Five-year objectives
Continue a programme of reform that began in the first term of the democratic government and in particular to:
Key objectives for 2001/2
The National Health Bill was published for public comment in November 2001. It is key to progressive realisation of the Constitutional right of access to health services within available resources. It seeks to establish a national framework for the delivery of health care services throughout South Africa and its provisions relate to the private sector as well as to the national, provincial and district components of the public health system.
The Department now intends to table the Bill in Parliament in the second half of 2002.
The Medical Schemes Amendment Act No 55 of 2001 was passed in December. The amendments extended certain rights of members to their dependants, further regulated the practice of reinsurance and strengthened the powers of the Council and the Registrar to act in the interests of beneficiaries. The Act also made provision for the regulation of marketing of medical schemes, for more frequent reporting by schemes to the Registrar and defined the circumstances in which schemes may be inspected.
Regulations under the Medical Schemes Act were also published during the year.
The Mental Health Care Bill was unanimously supported in the National Assembly in December and was to be processed through the National Council of Provinces in the first half of 2002. The Bill creates a significantly more responsive and transparent system for the admission of individuals to psychiatric institutions. It also emphasises the rights of a category of patients who are not always in a position to assert themselves. The process of drafting regulations began during the year under review, in anticipation of the enactment of the legislation.
A great deal of work was done on the regulations to the Medicines and Related Substances Control Act (No 101 of 1965) and the Amendment Act (No 90 of 1997) following the resolution of the protracted dispute between the Department and the Pharmaceutical Manufacturers Association concerning the Amendment Act.
Draft regulations were published for comment in the second half of 2001 and the Department actively engaged various interests - including the pharmaceutical industry and professional groupings - about aspects of the regulations. The regulations have since been revised but they will only be published after certain amendments to the principal Act are effected in 2002.
Work progressed on a statute to regulate traditional healers along the same lines that other health professionals are regulated. The proposed legislation is likely to be published for comment within 2002.
The Department's Legal Unit interacts regularly with lawyers employed by the various statutory professional councils - the Health Professions Council, the Nursing Council, the Allied Health Professions Council and the Pharmacy Council - on regulatory matters.
Significant litigation
Legislative reform and policy may be driven not only by planned processes but also by litigation that sets legal precedents. The action brought by the Treatment Action Campaign (TAC) and others against the Minister of Health went to the heart of the definition of the government's constitutional responsibility to ensure access to basic health care.
In December 2001, the Pretoria High Court made an order compelling government to make Nevirapine available at any health facility where the attending medical officer, in consultation with the medical superintendent, deemed it medically advisable for a particular mother-and-baby pair. It also ordered government to prepare a national plan for the full-scale roll-out of a PMTCT programme and to submit it to the court within three months.
The Minister and Health MECs decided to appeal against the order on the basis that the court had overstepped the boundaries laid down by the constitutional doctrine of the separation of powers. The appeal had still to be heard by the Constitutional Court at the close of this reporting year.