COmmittee on Health

The Department of Health incurred irregular expenditure of R5.7 billion in the last financial year, Parliament heard on Thursday.

In a statement issued by the Democratic Alliance (DA) after the hearings by the Portfolio Committee on Health, it said that this accounted for 25% of the total irregular expenditure by government during the 2010/11 financial year.

The findings by the Auditor General are particularly irksome for the Department of Health as it would be the primary vehicle to implement the planned National Health Insurance scheme that would eventually cost the country R255 billion by 2025.

WHO calls for a ban on all forms of direct and indirect advertising, promotion and sponsorship by the tobacco industry to protect young people from experimenting and becoming regular tobacco users. National Council Against Smoking (NCAS) calls on public to write to MPs and political parties to support laws that will stop the industry targeting kids. On World No-Tobacco Day, May 31, the World Health Organization (WHO) calls on governments, communities and individuals to take action to reduce the health, social and economic harms caused by tobacco use.

The Parliamentary Portfolio Committee on Health encourages interested individuals and organisations to submit written comments on the Choice on Termination of Pregnancy Amendment Bill [B 21-2007] and the Traditional Health Practitioners Bill [B 20-2007]

Prevention

There is a vast experience of prevention work in South Africa, from information and edutainment programmes, focus on youth, to the advancement of female controlled methods in the form of microbicides and femidom distribution

Trying to convince your employer to accept a medical certificate from a traditional healer could be a thing of the past in terms of a new bill to come before parliament. According to Jan Stemmett, chairperson of the Labour Law Committee of the Law Society of South Africa, the minister of health has published a notice in the Government Gazette indicating that she intended to introduce the Traditional Health Practitioners Bill. The bill will allow traditional healers, or traditional health practitioners as they will be known, to issue medical certificates for purposes of sick leave. Among other things, the bill provides for the establishment of an Interim Traditional Health Practitioners Council, the registration of traditional health practitioners,the fees they may charge and restrictions on unregistered persons. Healers will, however, not be able to issue certificates for purposes of maternity leave. Employers are advised to check whether a traditional healer is registered with the new Council before accepting his or her certificate. Presumably, certified healers will be issued with registration numbers.(source SAPA, 29 October 2003) Links //\// Traditional Health Practitioners Bill Latest Developments: This Bill was submitted on 14 August 2003 in terms of Joint Rule 159 and referred to the Portfolio Committee on Health and the Select Committee on Social Services. Background: The Bill provides for the establishment of an Interim Traditional Health Practitioners Council. It also provides a regulatory framework to ensure safety, efficacy and quality of treatment. The Bill provides for control over registration and training. For more information contact Debbie Pearmain at 012 312 0611 or email: peard@health.gov.za Draft Traditional Health Practitioners Bill http://www.polity.org.za/pdf/DraftTradHealthPractBill.pdf

This week, the National Health Bill has been the focus of public hearings by the Parliamentary Portfolio Committee on Health. Individual sections of the law were placed under the microscope to establish precisely what they mean. Of course, this is a valuable process. But as we took the bill apart, bit-by-bit, I invited participants to consider the measure as a whole. Why do we have a National Health Bill? We believe the fundamental purpose of the bill is to design a health system suited to the enormous task of ensuring all people in our country have access to healthcare. For government, this is not just a noble ideal. It is a real responsibility in terms of the bill of rights in the constitution. Moreover, we have a duty, over time, to increase the scope of services within the bounds of available resources. The National Health Bill tackles this challenge from a number of different angles. Very importantly, it assembles the pieces of the public health system in a coherent way and clearly defines what health functions each sphere of government perform. Our experience over the last nine years has informed this aspect of the legislation. It also makes sure the links between the various spheres of government are firmly in place, so that there is no excuse for poor co-ordination at policy level. The informal structures of consultation that we developed as a way of expressing co-operative governance are now cast firmly in legal language. Central to any rights culture - especially when it comes to socio-economic rights - is the consumer. And the bill deals with the rights of patients as individuals - focusing on patients' rights to information, to confidentiality, and to choices in terms of the health interventions they will undergo. It also deals with their collective rights to participate in policy making. Perhaps the most striking feature of the bill is that it defines private and public healthcare providers as part of a single national health system. When it talks about the rights of service users, the ethics of medical research and compliance with basic standards of care, this legislation draws no distinction between the public and private sectors. The degree to which government exercises control over the private healthcare sector is always a sensitive issue. In discussions on the National Health Bill, debate tends to focus on the provision that all health establishments will be licensed on the basis of need for their service. In the past, some of the loudest critics of this provision were precisely those who cry foul when medical aid rates shoot up, leaving pensioners and those with low incomes out in the cold. Or who decry the inability of the public health services to ventilate all low-weight babies, to provide kidney dialysis for all in need and to offer expensive drug treatments. You can't have it both ways. The market alone is not a fair or effective mechanism to distribute healthcare. Resources simply do not follow demand. If they did, we would not have 75% of our people depending on public facilities, while this sector consumes about 47% of national health spending. We would also not have the vast majority of doctors and medical specialists devoting themselves to the private sector. As government, therefore, we examined the existing relationship between the private and public health sectors - and how this impedes universal access to good healthcare. It is clear that inefficiencies and inflated costs in the private health sector not only hurt private consumers, they also turn the screws on the public sector. All health facilities draw their professional personnel from a limited common pool. If private hospitals proliferate in a situation where half their beds stand empty, they absorb professionals without providing value-for-money care. In this context, inflated prices and unethical practices, such as over-servicing, are likely to arise. Faced with unreasonable costs, many patients resort to the over-stretched public sector. And so the vicious cycle will continue ... unless someone stops it. Through the National Health Bill, and specifically through needs-based certification of health establishments, government seeks to establish a more rational and fair allocation of health resources. This is the key to good healthcare for all. Perhaps I am an optimist, but I believe debate on the certificate of need did not question its legitimacy but sought to improve the process. I believe that South Africans realise that we have to rise above our narrow interests to build a united nation. I also believe that we appreciate that effective healthcare reduces the inequalities and tensions in our society and enables us to look each other in the eye. ( Source: The Cape Times, 20 August 2003).

The sharp increase in multi-drug resistant tuberculosis in South Africa can be attributed to the loss of Directly Observed Treatment Short-course Strategy (DOTS) workers to the more lucrative field of caring for people living with HIV/AIDS, health department officials admitted this week. She said multi-drug resistant TB increase was mainly attributed to treatment interruption, a scenario DOTS supporters prevented. The health department’s annual report, which was presented to the committee, revealed that South Africa is ranked near the bottom (ninth) of the international league table in terms of the extent of the problem, and still the epidemic is growing. It is widely accepted that the HIV epidemic is one of the main driving forces fuelling the TB epidemic, but the disease can be cured quite effectively whether the person is HIV positive or negative. Dr Kami Chetty, a Deputy Director General in the health department indicated to the committee that the long-awaited National Health Bill had been published for public comment and should reach parliament in the first quarter of the year. The department identified 10 strategic targets to assist in prioritising and focusing its efforts: Improving the health status of the population by decreasing morbidity and mortality through strategic health interventions; The delivery of an essential package of services through the district health system; Revitalisation of hospital services; Improving quality of care at clinic and hospital level; Reorganisation of certain support services; Improving resource mobilization and management; Strengthening co-operation with international partners; Legislative reform; Improving human resource development and management; Improving communication and consultation with stakeholders. In her foreword, Health minister, Dr Manto Tshabalala-Msimang pointed out that: “It is impossible for us to ignore developments such as genetic modification of foods and the possibilities of human cloning, although the more common realities might be hunger among our nation’s people and birth defects arising from nutritional deficiencies. In this context the strategic framework (targets) represents a balance between building health systems on the one hand, and managing health risks, on the other. (Source: Anso Thom, Health-e, 21-02-2003)

The National Assembly's Portfolio Committee on Health was briefed this week by the Department of Health on the National Health Laboratory Services Bill.

In this issue, we present views of a number of stakeholders on the legislative process, most notably from the National Department of Health and the National Parliamentary Portfolio Committee on Health. We also present the views of non-government organisations and an unrepresentative sample of e-mail respondents to a questionnaire we sent out to our HealthLink users. From this, we hope to give you the reader a snapshot view of the possible interaction between civil society and this important legislative process.