While its own lawyers insisted that the provision to introduce controls over where medical practitioners and nurses could work was crucial for the future implementation of the National Health Insurance, the government on Monday maintained a firm stance on the future of the National Health Insurance.

After two decades of legal battles, a crucial piece of legislation, which would have given the government control over where medical practitioners and nurses could work, has been killed off by the Constitutional Court.

While the Department of Health's lawyers labelled the certificate of need scheme "a central pillar in the implementation of the National Health Insurance Act" in court, spokesperson Foster Mohale said the department wanted to point out that no part of the National Health Insurance Act had been declared unconstitutional.

Legal provisions for the certificate of need scheme were never brought into operation.

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In their submissions to the Constitutional Court, the government lawyers stated: "The scheme [regulating the certificates of need] empowers the minister to ensure a fair and equitable geographic distribution of health services across South Africa.

"This is to promote access to healthcare for disadvantaged communities or in areas with limited healthcare infrastructure and to prevent an over-concentration of health services in affluent areas, catering only to the few who can afford them."

Mohale said the department wanted to clarify that the judgment did not relate to the National Health Insurance (NHI) Act.

"The sections in question were passed by Parliament 23 years ago and...