Two Bills to improve access to affordable healthcare
18 April 2008
It is a pleasure for me to announce that Cabinet approved this week the publication of two draft pieces of legislation that are crucial in ensuring that the people of South Africa have access to affordable and quality healthcare.
The two pieces of legislation are the National Health Amendment Bill relating to the determination of tariffs for private health services and the Medicine Control Amendment Bill relating to the functioning of the Medicine Control Council.
The National Health Amendment Bill
The escalating cost of private healthcare services in South Africa has been of great concern as it undermines the right of access to healthcare for millions of South African consumers.
The Department of Health engaged with the private health sector on this matter and it was agreed that there was a need for government involvement in addressing these challenges as the sector had not been able to find solutions through self-regulation.
The National Health Amendment Bill is a proposal from the Department of Health aimed at achieving as a minimum, transparency on the costs forming the basis for prices and removal of conflicts inherent in the current price setting framework. The Bill also seeks to prevent unjustified cost escalations and unfair, collusive and undesirable business practices.
Currently, medical schemes are obliged by law to pay in full for services relating to the Prescribed Minimum Benefits (PMBs). However, the determination of prices of the services relating to PMBs is not regulated.
The Bill introduces a framework for determination of the cost of providing PMBs. It empowers the Minister of Health to appoint a facilitator who will, every year, convene stakeholders including service-providers and medical funders to negotiate on pricing of health services to arrive at schedules of fees. The facilitator will hear and seek to resolve disputes relating to pricing and record the schedule agreed upon individually and collectively.
Where there is no agreement, the facilitator will refer the matter to the Health Pricing Appeal Tribunal to make a final determination. The Bill empowers the Minister to call for nominations and appoint up to five suitable qualified and experienced individuals who will constitute a tribunal with a five year term of office.
The tribunal will receive representation by interested parties and then make a determination on the fees.
The Minister will consider the fees agreed upon through the facilitation process and those determined by the tribunal. If satisfied, the Minister will publish these schedules in the Government Gazette and no person shall charge a fee higher than the published fee for PMBs. The Minister may also refer back for further negotiations, the schedule of fees that the Minister is not satisfied with.
Medicine Control Amendment Bill
The Bill aims to ensure that the Medicine Control Council functions effectively and efficiently.
The Bill proposes the Council should function as an agency with a chief executive that is accountable to the Minister. The agency will retain its revenue and recruit and retain the critical human resource capacity needed for it to fulfil its functions. A panel of external experts will only be called upon where there is a need for such opinion or advice.
The Bill broadens the mandate of the Council to cover approval of complementary and African traditional medicines, medical devices and cosmetics or food products with medical claims.
The agency will have specific timescales within which it will register health products and approve clinical trials. It is proposed that new clinical entities should be registered within 12 months and generics within six months while clinical trials will be considered within 30 to 60 days.
Both these Bills were published in the Government Gazette today. We encourage all interested parties and members of the public to submit their comments to the Department of Health with the next month. These comments will be considered in the finalisation of the Bill for tabling in Parliament.
Dr Manto Tshabalala-Msimang
Minister of Health