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The National Health Act, 2003.

06 May 2008

In Categories: Medico Legal

On 02 May 2005, parts of the National Health Act became operational, and a new era of healthcare delivery based on patient-centered models and human rights commenced.

In the opinion of HASA radical reform will embrace both the public and private sector, with international norms and ethical standards being elevated to statute, with a primary emphasis on improving healthcare delivery for all. The Association welcomes these changes, and encourages both patients and health practitioners to embrace the rights recognised within the new law.

For example Chapter Two moves from the generality of the Constitutional right that no person be denied emergency medical treatment to imposing a legal obligation on the health establishment, health worker and health practitioner not to refuse any person emergency medical treatment. The application of which applies to both the public and private sector, and which potentially exposes both sectors to an ‘unfunded mandate’ of significant proportion. Neither the public nor the private sector can accurately calculate the extent to which ‘emergency medical treatment’ will impact on their facilities or personnel, as these are inherently connected to a variety of factors outside their control, such as chronic disease and motor vehicle accidents.

The new law recognises the patient’s right to be fully informed before any medical treatment or service is rendered. It also states that the patient must consent to such treatment before any medical intervention is performed. This provision of the law, read together with the recent High Court decision of Oldwage vs Louwrens [2004 1 All SA 532 (C), means that any health practitioner who does not obtain informed consent could be found guilty of violating the bodily integrity of his or her patient. Adv. K. Worrall-Clare, CEO of HASA, welcomes this provision believing that: “a fully informed patient, is an empowered patient.” In particular, he welcomed the provisions of law relating to minors, which stipulate that even when the minor patient is not in a position to consent (due to age), he or she must still participate in the decision making process. “This is a progressive move towards recognising the rights of all patients to their own bodily integrity.”

Of more significance is the recognition that all patients are to be respected as individuals, and that their medical information is to be protected as private. Worrall-Clare states that, “Husbands will need to obtain written permission to access information relating to their spouses, as hospitals cannot assume that she will automatically allow such disclosure.” The same applies to minors over the age of 16, which in terms of the Ethical Rules, stipulates that written permission must be obtained before any medical information is disclosed to either a parent or guardian. Accordingly, private hospitals will request a written confirmation from any patient before information is disclosed. “We are already in the process of training our staff to request such documentation.”

“We are also encouraged that the law recognises the rights of health workers, as we have experienced some unfortunate instances where staff are either physically or verbally abused by patients and their visitors.” Worrall-Clare hopes that by making patients aware of the rights of health workers, these incidents will be reduced.

HASA is hopeful that the aspects of law relating to the Certificate of Need will be rigorously debated, and that all stakeholders will utilise the opportunity to comment on the proposed law. “of particular concern to private hospitals, is the limited period of license duration, which means the recovery of capital investment over a shorter period of time.” Worrall-Clare, believes that this may diminish competition, whilst having the indirect effect of making healthcare more expensive to the consumer. “We will engage constructively with the State in this regard, as we believe the values incorporated within the new law, makes for an excellent partnership with the State.”

View all of the Department of Health legislations on the Department of Health website.

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Lucas Malambe

Lucas Malambe is Hasa's Executive Officer, Corporate Communications educated in the universities of the North and Witwatersrand. He is also the editor of the prestigious research-driven publications Health Annals and the monthly Hasa News.

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