The proposed National Health Insurance (NHI) was under threat, the South African Communist Party (SACP) said on Thursday in its political report presented to its Second Special National Congress.

"Powerful capitalist interests in the private health sector, in alliance with some in our own broader movement who have business interests in the sector are already involved in intense behind the scenes lobbying for either a total abandonment of the idea of an NHI or to try and build a watered down version of the NHI...," the report read.

Public private partnerships must be subjected to the "discipline of our development agenda" rather than being subjected to the logic of the capitalist market, the party said.

"A new area that the SACP will have to focus upon is how the defeated agenda of privatisation of the late 1990s continues to seek to resurrect itself through new ways of subjecting the Atate to the interests of an unfettered free market and its narrow BEE [Black Economic Empowerment] tentacles.

"One such form is that of the increasing use of Public Private Partnerships to imprison the state within the logic of private capital."

The SACP said that private interests in the health sector were "seriously exploring" ways of capturing the NHI scheme through these partnerships.

This was being done through "seeking to entice government's planned investment into the public health system through the rebuilding of hospitals and clinics via such private arrangements".

These partnerships would see public hospitals built with private sector money "where the State is locked into being a tenant for decades, paying for the use of such buildings".

These agreements could also extend to the private supply of drugs, the provision of private health personnel "under the guise of private sector support to the NHI".

"It is indeed possible that elements of the capitalist class are also considering similar arrangements in the building of schools, rural development infrastructure, and other planned government investment into infrastructure.

"It is, for instance, of no surprise that the DA [Democratic Alliance] has reacted negatively against the withdrawal of labour broking by the ministry of police, as labour broking in itself constitutes an important method of holding the State hostage in its transformation agenda," the report read.

A key challenge for the alliance in the post-Polokwane period was maintaining the independence of each alliance partner - the African National Congress (ANC), the SACP, the Congress of South African Trade Unions and the South African National Civics Organisation.

This had to be achieved while working toward "an inclusive transformative project whose primary objective is to address the needs of the majority of the people of our country, the workers and the poor".

Another challenge for the party was building a developmental State.

"... not in an oppositionist manner, but as part of the overall thrust of the goals of the ANC-led alliance."

The communist party welcomed the establishment of the national planning commission but urged its delegates to elaborate at the congress on how this body should function.

The report also welcomed Alliance Summit commitments to review macro-economic policy including a review of the mandate of the South African Reserve Bank.

"This marks a significant and positive departure from the neo-liberal economic perspectives that had dominated our economic policy since 1996."