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Writer's pictureCindie Muller

How will the National Health Insurance Bill affect B-BBEE in the health sector?

The National Health Insurance (NHI) Bill, which aims to provide universal access to quality health care for all South Africans, has been met with mixed reactions from different stakeholders in the health sector. One of the key issues that has emerged is the impact of the NHI on the Broad-Based Black Economic Empowerment (B-BBEE) of hospitals, clinics, and other healthcare providers.


According to the NHI Bill, the NHI fund will be the single purchaser and financier of health services for the entire population and will contract with accredited public and private health facilities and practitioners. This means that the government will effectively become the main client for healthcare providers, and will require them to comply with certain criteria and standards, including B-BBEE.


Currently, the health sector falls under the general charter codes of the revised B-BBEE Codes, which have specific requirements for ownership, management, skills development, enterprise and supplier development, and socio-economic development. However, the NHI Bill also gives the Minister of Health the power to prescribe additional criteria for contracting with healthcare providers, which may include B-BBEE-related targets or goals.


This implies that healthcare providers will have to adapt their B-BBEE strategies and policies to align with the NHI objectives and regulations or risk losing out on business opportunities and market share. Some of the possible implications and challenges for healthcare providers are:

  • Ownership: Healthcare providers may have to consider selling shares to black individuals or entities, or creating indirect ownership structures, such as broad-based ownership schemes or employee share ownership programmes, to increase their B-BBEE ownership levels and scores. This may entail finding suitable and strategic partners or beneficiaries, as well as ensuring compliance with the B-BBEE Codes and the NHI Bill.

  • Management: Healthcare providers may have to ensure that their management and board structures reflect the diversity and representation of the population and that they have adequate skills and competencies to deliver quality health services. This may require investing in leadership development, talent management, and succession planning, as well as addressing any barriers or biases that may hinder the advancement of black managers and directors.

  • Skills development: Healthcare providers may have to invest more in the training and development of their staff, especially black employees, to enhance their skills and qualifications, and to meet the accreditation and quality standards of the NHI fund. This may involve implementing skills programmes, learnerships, internships, bursaries, and mentorship schemes, as well as taking advantage of tax rebates and incentives applicable to some of these initiatives.

  • Enterprise and supplier development: Healthcare providers may have to support the development and growth of black-owned and black-empowered enterprises and suppliers in the health sector, by procuring goods and services from them, providing them with financial or non-financial assistance, or creating joint ventures or partnerships with them. This may entail identifying and nurturing potential suppliers, monitoring and evaluating their performance and impact, and ensuring that they adhere to the ethical and professional standards of the health sector.

  • Socio-economic development: Healthcare providers may have to contribute more to the social and economic well-being of the communities in which they operate, by supporting initiatives that address health-related issues, such as HIV/AIDS, tuberculosis, maternal and child health, mental health, and environmental health. This may involve engaging with various stakeholders, such as government, civil society, and non-governmental organisations, to identify and implement relevant and sustainable projects and programmes.


The NHI Bill presents both opportunities and challenges for healthcare providers in terms of B-BBEE. While some may view it as a threat to their profitability and autonomy, others may see it as a chance to improve their competitiveness and social responsibility. Ultimately, the success of the NHI and B-BBEE will depend on the collaboration and cooperation of all the parties involved and the shared vision of achieving a healthier and more equitable society for all.


GBS offers a holistic business solution, integrated with your Human Capital Strategy to ensure the ultimate Return on Investment (ROI) of your human assets.

We can assist in the initial assessment of your B-BBEE status and craft innovative strategies to optimise your industry positioning.


For more information, please contact our B-BBEE experts at Richard – richard@globalbusiness.co.za or Cindie – Cindie@globalbusiness.co.za

A diverse group of healthcare professionals and executives in a business meeting, discussing B-BBEE compliance and the National Health Insurance Bill.

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