National Health Insurance (NHI) Bill: Clause 42 to 47 deliberations

Meeting report

Clause 42: Complaints

The Chairperson took the Committee through Clause 42 of the Bill. 

Mr N Xaba (ANC) indicated the ANC’s support for Clause 42 (1). The party acknowledged the Treatment Action Campaign (TAC) and SECTION 27’s requests that the Clause should not limit those persons that may make representations to healthcare service providers; and their subsequent proposal that the terms natural and juristic person be replaced with terms persons (for a natural person) and affected party (for a juristic person), so that complaints of any nature, including those persons who are the subject of the complaint and affected third parties, may rely on the section to make representations to the Fund.

He further explained that the ANC supported the clause because it clearly stated that the Fund must develop and implement protocols and procedures to deal with complaints raised by various stakeholders, including: users, pensions, providers, and suppliers. These must be clearly communicated and readily accessible, to ensure that the Fund processes to address complaints are compliant with the Constitution and the provisions of the Promotion of Administrative Justice Act (PAJA). Additionally, the Fund should endeavour to deal with all complaints in a fair and lawful manner and make certain that the protocols and systems implemented to achieve those objectives, constitute reasonable administrative action.

Thereafter, he submitted the ANC’s support for Clause 42 (2) and outlined that the party expected the Fund to be able to speedily investigate any incident reported to it; and that it exercises its investigatory powers in a fair, non-procedural, and transparent manner. The outcomes of such investigations must be speedily reported within the stipulated timeframes. Where deemed necessary, the investigation unit, as established by the Chief Executive Officer (CEO), should be able to forward and furnish relevant information about a specific incident to other bodies, such as the Healthcare Professional Council (HPC), National Consumer Commission (NCC), Office of the Health Ombud (OHO) and South African Police Services (SAPS).

Ms H Ismail (DA) mentioned that she had various points to raise. One, she highlighted that the clause did not specify what would happen to the complaints process in the Office of Health Standards Compliance (OHSC) and the OHO.

Two, she asked for clarity on what mechanisms were in place to ensure the impartiality of the NHI Fund. Furthermore, she asked how the complaints would be dealt with in an impartial and fair manner.

Three, she called for specifications to be put in place to regulate the administration of fines.

Four, she pointed out that the lengthy complaints process set out by the NHI Bill did not consider the grief that a complainant would endure. To resolve this, she recommended the inclusion of specified timeframes for when complaints should be heard, processed and the outcome communicated to the complainant. 

Five, she noted that no clarity had been provided on what structure should be in place to ensure a smooth and proactive process, which would, amongst other things, assist in minimising NHI customers’ need to lay complaints. Implementing such a system, she added, would also reduce the NHI’s likelihood of experiencing consistent litigation.

Ms M Clarke (DA) asked why the Clause required the Minister to be consulted on the complaints procedure.

Referring to Clause 42 (3), she asked what the department defined as a reasonable time for the Fund to communicate the outcome of an investigation into a complaint laid to the complainant.

She pointed out that the centralisation of purchasing either through the NHI Fund could not be reasonably argued to improve efficiencies and local responsiveness. As a result, communities, she added, had no say over any aspect of the proposed national framework.

Like Ms Ismail, she felt that the complaints’ regime was not independent. In addition, she believed that the limitation on natural and juristic persons may prevent partnerships; and unincorporated entities from furnishing complaints.

Referring to clause 42 (2), which spoke to the CEO’s powers to launch an investigation of an incident reported, she mentioned that the section was vague in that it did not specify whether the investigation would be resolved within 30 days. She questioned the point of the section if a complaint was not required to be resolved in 30 days. Thereafter, she asked two questions. One, she asked what the department defined as a reasonable time period. Two, she asked how either the Minister or the NHI Fund planned to ensure the effectiveness of this section when the vast majority of public healthcare providers did not comply with the requirements for registration and receipt of a certificate.

Ms E Wilson (DA) said that her major concern with the NHI Bill related to the powers allocated to the Minister, which, in her opinion, left him in charge of all appointments, as well as of all the structures in the entity. This also meant that the Minister controlled the complaints and appeal process, making him the judge, jury, and executioner. She disagreed with this and suggested that this process be done through an independent entity, to ensure impartiality.

Thereafter, she asked three questions. One, whether private or non-contracted hospitals and healthcare providers who were not contracted to the NHI would fall under the OHO once the Bill was enacted.

Two, what is the size of the investigation unit, established by the CEO, its job description, and its cost?

Three, what did the department define as a reasonable time, and by whose standards?

Mr E Siwela (ANC) submitted that the ANC supported Clause 42 (3) for the following reasons. One, it complied with the PAJA, as it allowed the Fund to treat all complainants fairly and dedicate reasonable effort and resources to investigate any complaints raised. The ANC had consistently called for the Bill to promote access to information in a transparent and accountable manner. Further, in its earlier input, the party supported the recommendation that a definition of what constitutes a reasonable period of time is placed in the definitions section of the Bill.

Ms N Chirwa (EFF) indicated that the clause lacked a breakdown in the number of severe cases. Further, it did not specify what a reasonable amount of time was. Both issues, she added, were problematic, as numerous persons are currently subjected to poor health services because there had been no room to decipher complaints based on severity, be it health or financial (on the part of a service provider).

Still referring to clause 42 (2), she asked what method and or system is in place to finalise a severe complaint that cannot be concluded within the 30-day timeframe. In addition, if there was, why had not been stipulated in the Bill?

Referring to clause 42 (3), she asked what would happen in the instance where the Fund did not communicate the outcome of an investigation within the stipulated time.

Touching on clause 42 (4) (c), she mentioned that the NHI Bill, in its current form, did not stipulate what the jurisdictions of healthcare facilities were if they did not register and receive accreditation. As such, she asked what the effect of the payment of services by a customer, utilising healthcare facilities under the NHI, would be, as that would ordinarily be done with the assistance of private medical aid and insurance.

Ms X Havard (ANC) supported the submissions made by both Mr Siwela and Mr Xaba on Clause 42. 

Mr P Van Staden (FF+) felt that the entire Bill was a complete disaster.

He informed the Committee that he had two concerns. The first related to, what he described as, the lack of impartiality regarding the Fund, which according to Clause 42, is expected to conduct an investigation on complaints received.

His other concern was that once affected, the NHI would reduce the roles of the SA Medical Association, OHSC, OHO, and HPC.

Dr S Thembekwayo (EFF) felt that the clause did not consider the end-user in the NHI’s complaint system design. This system, she believed, failed to appreciate the magnitude of the difficulties faced by a complainant, particularly as many of them would be indigent, rendering them unable to afford legal representation to pursue a complaint. She requested that the department provide greater detail on the structure planned for administering complaints.

Due to all of the reasons mentioned, the EFF did not support the adoption of Clause 42.

Ms A Gela (ANC) supported Mr Xaba and Mr Siwela’s submissions on Clause 42.

Ms Gela elaborated that while the ANC supported clause 42 (2), the party had two additions to make. One, the ANC believed that the Fund must be capable of speedily investigating any incident reported to it and must exercise its investigatory powers in a fair, and transparent manner. The outcomes of such investigations must be speedily reported within a stipulated time frame.

Two, the ANC suggested that where necessary, the investigation unit established by the CEO should be able to forward and finish relevant information on a specific incident, to other bodies, such as the HPC, NCC, SAPS, and OHO. 

Ms Wilson pointed out that Clause 42 did not stipulate whether the complaints and appeals related only to the services the Bill would pay for once implemented. If it only related to services that the NHI would be contracted to at that point in time, she asked where it would leave other institutions like the OHO, NCC, and HPC. She added that it was unclear what the Clause sought to achieve.

The Chairperson indicated the ANC’s support for Clause 42 (2)( a-c). The party believed that the Clause, in its entirety, provided an interrelated and clear approach to how the Fund should apply when a complaint is lodged in terms of subsection 3. Notwithstanding that, the ANC proposed that the Fund ensure that it creates channels for all health service providers to which they can reasonably make representations in respect of any decision it reaches against the said provider. Furthermore, the Fund should establish mechanisms to make such considerations or representations.

In instances where the fund withdraws or refuses to review the accreditation of a healthcare service provider, the ANC advocated that reasons for such a decision be communicated to the set provider, using acceptable communication channels, and within a reasonable period of time. In addition, the party submitted that the meaning of a reasonable period of time be enhanced within the definition section of the Bill.

The Chairperson further highlighted his support for Mr Xaba, Mr Siwela, and Ms Gela’s submissions on Clause 42.

Mr Xaba supported the Chairperson’s submission on Clause 42.

Clause 43: Lodging of appeals

The Chairperson took the Committee through Clause 43.

Mr Xaba said that the ANC supported Clause 43. The ANC recognised the inevitability of the Fund receiving complaints from various parties, as it was entrusted with ensuring that every registered user has access to healthcare benefits rendered. Complainants dissatisfied with the outcome of their complaint may appeal to the Fund’s Appeal Tribunal. This provision was important as it ensured that the Fund would have a body vested with the necessary powers to review its decisions (the Fund) and make the necessary determinations.

Mr Siwela said the ANC supported Clause 43 for the following reasons. One, the clause addressed the concerns, raised by stakeholders such as SECTION 27 and the TAC, that the Bill should not limit those persons who may make representations to HSPs only, as it also encompasses users, health establishments, and suppliers. For that reason, the ANC did not deem it necessary to have the proposed replacement with the affected party, as these parties had been provided for.

Thereafter, he underlined his support for Mr Xaba’s submission on Clause 43.

Ms Wilson asked why the stipulated period to lodge an appeal was 60 days rather than 42; and whether a complainant would only be able to appeal a decision based on the services rendered by the NHI. If that were to be the case, she asked what the implications would be for the OHO. 

Ms Ismail indicated that the Clause gave the impression that only the complainant would be able to appeal a decision taken by the Fund and asked the Parliamentary Legal Advisors to clarify whether a third party would be able to join the appeal. The clause also did not give other relevant people opportunities to appeal the decision.

Mr Van Staden questioned the impartiality of the complaint and appeal process, as the Fund would be responsible for; the processing of a complaint; subsequent deliverance of a judgement; and consideration of the appeal.

Ms Clarke was concerned by the lengthy time period allocated for a complaint to be processed and asked how the department would ensure that medical-legal claims are escalated within the 60-day time frame.

Ms Havard supported the submissions made by Mr Xaba and Mr Siwela. 

Dr Thembekwayo mentioned that public healthcare practices’ capabilities remain a problem, especially for those who rely on public facilities. Furthermore, she underlined that the clause was vague on the role of provinces and their relationship with the new district management units. Both of these issues would further increase the backlogs in the Department of Health (DoH). Due to the stated reasons, the EFF did not support the Clause.

Ms Chirwa proposed that the 60-day time period allocated for appeals be scrapped, as the access to information, particularly within the DoH, rarely arrived to specified persons on time. Greater consideration should be given to ensuring access to legal recourse for economically disadvantaged persons so that they are able to appeal the NHI Fund’s decisions. Obtaining such access would ensure that their human rights are not violated, in a country with a history of such violations. One such example (of a gross violation) was the forced sterilisation debacle, where the majority of victims only found out they were forcibly violated years later, thus preventing them from filing a formal application of negligence – as the law only makes room for such cases to be reported within three years.

Based on those reasons, she recommended that the Clause be amended and make room for a timeless appeal period. Nonetheless, the EFF rejected the Clause as it stood.

Ms Gela supported both Mr Xaba and Siwela’s submissions. She explained that the ANC’s support for Clause 43 was based on five reasons: one, it ensured good governance and supported fairness in the decision-making process of the Fund, concerning PAJA. Two, its inclusion of a 60-day period to lodge an appeal, which it believed provided complainants sufficient time to consider and formulate their response to the Fund’s decision. Three, its provision that aggrieved parties will be provided the opportunity to take particular decisions reached by the Fund, under review through an independent panel and structure. Four, that it did not limit those persons who may make representations to the relevant healthcare service provider – which addressed the concerns raised by TAC and SECTION 27. Five, it encompassed users, healthcare service providers, healthcare establishments, and suppliers.

The Chairperson support Mr Xaba, Mr Siwela and Ms Gela’s submissions on the Clause. He explained that the Clause stipulated that one could appeal within a period of 60 days, which meant that a complainant could appeal any time before the final date. This provision did not restrict a complainant, in fact, it seemed to assist them.

Clause 44: Appeal Tribunal

The Chairperson took the Committee through Clause 44.

Ms Gela indicated that the ANC supported Clause 44 (2) for the following reasons. One, it provides that the Minister will, after consultation with Cabinet, appoint the Appeal Tribunal for a three-year term. Two, that such an appointment is consistent with other appeal bodies, such as the one for the Council for Medical Schemes. Three, it ensures that there will be a maintenance of good governance, transparency, and fairness for the appellants.

Ms Ismail mentioned that she took issue with the proposal for the Minister to establish the Appeal Tribunal, as it indicated a lack of impartiality. Furthermore, she felt that there was no transparency in the nomination process and final appointments of members to the body.

She requested that greater clarity be provided on what was meant by the term good cause in subsection 3 of the Clause. She was troubled by the lack of specification on; how deceased members in the Tribunal will be replaced; the disqualification criteria; and quorum requirements for the Section.

Mr Xaba supported Ms Gela’s submission. Thereafter he submitted that the ANC supported the clause for various reasons. While the party noted the National Planning Commission’s (NPC) concerns regarding the powers vested in the Minister to appoint the Appeal Tribunal – describing them as excessive and may lead to a potential conflict of interest; and perceptions that the process is not sufficiently neutral – it was of the opinion that the Tribunal would assist in ensuring that any decision reached by the Fund against a given party, or where the party is unhappy with such a decision, a review process would be undertaken to assess the fairness of the decision and its administrative appropriateness.

He added that similar to the Council for Medical Schemes (CMS) appeal board, the Minister would only appoint the Appeal Tribunal board for a term of up to three years. Therefore, the ANC, he said, supported the Minister’s role in the appointment of the Appeal Tribunal, after consultation with Cabinet. The Minister had never interfered with the functioning of the CMS’ appeals board, which in most instances has been chaired by a judge. Considering that point, the ANC proposed two minor amendments to Clause 44.1. One, that an Appeal Tribunal is hereby established consisting of five persons appointed by the Minister, after consultation with the Cabinet. Two, that 44.1 (a) be amended to allow for one member of the board to be appointed as the Chairperson, based on his or her knowledge of the law. 

The Chairperson asked if he had suggested that the words Appeal Tribunal replace the word board.

Mr Xaba acknowledged that is what he meant.

Ms Clarke said that the provision for the Minister to appoint the Appeal Tribunal and the Chairperson of the Board, illustrated the body’s lack of independence from its political authority. She recommended that the vacancies be advertised in the gazette or appointed by the Fund, without undue influence from the Minister. The effect of the section was that the Minister would effectively become the judge, the jury, and the executioner.

In response to the ANC’s proposed amendment to 44 (1) (a), she mentioned that there was no requirement in Section 14 that the Chairperson of the Board must have knowledge of the law; as such, it should first be proposed as an additional requirement.

Next, she asked why there was a difference in the appointment terms of the Board (five-year term) and the Appeal Tribunal (three-year term).

Referring to 3 (b) of the Clause, which speaks to the termination of the Board or Appeal Tribunal by the Minister, she pointed out that this created the space for abuse by the Minister, particularly when decisions went against him/her and the Fund.

Mr Van Staden was not pleased with the provision that the Minister would be responsible for the appointments of the Board and the Appeal Tribunal. Instead, he recommended that these powers be allocated to Parliament, strengthening oversight and transparency in the Bill.

Ms Wilson questioned the costs of establishing the six boards, an investigation unit, and an Appeal Tribunal; and remunerating those serving in each body. All the bodies would have to be established before any money was spent on hospitals and other related infrastructure. The implementation of the Bill, she indicated, could not be done. As such, she asked Members why they should continue with the deliberations on the Bill.  

Mr Siwela supported Ms Gela’s and Mr Xaba’s submission on Clause 44.

Dr Thembekwayo mentioned that the ANC had forced Clause 44 down the throats of both the EFF and South Africans at large. She suggested that Parliament be given the powers to appoint members of the board and the Appeal Tribunal, to improve transparency as well as public involvement in the processes, who would assist in guarding against undue political influence. Further, she submitted that the Appeal Tribunal be given the power to appoint its Chairperson, without the Minister’s approval.  Considering those reasons, the EFF objected to the inclusion of the Clause and called for it to be scrapped.

Ms Havard supported the submissions made by Mr Siwela, Mr Xaba and Ms Gela.

Ms Chirwa supported Dr Themekwayo’s submission on Clause 44.

Thereafter, she listed additional objections to the Clause.

Referring to clause 44 (1), she said that it had been raised several times in the Committee that Parliament should be involved in the process of appointing individuals to the Appeal Tribunal by interviewing candidates by recommending the chosen names to the Minister. 

Touching on clause 44 (3)(c), she requested that the reasons for non-renewal be clearly stated in the section. The entire NHI Bill gave the Minister undue power and authority, thus weakening transparency and impartiality.

Regarding clause 44 (3) (b), she proposed that the meaning of good cause be stipulated clearly in the terms of reference. She further advised that a good cause with the termination of a board member be viewed as an encompassing term, particularly as the Bill assigned significant powers to the Minister. With consideration of those reasons, the EFF rejected the Clause.

The Chairperson stated that the ANC supported Clause 44 (3)(a – c) because its provisions ensured that any Tribunal member who violated the conditions of his or her appointment could be removed by the Minister, as the appointing authority, following a duly outlined process. This, he argued, was important for oversight, good governance, and the functioning of the Appeal Tribunal – to the benefit of the affected parties.

He also supported Mr Xaba and Ms Gela’s submissions on Clause 44.

Clause 45: The Powers of the Appeal Tribunal

The Chairperson took the Committee through Clause 45.

Ms Havard mentioned that the ANC supported Clause 45 (1) (a-d) because similar to the CMS appeal board, the NHI Appeal Tribunal would have the same powers as the High Court (HC) to summon witnesses; for examinations and information to be administered; and to call for the production of goods, documents, and objects. The ANC deemed it appropriate for the Tribunal to be equipped with these powers. 

Ms Ismail asked if the assignment of powers, similar to the HC, to the Appeal Tribunal, would mean that it could make orders on costings. Two, she asked whether it meant that persons appealing to the Tribunal could have the same rights as they would have at a HC, such as the right to legal representation. She was concerned by this assignment of powers, as it would mean that the NHI would act as a parallel legal platform to the HC. She asked whether this development would take away the rights of appellants to take an appeal further if they are not pleased with the Tribunal’s verdict.

Ms Clarke said that the Tribunal did not have jurisdiction to condone late appeals after 60 days; and that it should either allow for; such condemnation; no appeals after sixty days; or for the appellant to approach the HC.

Ms Wilson mentioned that the adoption of Clause 45 would make the Minister the judge, jury, and executioner.

Mr Siwela indicated that the ANC supported clause 45 (1) (a-d) because similar to the CMS appeal committee, the Appeal Tribunal may, after the hearing, confirm the decision concerned or rescind it and resolve on another verdict. The ANC felt that the provisions are consistent with those outlined in Chapter 8 of the Constitution of the Republic, specifically those relating to HCs under Section 169. Furthermore, the party submitted that the provision was also consistent with Section 7 of PAJA.

In addition, he supported the submissions made by Ms Havard on Clause 45.

Mr Xaba supported the submissions made by Ms Havard and Mr Siwela.

Mr Van Staden mentioned that the danger arising from this Clause was that the complainant would not be able to approach any court if an appeal is upheld. He suggested that the Committee obtain external and internal legal opinions on this.

Ms Gela supported Ms Havard and Mr Siwela’s submissions on Clause 45.

The Chairperson also supported Ms Havard and Mr Siwela’s submissions on Clause 45.

Clause 46: Secretariat

The Chairperson took the Committee through Clause 46

Ms Gela indicated the ANC’s support for Clause 46, as it believed that it was consistent with the administrative procedures and processes implemented by similar bodies to support the functioning of their appeal tribunals. However, the party proposed a minor amendment to the Clause: ‘The Chief Executive Officer of the Board must designate a staff member of the Fund to act as a secretary for the Appeal Tribunal, who must keep the minutes and all records of the decision of the Tribunal for a period of at least three years after the decision has been recorded. The existence of the secretariat will assist the records keeping and also ensure that in instances where aggrieved parties require access to specific information, they may be granted such access as per the Promotion of Access to Information Act.’

Ms Ismail voiced her concern regarding the Appeal Tribunal’s lack of independence. As such, she recommended that the Tribunal have its own members and infrastructure, to ensure a separation between it and the Board. She requested the Committee seek a legal opinion to clarify the legality of the Clause.

Ms Wilson asked if the provision that the Fund keeps the minutes and all records of the Board's decisions for at least three years after the decision has been recorded was legally sound. As it was her understanding that if the Fund and Appeal Tribunal had such significant powers, their legal documents would need to be kept for five years.

Mr Xaba supported Ms Gela’s submission on Clause 46.

Mr Siwela supported Ms Gela’s submission on Clause 46.

Ms Havard also supported Ms Gela’s submission on Clause 46.

Ms Chirwa said that the EFF rejected Clause 46 due to its lack of detail concerning the role of the secretariat; and the requirement for the board to keep its decisions for a three-year period.

Dr Thembekwayo supported Ms Chirwa’s submission on Clause 46.

Ms Clarke proposed that all financial records be kept for at least a period of ten years.

The Chairperson supported Ms Gela’s submission on Clause 46.

He indicated that the Committee would only go up to Clause 47 for the meeting for the following reasons: one he had to attend a Committee of Chairpersons meeting; two, the Committee had to consider and adopt its outstanding minutes.

Clause 47: Procedure and Remuneration

The Chairperson took the Committee through Clause 47.

Mr Siwela indicated the ANC’s support for Clause 47 (4), as it believed it to be consistent with an aggrieved party’s constitutionally enshrined rights to seek redress in a court of law, as outlined in Chapter 8 of the Constitution and the relevant jurisdictions outlined by the various courts; that is Section 167, as it relates to the Constitutional Court; Section 168, as it relates to the Supreme Court of Appeal (SCA); and Section 169, as it relates to the HCs.

Regardless, the ANC felt that the inclusion of the Appeal Tribunal, as a provision in the Act, should not preclude aggrieved parties from seeking redress in the country's judicial system. The option of redress should mirror that of the CMS appeal board, which provisions a person to seek relief from the HC at any stage during the appeal process. This should only occur once the Fund has exhausted all of its internal processes, as provided in Section 7 of PAJA.

Ms Clarke asked what the remuneration amount applicable to members of the Appeal Tribunal – decided by both the Minister of Finance (MoF) and Minister of Health (MoH – would be. In addition, she asked if the MoF would be tasked with providing an additional budget for their remuneration; and whether the amount would be calculated within the DoH’s annual budget.

She argued that clause 47 (2) would be open to possible abuse by political parties and the Minister, considering that the Tribunal only contains five members. This provision would slow down the processing of complaints, which she assumed would be quite significant. Instead, she recommended that the provision be amended to allow complainants to approach the magistrate or HC as an ordinary course, as per clause 47 (4).

She asked why a 180-day time period for the Tribunal to determine the outcome of the appeal had been set, in clause 47 (3), whilst Clause 42 did not contain one for an aggrieved party to file a complaint. She urged that one be added so that there is uniformity.

Ms Gela mentioned that the ANC supported Clause 47 (1) because it will ensure that the Fund remunerates all members of the Appeal Tribunal, through the use of the provisions of the Public Finance Management Act, 1999, which in part aim to ensure that all revenues and assets of the government are managed efficiently and effectively. In addition, the ANC submitted that the Fund should make certain that the remuneration rate paid is consistent and compliant with the National Treasury prescripts, which can be released and updated from time to time.

She subsequently voiced her support for Mr Siwela’s submission on Clause 47.

Mr Xaba said that while the ANC noted the NPC’s concerns regarding Clause 47 (2) –  that the powers vested in the Minister to appoint the Appeal Tribunal (especially in Clause 45), are excessive and may lead to a potential conflict of interest and perceptions that the process is not sufficiently neutral – it supported the provision, mainly since it ensures that any member with a conflict of interest, regarding a matter serving on the Tribunal, being excluded from the proceedings.

This, the party believed, will prevent undermining the accuracy of the Tribunal's decision, and ensure that each one is transparent, enabling the Minister, after consultation with the Cabinet, to proactively appoint a replacement for the duration of the hearing, to which the applicable conflict of interest arises. Furthermore, it ensures that the capacity and knowledge base of the Tribunal is not weakened to the detriment of his decisions.

He also supported Mr Siwela and Ms Gela’s submissions on Clause 47.

Ms Wilson thought that clause 47 (3), which allowed the Appeal Tribunal to determine the outcome of an appeal within 180 days after the lodgement of the appeal, was incorrect, as the complaints would concern the health or finances of a patient or a service provider. Further, she believed this would further delay payments to service providers, who are often not paid on time. 

Ms Havard supported the submissions of Ms Gela, Mr Xaba and Mr Siwela.

Ms Ismail requested that the legal advisors look into the 180-day stipulated time period for the Tribunal to determine the outcome of an appeal, as the usual time would be at least 90 days.

Ms Chirwa asked what type of assistance an indigent appellant, whose appeal has been rejected, would receive to take the matter to the SCA. 

The Chairperson indicated that while the ANC supported Clause 47 (3), it wanted to propose an amendment. The party proposed that the 180-day time period be reduced to 90 days, similar to the CMS appeal boards and that the appeal be in the form of an affidavit. Furthermore, it submitted that the clause be amended as follows: ‘The appeal tribunal must determine the outcome of the appeal within 90 days after the lodgement of the appeal and inform the appellent of the decision in writing; and the secretariat appointed in Section 46, must keep record of all proceedings, outcomes and the decision that is being appealed against the suspended, pending the outcome of the hearing.’

This amendment was in line with the principles of administrative justice, which requires that public institutions adhere to due process principles when making administrative decisions and taking action. The principles of administrative justice include: lawful action, reasonableness and procedural fairness. Regarding lawful action, he argued that the decision must have been taken by the official duly authorised to do so, and must not be inconsistent with the confines of the applicable legal framework. In terms of reasonableness, all decisions and pursuing action must meet the rationality test and must be fit for purpose. As to procedural fairness, he explained that the affected parties must be given reasonable notice, be consulted, and the decision-making process must be impartial.

He supported the submissions made by Mr Xaba, Mr Siwela and Ms Gela.

Mr Xaba supported the Chairperson’s submission on Clause 47. 

Consideration and adoption of the minutes for 31 August 2022

The Chairperson requested a mover for the adoption of the minutes.

Mr Siwela moved for the adoption of the minutes.

Mr Xaba seconded the mover for the adoption of the minutes.

The minutes were duly adopted.

Consideration and adoption of the minutes for 7 September 2022

The Chairperson requested a mover for the adoption of the minutes.

Mr Van Staden moved for the adoption of the minutes.

Ms Gela seconded the mover for the adoption of the minutes.

The minutes were duly adopted.

Consideration and adoption of the minutes for 14 September 2022

The Chairperson requested a mover for the adoption of the minutes.

Ms Havard moved for the adoption of the minutes.

Ms Gela seconded the mover for the adoption of the minutes.

The minutes were duly adopted.

The Chairperson then announced that the Committee hoped to be briefed by the Minister on 28 September 2022, after the Joint Sitting.

Ms Chirwa requested that the Minister respond to two issues at the briefing. One, that he explains why SAHPRA had approved Sinopharm for private use and not public. Two, that he addresses the allegations of interference by Prof Glenda Grey and Lord Peter Hain in the National Health Laboratory Services (NHLS) appointment of a service provider to provide Covid-19 test kits.

Mr Van Staden asked if the Committee would be able to address the various issues which have affected the health sector over the past few weeks. 

The Chairperson requested that the Members send a list of issues they want to be addressed by the Minister, in writing, to the Committee Secretary. 

The meeting was adjourned.