Governance expert warns National Health Insurance focus masks systemic corruption and procurement failures in South African hospitals

Professor Alex van den Heever warns the NHI is a distraction from the R2.3 billion corruption draining hospitals like Tembisa, calling for professional leadership.

By: AXL Media

Published: Mar 4, 2026, 8:39 AM EST

Source: The information in this article was sourced from Daily Investor

Diversion from root causes

The intense administrative and political focus on the implementation of the National Health Insurance (NHI) is reportedly obstructing efforts to fix South Africa’s core healthcare challenges. Governance expert Professor Alex van den Heever argues that by prioritizing the NHI, the government is neglecting a 20-year decline in the quality of care caused by unaddressed institutional flaws. He suggests that the scheme acts as a mask for the "progressive deterioration" of the system, taking resources away from credible policy alternatives that could achieve universal coverage more effectively.

Institutional design and funding flaws

According to Van den Heever, the NHI will fail to achieve its stated goals even if it successfully navigates its current legal challenges. He maintains that the scheme lacks a viable funding model and an institutional design capable of delivering universal healthcare. The critique centers on the idea that the government has failed to provide the necessary basis for such a massive transition by neglecting the foundational issues within the current public healthcare system, which remains plagued by inefficiency and resource depletion.

The drain of systemic corruption

The primary obstacle to effective healthcare in South Africa is identified as widespread corruption that extracts vital resources from the budget. Van den Heever cited the Tembisa Hospital matter as a prominent example, where approximately R2.3 billion was allegedly extracted from a single facility in Gauteng. He warned that this is not a unique occurrence, asserting that the entire public procurement system is "capturable" by political networks. This dynamic ensures that a significant portion of the money allocated for patient care instead reaches politically connected individuals.