Draft health bill a concern

2003-08-18 15:48

Cape Town - While some initiatives put forward in the draft National Health Bill are to be welcomed, other proposed provisions are of serious concern, the Hospital Association of South Africa (Hasa) said on Monday.

Hasa legal affairs executive officer Kurt Worrall-Clare told the National Assembly's health committee the bill still did not provide for private sector representation on the proposed National Health Council and other committees.

This was despite the fact the council would be responsible for policy that included the private sector, he said in his submission during public hearings on the bill.

Provision should be made at the very least for the co-option of a private sector representative, under circumstances deemed necessary by the minister, and where the private sector was in any way involved in or subjected to health-related policy.

Turning to the provisions for a "certificate of need", he said Hasa believed these might seriously undermine the constitutional rights currently enjoyed by licensed and/or registered members of the private sector.

In terms of the draft legislation, no one may establish, construct, modify, or acquire a health establishment or agency without such a certificate, which will be valid for a maximum of ten years.

Worrall-Clare said in effect the law sought to remove the licenses granted to establishments, and to restrict their right to operate to ten years. This was inconsistent with the constitutional right to just, reasonable and fair administrative action.

Provisions for regulations relating to certificates of need also did not distinguish between public and private sector establishments.

As it now stood, the council could determine policy related to, among other things, human resources and technology.

As the certificate of need process applied to both the private and public sectors, the state was now a competitor, he said.

Thus, Hasa was concerned that the state was both the allocator of certificates as well as a competitor, which was inequitable.

There was also no provision for a timeframe for the health department director general to consider an application for a certificate of need, and Hasa believed this was not only inequitable, but might even be unconstitutional.

It was also inequitable to require the private sector to obtain insurance cover, but not the state.

Restricting the validity of the certificate to 10 years was also contrary to economic stability and undermined Hasa's commitment to reducing health care costs.

Hasa believed that the duration should not be limited, and once granted, should only be subject to inspection to ensure compliance.

However, should the department insist on limiting the duration, it should be for a reasonable period of time to ensure a return on the cost of capital investment, Worrall-Clare said.

- SAPA