The Concept of “Need” in South Africa’s Healthcare Framework: From Certificates of Need to National Health Insurance Accreditation

On 18 May 2026, the Constitutional Court (“CC”) in Solidarity Trade Union and Others v Minister of Health and Others confirmed the invalidity of the Certificate of Need (“CoN”) provisions contained in sections 36 to 40 of the National Health Act (“NHA”).

The CC found that the CoN provisions were irrational and unjustifiably limited the right to choose a trade, occupation or profession freely. The CC’s invalidity confirmation has prompted closer examination of the role that the concept of “need” plays within South Africa’s healthcare legislative framework. …more