Fight against restrictive new ‘NHI change’ in South Africa
The Pretoria High Court has reserved judgement in trade union Solidarity’s application to have sections 36 to 40 of the National Health Act declared invalid and to have them reviewed.
According to Solidarity, this legislation forms one of the pillars of the proposed National Health Insurance (NHI), and victory in this matter would deal the NHI a significant blow, even before its inception.
In terms of the regulations, all healthcare practitioners must apply for a certificate that will enable them to practice – known as a ‘certificate of need’. Following this, healthcare practitioners will then be prescribed where and how they may practice by the government.
Solidarity argues that these prescriptive regulations infringe on both the rights of practitioners and patients and are therefore unconstitutional. Furthermore, it will severely restrict the provision of healthcare services, it said.
In its application, Solidarity argued that the requirement of such certificates infringes unlawfully on the right of health practitioners to practise their profession.
“It is unacceptable and absurd that someone such as a private general practitioner should first apply to the government before they may set up a practice,” said Pierru Marx, the network coordinator for Solidarity’s medical sector.
“What is even worse is that it is within the powers of the Director-General of the Department to prescribe virtually all the practice’s activities, ranging from the equipment to its human resources, and even the size of the practice.”
Solidarity said the change effectively empowers the government to capture medical practices almost in their entirety, and to manage them as it deems fit, rather than leaving it to the doctors’ discretion.
“We cannot just take a backseat and hope that the government would simply always apply its wide discretion responsibly. The government should not have such powers at all,” Marx said.
Solidarity contends that decisions on healthcare should rather be taken by health practitioners and that more government interference would ultimately be to the detriment of everyone.
“The medical sector in South Africa does not need yet more bureaucracy. We should actually empower and encourage our health practitioners. This type of legislation leads to ineffective care, a sicker country and an outrage among medical staff whose rights are being trampled on as a result of this legislation,” Marx said.
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