Speculation over why National Council of Provinces postponed NHI Bill vote

Posted on

The National Council of Provinces (NCOP) yesterday decided to delay its vote on the National Health Insurance (NHI) Bill by a week.

The NCOP was scheduled to vote on the Bill after the House’s Select Committee on Health and Social Welfare approved the Bill last week without making any changes to the version submitted to it by the National Assembly in June.

News24 reported that the chairperson of the NCOP, Amos Masondo, received a letter asking that the vote be rescheduled. It was not stated who sent the letter.

The report said the ANC’s Chief Whip in the NCOP, Seiso Mohai, tabled an amendment to allow the debate to continue on 6 December. Eight of the nine provinces supported the motion except for the Western Cape.

There is speculation over what prompted the decision to delay the vote.

The Daily Maverick quoted Parliamentary spokesperson Moloto Mothapo as saying the rescheduling was the result of “programming-related issues”. “Such rearrangements are not uncommon as part of parliamentary programming,” he said.

It also quoted the DA’s Chief Whip, Siviwe Gwarube, as saying: “It’s unthinkable the national legislature is dictated to by some mysterious forces. It cannot be that at the 11th hour an order is removed … on the basis of a letter that the NCOP chairperson refuses to share.”

Business Live cited Deputy Health Minister Sibongiseni Dhlomo as saying there was a delay in the Western Cape submitting its final position on the Bill, so the NCOP’s Select Committee submitted its report on the Bill to the House only on Tuesday. The NCOP may have needed more time to consider the report before it voted on the Bill.

Lobbying by organised business

It is believed the decision to delay the vote may be linked to lobbying earlier in the week by Business Unity South Africa (Busa) and Business for South Africa (B4SA).

In a joint statement on Monday, Busa and B4SA said they sent letters to the presiding officers of the NCOP and Deputy President Paul Mashatile – in his capacity as leader of government business in Parliament – requesting the Bill be sent back to the Select Committee for proper engagement with the comments and amendments that stakeholders put forward.

“No consideration was given by the Select Committee to the many constitutional issues, both procedural and substantive, in the Bill, which were raised by four provinces and a wide range of stakeholders. This amounts to a serious and significant procedural lapse and a violation and disregard of Parliament’s own public participation model, fundamentally undermining the principles of participatory democracy on which our Constitution is based,” the two organisations said.

The statement quoted Busa’s chief executive, Cas Coovadia, as saying: “For the National Assembly and the NCOP to disregard proposed amendments that will have a beneficial and tangible impact on citizens, or indeed would prevent harm to citizens, in the interest of rushing the Bill through Parliament, is unconstitutional. It makes a mockery of due process and portrays the NCOP as nothing more than a rubber stamp.”

Click here to read the full statement.

Busa and B4SA yesterday welcomed the postponement of the NCOP’s vote on the Bill.

The organisations said they will continue to engage government “on the substantive and procedural constitutional shortcomings of the Bill, to ensure these concerns are addressed.

But the Congress of South African Trade Unions said it was “deeply dismayed” the government “wilted like a cheap suit under pressure from a little bit of lobbying by business” to delay the passage of the Bill.

“Pandering to the vested interests of private industry’s insatiable lust for profits at the expense of the health of millions of ordinary South Africans marks a dark day in our democracy,” Cosatu said in a statement yesterday.

Doctors call for critical amendments

Organised business is not alone in challenging the legislature for not amending the Bill to account for submissions from stakeholders.

Also on Monday, the SA Health Professionals Collective (SAHPA) – an alliance of nine medical and allied healthcare practitioners’ associations, representing 25 000 doctors – issued a statement saying it was “concerned that the Bill’s hasty progression through the legislative process, without taking into account the diverse perspectives and expert insights delivered through numerous prior expert submissions, is a lost opportunity to put the country on a pathway to quality healthcare for all”.

Simon Strachan, a spokesman for the SAHPC and the chief executive of the SA Private Practitioners Forum, said the potential consequences of rushing through the Bill without critical amendments “are far-reaching and will further undermine the country’s ability to deliver quality healthcare to the very patients it seeks to protect”.

The SAHPA does believe this version of the Bill is in the interests of patients.

But will the president sign it?

Once it has been approved by the NCOP, the Bill will be referred to President Cyril Ramaphosa, who can either sign it into law or request lawmakers to amend it.

The Daily Maverick reported: “The possibility of the NHI Bill being returned to Parliament was signalled on Wednesday when, at a media briefing, Presidency spokesperson Vincent Magwenya was asked about the Bill and organised business’s eleventh-hour lobbying.”

News24 quoted Magwenya as saying: “Concerns have been expressed directly to the president [about] certain parts of the Bill. Once the Bill has been passed, the president still has a constitutional imperative in processing that Bill before he signs it. He will look at the process. One of the things he will look at is, has there been sufficient consultation and if so, have those consultations sufficiently addressed the issues of concern.”

Magwenya said it was not a given that the president will sign every Bill he receives. “If he so desires, he can open another round of consultation to satisfy himself that what he will sign will not be subjected to endless litigation,” he was quoted saying.

“The passing of the Bill does not necessarily mark the end of the process,” he said.

Solidarity and the DA have said they will challenge the constitutionality of the NHI Act if it is promulgated in its current form.