The National Department of Health (NDoH) has published a draft legislation proposing reforms to the financially-burdened National Health Laboratory Service (NHLS).

This will pave the way for the creation of a new institute responsible for monitoring and responding to outbreaks of diseases such as Ebola, reported BDLive. The NHLS Amendment Bill and the National Public Health Institute of SA Bill were published on 11 November 2015.

The NHLS is the largest diagnostic pathology service in the country and raises most all of its funds from the diagnostics tests it performs for provinces providing laboratory and related public health services to about 80% of the population.

The NHLS’s financial crisis is reported to have strained its capacity to fulfil other responsibilities, which include training pathologists and running the National Institute for Communicable Diseases, the National Cancer Registry and the National Institute for Occupational Health.

The NHLS Amendment Bill proposes strengthening the governance of the institution by changing the size and composition of its board, and giving the minister the power to institute a formal inquiry if it fails to fulfil its duties.

“Currently the minister cannot intervene to address problems or non-performance without having to go to court,” said NDoH’s Deputy Director-General for Regulation and Compliance, Dr Anban Pillay.

Instead of having a 22-member board with representatives from all nine provinces, the bill proposes a smaller board of between seven and eleven members.

The bill also clarified the minister’s role in appointing the CEO of the NHLS. The Health Department was discussing a new funding model with the NHLS and provinces, said Dr Pillay.

“The current model is that of a fee-for-service approach. The legislation is being changed to allow greater flexibility in changing the reimbursement methods. A fee-for-service model has been shown to entrench perverse incentives,” said Dr Pillay.

According to Dr Pillay, the NHLS’s financial position had improved, as provinces were paying more of their bills on time.

“The NHLS has been able to steadily reduce its liability to suppliers and has maintained a two-month buffer in terms of salary costs,” said Dr Pillay.

In March NHLS officials told Parliament KwaZulu-Natal owed R3.289 billion and Gauteng owed R1.092 billion.

The National Public Health Institute of SA Bill proposes the establishment of an institution similar to that of the US Centres for Disease Control and Prevention to conduct surveillance of disease and research.

“The aim is to provide integrated and co-ordinated disease and injury surveillance, research, monitoring and evaluation of services, and interventions directed towards the major public health problems affecting people in SA,” said Dr Pillay.

“It will be funded through a direct transfer from the fiscus. It may also complement its revenue through other funding streams,” concluded Dr Pillay.

Direct funding will make it simpler for the government to provide it with extra finances to respond to disease outbreaks, such as the recent Ebola epidemic in West Africa.

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