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