[ Home ] [ Speeches & statements ]

19 April 2005

At least 10 of the 12 chapters of the National Health Act (Act No 61 of 2003) will come into effect on 2 May 2005 after the Act was proclaimed by President Thabo Mbeki in the Government Gazette published yesterday.

This Act replaces the last trace of apartheid in health policy - the Health Act of 1977. It also provides a framework for a structured uniform health system in order to unite the various elements of the national health system in a common goal to improve universal access to quality health services, taking into account the obligations imposed by the Constitution.

This Act rests heavily on the Constitution which, amongst other things, requires the State to take reasonable legislative and other measures to progressively achieve the right of access to health care services, and reproductive health care, within its available resources. The National Health Act is one of those legislative measures contemplated by the Constitution.

The Act also covers various issues contained in the Bill of Rights including:

* The right of children to basic health services
* Everyone's right to an environment that is not harmful to health or well-being.

The National Health Act is regarded as the single, most important piece of legislation for the health sector. This Act is framework legislation, which means that it sets out broad legal and operational principles that must be fleshed out in regulations.

Today's proclamation puts into effect mainly those sections that do not require regulations for them come into effect. The sections that come into effect on 2 May are the following:

Chapter 1 which establishes the National Health System gives the Minister of Health stewardship over the National Health System and the responsibility to protect, promote and maintain the health of the population. It further consolidates the principle of free health care to those who cannot afford it, in particular, women, children, older persons and persons with disabilities.

Chapter 2 begins to bring in some of the transformative elements of this Act which aim to restore the dignity of every citizen. This chapter gives emphasis to:

* The right to emergency medical treatment;
* The right to have full knowledge of one's condition;
* The right to exercise one's informed consent;
* The right to participate in decisions regarding one's health;
* The right to be informed when one is participating in research;
* The right to confidentiality and access to health records;
* The rights of users to lay complaints about the service; and
* The rights of health workers to be treated with respect.

This Chapter is proclaimed with the exception of section 11, because regulations and guidelines have to be developed to set parameters and criteria for conducting experimental and research work in health establishments.

Chapter 3 describes the general functions of the national Department of Health and the Director-General. It establishes the highest policy body in health which comprises the Minister of Health, the MECs for Health and representatives of local government. This body which used to be known as the Health MinMec will now be called the National Health Council.

In this chapter a National Consultative Health Forum is also established. The Minister of Health will consult with this forum of stakeholders in the health sector to promote and facilitate communication and the sharing of information on national health matters, thus giving meaning to the people's contract that government is promoting in all sectors of society.

Chapter 4 establishes provincial health services and outlines the general functions of provincial health departments.

Chapter 5 establishes the District Health System based on the principles of primary health care, promoting universal access to quality, equitable, responsive and efficient health care services that are accountable to the communities they serve. To give effect to these principles, this chapter provides for a planning framework for health services, governance and consultative structures.

Chapter 7 deals with Human Resources Planning and Academic Health Complexes. The Act mandates the national Department to develop a human resources policy and guidelines to ensure adequate distribution of health personnel, to provide for trained staff at all levels of the health system and to ensure the effective utilisation of health personnel.

This chapter is proclaimed with the exception of section 50 and 51, which provides for the establishment of a Forum for Statutory Councils and academic health complexes. The establishment of the Forum of Statutory Councils will require that the various councils elect their representatives on the Forum and make their nominations to the Minister while academic health complexes require further consultation with the Department of Education.

Chapter 9 provides for the establishment of a National Health Research Ethics Council and Health Research Ethics Committees at every institution, health agency and health establishment at which health research is conducted. The proclamation excludes section 71 which requires regulations that prescribe conditions under which research on a living person may be conducted.

Chapter 10 provides for the appointment of health officers to monitor and enforce compliance with this Act. The proclamation excludes a significant section of this chapter dealing with quality assurance including the establishment of the office of standard compliance and the inspectorate for health establishments.

Chapter 11 also come into effect on 2 May because it empowers the Minister to make regulations on many of the issues covered by the Act.

Lastly, Chapter 12 empowers the Minister to appoint advisory and technical committees, to assign duties and delegate powers and to prescribe transitional arrangements as may be necessary to effect a smooth transition and introduction of various provisions of this Act.

Chapters that are not yet proclaimed are chapters 6 and 8.

Chapter 6 deals with one of the most innovative elements of the National Health Act - classification of health establishments, the certificate of need, the establishment of boards for hospitals, clinics and community health centres, the relationship between the public and private health establishments. The objectives of this chapter are:

* To ensure that each and every health establishment, whether public or private, is registered with the Department of Health;
* To ensure that health establishments, whether public or private, are distributed equitably throughout the country to enable equitable access to health services for everyone;
* To ensure greater public participation in the governance of health establishments, particularly, to improve local accountability and responsiveness to community health needs;
* To establish a set of norms and standards and criteria to be met by all health establishments, whether public or private;

The draft regulations relating to this chapter are going to be published for public comment. We urge all health stakeholders and other interested parties to submit their comments to ensure that their input is considered when these regulations are finalised. We are committed to ensure that this becomes an inclusive process that assists us to achieve our health objectives as a country.

Chapter 8 deals with complex issues such as the control of use of blood, blood products, tissue and gametes in humans. The draft regulations relating to this chapter are also being finalised.

The proclamation of the National Health Act is an important step forward in the transformation of the South African health sector. We therefore intend to use this National Health Act in achieving our policy objectives and improving access to quality health care services for all.

Contact: Sibani Mngadi
Cell: 082 772 0161

Issued by: Department of Health
19 April 2005