On 18 May the Constitutional Court (ConCourt) ruled that Sections 36 to 40 (including the Certificate of Need) of the NHI Act is unconstitutional and failed to provide a rational and lawful mechanism for improving access to healthcare.
“Although the NHI Act does not specifically address the CoN, the ruling is widely seen as a setback to the government’s broader NHI plans and could have broader implications for ongoing legal challenges to the Act. - Business Day Editorial (22 May 2026)
“Several critics have argued that the Act lacks sufficient detail on key issues, including how the NHI Fund will be financed, what benefits it will cover, and how healthcare providers will contract with the state-controlled fund.
“Despite the ruling, the health department has indicated it still intends to pursue some form of certificate-of-need system. “