Health bill threatens conflict in standards

Doctors fear duplications

THE STANDARDS to be adopted by the proposed office of health standards compliance (OHSC) could overlap and conflict with the rules of existing bodies, which could create doubts about the future for some health professionals, Parliament heard during the public hearings on the National Health Amendment Bill yesterday.

Health professionals’ organisations told the portfolio committee on health that if the standards to be adopted by the OHSC were not tabled in a public platform, this office could undermine the functions of existing laws and accreditation bodies in the health-care sector.

The National Health Amendment Bill, which was gazetted for public comment in January last year, seeks to amend the National Health Act of 2003, so as to provide for the establishment of the OHSC. Once established, this office is expected to “pave the way” for the successful implementation of the National Health Insurance (NHI) system.

The green paper states that the proposed quality standards will apply to “all health establishments” in the public and private sectors who wish to be considered for rendering health services under the NHI system. The envisaged accreditation standards would specify the minimum range of services to be provided at different levels of care.

The office would inspect and certify the compliance of health institutions. Where an institution is proven to be noncompliant, a notice would be served to the person in charge of that hospital or health establishment and a fine not exceeding R10 million may be imposed. The matter may also be referred to the National Prosecuting Authority.

But the Southern African Laboratory Diagnostics Association (Salda) said yesterday that it was concerned that manufacturers of diagnostic products, laboratories and doctors already had a number of standards to comply with under the Hazardous Substances Act, Standards Act and Health Professions Act, among others.

“It is likely to lead to duplication, and possibly conflicting standards and assessments being made. Salda understands it is not the intention to overregulate laboratory medicine but we feel like that’s what will happen,” said Greg Northfield, the chairman of Salda.

He said other countries published such standards for comment to prevent overlaps.

Northfield also said that internationally, quality control bodies were totally independent from government organs. He said although this was also the intention with the OHSC, legislative provisions did not support such independence.

Pure Health Consulting said the way this office would be structured showed that there would be no independence in terms of its reporting. But the organisation said it believed the standards setting and development role should be within the Department of Health and the OHSC should be consulted and allowed to participate on the review of such standards.

The organisation wanted the OHSC to set progressive fines for continued gross non-compliance, as well as suspensions. It also recommended closure of non-compliant wards.

But Dr Tjaart Erasmus from the National Pathology Group said there was a possibility that the OHSC standards could conflict with professional registrations in the health sector. “We are… short of professionals… You don’t want people to feel unsecure about the future.”