Proposed amendments to the 2003 National Health Act in anticipation of national health insurance (NHI) implementation were spelled out last week in a written reply to questions from the Democratic Alliance’s (DA’s) Mbulelo Bara, reports Pam Saxby for Legalbrief Policy Watch. Among other things Health Minister Zweli Mkhize’s response has confirmed that the provincial equitable share ‘will decrease in relation to the functions … shifted from provincial to national government’. However, a draft National Health Amendment Bill yet to be released for public comment will seek to ‘allocate’ a raft of ‘direct powers’ to the provinces, including responsibility for providing ‘specialised hospital services’ (infectious diseases and mental health); services relating to the management, prevention and control of communicable and non-communicable diseases; occupational health services; environmental pollution control services; emergency medical services; and forensic pathology, forensic clinical and related medico-legal services.
Once the amendments envisaged are operational, under NHI provincial governments will also be required to ‘participate in interprovincial and intersectoral co-ordination and collaboration’ initiatives; ‘co-ordinate the funding and financial management of district health councils’; provide these councils with ‘technical and logistical support’; ‘co-ordinate health and medical services during provincial disasters’; consult affected communities on health matters; promote healthy lifestyles; facilitate community participation in the planning, provision and evaluation of health services; undertake health systems research; and provide and maintain the equipment, vehicles and healthcare facilities necessary to perform these functions. In addition, it is envisaged that some ‘national powers’ could be delegated to the provinces, possibly including the management of ‘provincial tertiary and regional hospitals’, as well as district hospitals and health services.Legalbrief Policy Watch report