Note to Editors: English and Afrikaans voicenotes from the DA Leader, Geordin Hill-Lewis.
The DA government in the Western Cape is today before the Constitutional Court to defend both the Constitution and the principle that better healthcare is built through good governance, not centralised control.
The Western Cape Government’s Constitutional Court case argues that major reform cannot be pushed through Parliament as a box-ticking exercise.
Public participation must mean listening, considering, engaging and remaining open to persuasion, especially where legislation affects provincial powers, patients, healthcare professionals, taxpayers and the future of the entire health system.
This case is not about whether South Africans deserve better healthcare. They do.
Every South African, regardless of income, race, province or background, deserves access to dignified, reliable and excellent healthcare.
The question before the country is whether an unaffordable and centralised funding model is the right way to achieve that goal.
We do not believe it is.
South Africa cannot build a better healthcare system by centralising enormous power, money and decision-making in a national state that has repeatedly failed to manage the responsibilities it already has.
The lesson of state capture, failing hospitals, broken procurement systems and collapsing public services is clear that concentration of power without competence does not produce better health outcomes.
It simply produces failure at a larger scale. In the DA-governed Western Cape life expectancy is 67.6 years for men and 72.2 years for women, above the national figures of 64.0 and 69.6 respectively.
In the Free State, life expectancy falls to 57.3 years for men and 64.2 years for women. A ten-year life expectancy gap is the clearest possible proof that healthcare is ultimately a governance and accountability issue.
The good government case against the NHI is that before national government asks South Africans to trust it with a vast new healthcare fund, it must first prove that it can manage the health system it already controls. That means running hospitals properly, keeping clinics stocked with medicine, appointing competent managers, paying suppliers on time, preventing corruption, and treating patients with dignity.
The NHI Act also threatens the hard-earned security of millions of working and middle-class South Africans.
These are not wealthy elites. They are teachers, nurses, police officers, small business owners, young professionals, pensioners and working parents who already pay tax, VAT, school fees, security costs and, in many cases, private healthcare because the state has failed to provide reliable services.
A government that has failed to fix public healthcare has no moral right to make these families less secure without a credible guarantee that healthcare will improve for everyone.
The goal must be to lift all South Africans up, not to level everyone down.
South Africans deserve healthcare reform that is practical, lawful, affordable and grounded in good governance. Healthcare is too important to be built on wishful thinking.