National Health Laboratory Service Amendment Bill [B15-2017]: public hearings

Meeting report

NEHAWU submission
Mr Tshegofatso Moralo (NEHAWU Public Health National Organiser) said the Amendment Bill was a welcome development. NEHAWU had led the struggle for equity and accessibility to proper health care system in South Africa. The National Health Laboratory Services (NHLS) was a critical instrument for delivering quality healthcare and needed to be well governed for it to deliver its mandate. Proper governing of NHLS was only possible if NHLS was integrated into the Department of Health. NHLS must be properly governed and not fragmented. The Amendment Bill fell short of addressing major issues that were pertinent to the delivery of the NHLS mandate. There was a need for improvement in the quality of service delivery by NHLS. NEHAWU was the first union to raise alarm on deep structural challenges such as corruption, nepotism, and lack of facilities which affected NHLS. Although NEHAWU appreciated the response of the Department of Health to complaints by proposing the Amendment Bill, NEHAWU had been calling on the Department of Health to restore the NHLS to the public sector so that the National Health Insurance could be delivered. The NHLS current model was susceptible to mismanagement and non accountability. NEHAWU supported the amendment but there was a need to redefine the vision and mission of NHLS. NEHAWU requested the immediate suspension of the CEO and appointment of an acting CEO by Department of Health and NEHAWU was prepared to further engage with the department to discuss other matters outside the platform of the Portfolio Committee’s meeting so as to reposition NHLS.

Mr Tengo Tengela (Parliamentary Officer, NEHAWU) said the current NHLS had a fragmented mandate. The research aspect should be channeled to the Medical Research Council. NHLS should be integrated because it is not good that patients had to go to other institutions for diagnostic services.

Discussion
Mr A Mahlelela (ANC) observed that NEHAWU supported the Amendment Bill conditionally. One of its recommendations was a request that NHLS is returned to the National Department of Health. There was no legislation to support this and there was no proposal for the absorption of NHLS by National Department of Health (NDoH) in the Amendment Bill. The support of the current amendment by NEHAWU was confusing. The NHLS was a part of the NDoH and hence he did not understand what NEHAWU meant by saying ‘DoH should take back NHLS’.

Mr Mahlelela commented that there was no new funding model in the NHLS Amendment Bill. NHLS would still have to charge the provinces and there was no deviation from the previous arrangement. The challenge had been that provinces had often failed to pay for NLHS services. In the Amendment Bill there is no mechanism for compelling provinces to pay and there are no consequences for the defiance of provinces. He had expected that NEHAWU would come up with a proposal to strengthen financial sustainability.

Ms C Ndaba (ANC) asked for clarity on NEHAWU's proposal for the immediate suspension of the Chief Executive Officer (CEO). If there is an issue with the CEO it should be regarded separately from the Amendment Bill.

Ms P Kopane (DA) said she did not understand the need to redefine the vision and mission of NHLS. She asked why NEHAWU would prefer to have further engagements with the Department outside the Committee’s platform. It would be better to present it at the meeting so that the Committee can make an input since the matter would be brought back to the Committee.

Dr S Thembekwayo (EFF) shared the same view as other members that all the points raised by NEHAWU have to do with the repositioning of NHLS. It would be better to present it at the meeting so that the Committee can make an input since the matter would be brought back to the Committee.

Dr P Maesela (ANC) said the problem in the submission was that systemic problems were mixed with structural problems. The points can be refined to make them stronger and more cogent. What are the things that need to be corrected and why should they be corrected. The issues should be dealt with before the finalisation of the Amendment Bill because these would no longer be relevant afterwards.

The Chairperson observed that NEHAWU had made a submission only on the NHLS Amendment Bill and nothing was said on the National Public Health Institutes of South Africa (NAPHISA) Bill.

Ms Kopane said NEHAWU should return to the Committee after reading the Amendment Bill clause by clause and make their observations and input on the Amendment Bill rather than making a general contribution about the NHLS.

Mr Moralo replied that there were systematic and structural challenges that the Amendment Bill did not address. All stakeholders except NEHAWU were consulted by the Department when drafting the Bill. NEHAWU is directly engaged with the challenges and these need further engagement between NEHAWU and NDoH.

The Chairperson said the Draft Bill was published for public comment on 11 November 2015 and asked if NEHAWU is a part of the public or not. If NEHAWU had never been consulted, the Committee would have to engage with the Department of Health about this.

Mr Moralo replied that NEHAWU was part of the public but said NEHAWU expected a bi-lateral engagement. The CEO had been currently suspended but the structural and systematic issues needed urgent attention. Addressing the current problems may solve current problems but not addresses the root cause of the problems.

Mr Tengela said the NHLS was conducting research, which should not be the function of the NHLS. There was a need for the Department of Health to ask NEHAWU what it meant by integration and how integration would occur.

Ms Kopane observed that the Committee had met with the NEHAWU president on 1 August but what was said then was different from what the delegates said. The NHLS Amendment Bill was being clogged with other issues by NEHAWU. These other issues should be attended to on another platform.

Ms L James (DA) asked if NEHAWU had raised these recommendations on any other platform.

Mr Moralo replied that NEHAWU would have gone clause by clause but there was no formal engagement on the Amendment Bill.

The Chairperson said that NEHAWU should come back to the Committee after identifying any problems clause by clause in the Bill. NEHAWU should also come with its view on the NAPHISA Bill. The Committee would find time to receive the feedback. Although the Committee would not want to be prescriptive, it asked the delegates to pass the information on to its national leadership.

Mr Tengela asked how the inputs could be incorporated.

The Chairperson said the NEHAWU contribution should follow the clauses in the Amendment Bill. If there is any doubt, NEHAWU can clarify this with the Committee Secretary.

Mr Moralo thanked the Committee for giving them a second chance.

The Chairperson thanked everyone and adjourned the meeting.