The National Health Bill, which is supposed to be the cornerstone of the country’s new health system, will not be tabled in Parliament this year despite an earlier promise from Health Minister Manto Tshabalala-Msimang.
Describing the Bill as “the basic law underpinning the new health system”, Dr Andy Gray of Health Systems Trust said it was a “significant failure” that the health department could neither table the Bill nor publish a final draft.
The Bill has been in the pipeline for the past five years. It aims to regulate both public and private healthcare, set out how the different spheres of government should interact in health service delivery and entrench the Patients’ Charter which sets out patients’ rights.
Health department legal officer Sello Ramasalla confirmed that the tabling was “delayed by continuing discussions and the need for consensus on major policy issues”.
He said that a draft of the Bill may be published this year, but this depended on whether the minister and MECs had time this year to approve it.
The two main sticking points, said Ramasalla, were whether the Bill should apply to the medical services of the military and correctional services and issues surrounding a “certificate of need” for private health facilities.
According to the last draft of the Bill, published in May 1998, companies wanting to set up private healthcare facilities would have to get a “certificate of need” from the health minister.
Such certificates would only be issued once the minister was satisfied that the planned facility was necessary in the area, and these would have to be renewed every two years.
However, the private healthcare groups objected, saying they would not be prepared to invest in facilities that were only guaranteed a two-year life span.
Impatient with the lack of national progress, five provinces have already passed their own Health Acts. The most recent of these, the KwaZulu-Natal Health Act, says certificates of need will be issued for a 10-year period.
Hospitals Association of SA spokesperson Debbie Pearmain said that her organisation ‘ which represents all private hospitals ‘ was not involved in any negotiations with government.
“There is no draft out there that we can look at,” said Pearmain. “The last one we saw about two years ago. Rumour has it that the KwaZulu-Natal Health Act is a more accurate reflection of government thinking [than the old national draft]. We would be quite happy with a 10-year period. But we would very much like to see a new Health Act.”
Ramasalla confirmed that at present negotiations around the Bill were confined to government officials, rather than all stakeholders.
A departmental source who asked not to be named said new MECs had not yet been briefed on the Bill. ‘ Health-e News Service.