As 2026 approaches, SA’s healthcare system remains strained, caught between scientific progress and persistent financial and administrative instability. - Marcus Low in Spotlight (8 Dec 2025)
The NHI remains locked in legal and political conflict, with eight court challenges currently contesting the Act. However, Health Minister Dr Aaron Motsoaledi has refused to revisit the legislation, despite calls for compromise. Although Finance Minister Enoch Godongwana announced an improved health budget in May, chronic underfunding persists at provincial level, leaving critical posts unfilled.
Meanwhile, the proposed scrappimg of medical tax credits developed into a to-and-fro between Minister Motsoaledi and Finance Minister Enoch Godongwana. While Minister Motsoaledi told Parliament that tax credits may be phased out from 2026-27, Minister Godongwana says he has made no statement about the scrapping of the medical tax credits as there is no alternative in place to fund an NHI.
Governance failures on provincial level also dominated 2025, particularly in Gauteng, where the Gauteng Health Head of Department, Lesiba Arnold Malotana, was suspended following an SIU lifestyle audit. This occurred against the backdrop of systemic corruption previously exposed at Tembisa Hospital.
There were, however, some advances in accountability. The Special Tribunal ordered companies linked to Thapelo Buthelezi to repay more than R500m related to irregular emergency medical services contracts in the Free State and NorthWest - misconduct first uncovered in 2018.