The Department of Health spent R1.3bn on the NHI project during 2025/26, despite implementation of the NHI Act being effectively paused while constitutional challenges are before the courts.
Health Director-General Thembisile Xulu told MPs that the NHI budget was R1.4bn, with spending including R7m on project management, R43m on affordable medicines and about R1.3bn on project financing. The Department maintains that implementation should proceed in phases and that preparatory work must continue.
President Cyril Ramaphosa undertook in February not to bring NHI Act provisions into operation until court cases are finalised. However, Health Minister Aaron Motsoaledi has said the department will continue preparing for –implementation. A Constitutional Court ruling could either force major delays or trigger further litigation. - MedicalBrief (6 Nov (2026)