When Health Minister Manto Tshabalala-Msimang assumed power last year, she promised a new health bill this year. But this has been delayed yet again, in a saga that is over five years' long.

Although too early to accurately determine, medical schemes are reporting a positive response to the newly promulgated Medical Schemes Act, which allows people to join schemes without being penalised on the basis of age or health status.

Ever since provinces were given the power to allocate their own budgets, provincial health departments have been battling to get enough funds. Three health economists propose that central government establishes national norms and standards for health services to ensure that provinces allocate enough money to health.

Despite the HIV/AIDS epidemic, government has cut health spending over the past year and it will spend even less per capita next year. "Add to this the pressure of HIV/AIDS and it becomes clear that we have more difficulties ahead of us," Tshabalala-Msimang told the first-ever consultative meeting between herself, health MECs, MPs and MPLs dealing with health matters.