South African billionaire Johann Rupert has secured approval for one of the country’s biggest healthcare transactions in recent years, strengthening his control over a network of 50 hospitals and nearly 9,000 beds as debates intensify over the future of private healthcare under the government’s National Health Insurance (NHI) plans.

South Africa’s Competition Tribunal has approved Remgro’s acquisition of full ownership of Mediclinic Southern Africa in a transaction valued at $950 million (R16.2 billion), clearing a major domestic regulatory hurdle for a deal that will give Rupert’s investment vehicle outright control of one of the largest private healthcare platforms in southern Africa.

The approval advances a restructuring agreement announced in March between Remgro and Investment Holding Limited (IHL), a subsidiary of Mediterranean Shipping Company (MSC), under which the two partners are unwinding part of their joint ownership of Mediclinic International.

Under the arrangement, IHL will assume full ownership of Switzerland’s Hirslanden private hospital group, while Remgro will take complete ownership of Mediclinic Southern Africa.

The two businesses are valued equally at $950 million (R16.2 billion) each.