Government may not need to introduce new taxes to finance the NHI scheme for almost another decade, according to a presentation to Parliament by the Department of Health’s Deputy Director-General for NHI, Dr Nicholas Crisp. - Business Day (29 October 2025).
A 15-year phased funding model projects that new tax levies would only commence around 2033/34. Crisp predicts that “if all proposed measures are realised” R458bn would be available to finance NHI by 2037/38.
“This is a significant departure from previous targets. The 2011 Green Paper aimed for full implementation by 2025, while the NHI Act itself outlines a two-phase implementation concluding by 2028.
“It remains unclear, however, to what extent the National Treasury supports this proposal or how it would be implemented.
According to critics it is unclear how Crisp’s suggested redirection of funds - such as tax credits or civil servant subsidies,phasing out the medical scheme tax credits and funnelling conditional grants and provincial health budgets into the central NHI Fund - could be effectively ring-fenced for the NHI, as Treasury may assign them to other competing national priorities.
On 17 October Business Day reported that the Department of Health, in collaboration with the National Treasury, announced plans to establish thresholds for medical tax credits to redirect the estimated R34bn lost to the fiscus annually.