Parliament has moved to defend its handling of the National Health Insurance (NHI) legislative process after a Constitutional Court (ConCourt) judge raised concerns that the public participation phase appeared to have been rushed.
The apex court on Wednesday, 6 May 2026, heard arguments from parliament and the Western Cape government in a case challenging the constitutionality and validity of the NHI Act.
Western Cape challenge over NHI public participation
Western Cape Premier Alan Winde brought the application, arguing that parliament – specifically the National Council of Provinces (NCOP) – failed to properly consider the views of Western Cape residents during deliberations on the NHI Bill.
According to the province, the NCOP’s Select Committee on Health and Social Services set a timetable it described as “unreasonable and inflexible“, which limited the time available for public submissions in November 2023.
The provincial government further argued that its request for an extension was rejected by the select committee as MPs pushed to finalise the legislation before the end of that year.
On that basis, the Western Cape contends that the NCOP did not meet its constitutional obligation to facilitate “meaningful” public participation in the legislative process.
ConCourt judge questions whether process was ‘rushed’
During Wednesday’s proceedings, a ConCourt judge directly questioned parliament’s legal representative, Advocate Ngwako Hamilton Maenetje, on whether the process had been unnecessarily hurried.
“The entire process in the NCOP to that in the National Assembly, this one in the NCOP seems rather rushed.
“It was initially a six-week cycle, but it ended up being an eight-week cycle. What was the rush?” the judge asked.
In response, Maenetje argued that determining whether there was a “rush” requires examining the timetable’s consequences rather than the schedule alone.
“If the consequence was that the public were not able to have proper meetings, they had short notices, and they didn’t have enough time, and they were not able to express their views properly, then that is a [rushed] process.
“So the timetable itself must have the consequence of prejudicing the provincial public participation process,” he said.
Maenetje maintained that such consequences were not evident in the current case.
“One looks at the adequacy of the timetable only through the lens of the request by the Western Cape, because no one else made those requests [for an extension].”
Watch the proceedings below:
The lawyer also addressed concerns raised about Gauteng’s public participation report, which was not submitted or considered by the NCOP, according to the Western Cape government.
“The Gauteng [government] doesn’t say if the time was longer, we would have produced a report.
“They just did not do their work in compiling a report. But when you look at it through the lens of the Western Cape, it is not unreasonable.
“And we submit with great respect, it is the conduct of the Western Cape that put it in the position in which it ultimately found itself.”
NHI legislation
The NHI legislation had been several years in the making, having first been tabled in parliament in 2019.
The National Assembly passed the bill in June 2023, with the NCOP later giving its approval in December of the same year.
President Cyril Ramaphosa formally enacted the law in May 2024.
However, despite being signed off, the NHI rollout is yet to begin, largely due to a series of legal challenges.
