Speaker 1: is easier to change an act then reverse practical things

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Speaker 1: which have started to be done as a result of

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Speaker 1: proclaiming the Act and then having the Constitutional Court find

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Speaker 1: against key revisions of that Act. So this does seem

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Speaker 1: like a sensible approach from the presidency.

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Speaker 2: I agree. I think that's right. You know, at the

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Speaker 2: end of the day, moving in a direction where you

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Speaker 2: are trying to bring into legislation that is confronted with

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Speaker 2: legal challenges that are multiple, it just doesn't seem to

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Speaker 2: be a sensible position, not from a legal perspective only,

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Speaker 2: but from a commercial and economic perspective that you're faced

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Speaker 2: with a range of people who are saying no, don't

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Speaker 2: and you're then saying, well, I'm going to commit large

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Speaker 2: amounts of money to putting this into into action. Those two,

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Speaker 2: those two courses of action are counter productives. It doesn't

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Speaker 2: make it doesn't make sense.

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Speaker 1: I look, everybody, everybody in this citizens government, the various

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Speaker 1: parts of the provision of medical services, the various players

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Speaker 1: in the broad medical health field, say they all agree

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Speaker 1: with universal health access. They all agree that health provision

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Speaker 1: in South Africa is unequal and problematic. And you know,

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Speaker 1: this is again maybe it's not a question for a

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Speaker 1: legal person, but it's just something I can't understand why,

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Speaker 1: given our history of negotiation, why we haven't been able

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Speaker 1: to put something together which is never going to please

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Speaker 1: everybody because that's impossible with whatever you're dealing with, but

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Speaker 1: would cause less contention, political dissension, legal dissension. Then what

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Speaker 1: is on the table at the moment?

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Speaker 2: Neil, Yeah, agreed. I think that you know the overall

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Speaker 2: the overall theme here is universal access to healthcare. Now,

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Speaker 2: that's that is the most uncontentious part of this debate

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Speaker 2: because that concept is a is an international concept that

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Speaker 2: runs through a number of jurisdictions and a number of countries.

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Speaker 2: That runs through international agreements that we've that South Africa

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Speaker 2: has ratified, It runs through it runs through memorandumus incorporation

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Speaker 2: in private companies. The difficulty is that when you decide

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Speaker 2: to implement such a scheme and you put it under

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Speaker 2: that rubric, the issue is, well, okay, does that match

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Speaker 2: on all fours with our constitutional dispensation. Does that mean

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Speaker 2: that if you've decided to do it in this way,

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Speaker 2: that the Constitution is going to agree with you. That's

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Speaker 2: all we have to talk about. That This isn't some

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Speaker 2: debate about or who's doing what for whom? This is

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Speaker 2: a constitutional debate. I mean, the reason we have a

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Speaker 2: constitution is because every law that is passed by Parliament

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Speaker 2: is tested against it. That that's the point. Otherwise it'd

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Speaker 2: be a free for all. We'll be back, We'll be

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Speaker 2: back thirty years where Parliament was fundamentally also a court

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Speaker 2: and it could do as it pleased. No, no, no, no,

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Speaker 2: no no, I'm afraid not. I get the concept. I

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Speaker 2: understand the concept. I've been living with the universal access

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Speaker 2: to care for twenty years and I am required as

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Speaker 2: an officer of the Court to ensure I've taken an

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Speaker 2: oath to this effect, to uphold the Constitution.

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Speaker 1: Neil Kirby, thank you very much. Out of Healthcare and

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Speaker 1: Life Sciences at Worksmen's Attorneys