GP & GP & SPECIALISTSPECIALIST

INDABA INDABA 20122012

National Health Act: National Health Act: Section 46Section 46

Presentation to the Parliamentary Portfolio Committee on Health

5 June 2013

The National Health Act 61 of 2003

Section 4646. Obligations of private health establishments

Every private health establishment must maintain insurance cover sufficient to indemnify a user for damages that he or she might suffer as a consequence of a wrongful act by any member of its staff or by any of its employees.

The National Health Act : Section 46

Section 46 raises two questions:1.Are individual / group medical practices

included under the concept “Private Health Establishment”?

2.What type of damages and wrongful acts the insurance cover is required to provide indemnity?

The National Health Act : Section 46

Definitions:“private health establishment” means a health

establishment that is not owned or controlled by an organ of state;

“health establishment” means the whole or part of a public or private institution, facility, building or place, whether for profit or not, that is operated or designed to provide inpatient or outpatient treatment, diagnostic or therapeutic interventions, nursing, rehabilitative, palliative, convalescent, preventative or other health services;

The National Health Act : Section 46

Definitions:• “user” means the person receiving treatment in a health

establishment, including receiving blood or blood products, or using a health service, and if the person receiving treatment or using a health service is-(a) below the age contemplated in section 39(4) of the Child Care Act, 1983 (Act No. 74 of 1983), “user” includes the person’s parent or guardian or another person authorised by law to act on the firstmentioned person’s behalf; or(b) incapable of taking decisions, “user” includes the person’s spouse or partner or, in the absence of such spouse or partner, the person’s parent, grandparent, adult child or brother or sister, or another person authorised by law to act on the firstmentioned person’s behalf;

The National Health Act : Section 46

Applying the Definitions• GPs and Medical Specialists diagnose patients

at consultation and may provide diagnostic or therapeutic interventions in their rooms. This may therefore bring their rooms under the definition of “health establishment”

• Physiotherapists engage in rehabilitative services in their rooms and rendering their rooms a “health establishment”

The National Health Act : Section 46

Concerns with Section 46• No definition for “Insurance Cover”.• No “ceiling amount” or “cap” for the cover is

stated• Staff or employee may also be medical or

other healthcare providers.

The National Health Act : Section 46

Clarity and confirmation is sought on the following:

• Are private medical practices considered “private health establishments”?

• Is the indemnity / insurance intended to indemnify the private health establishment and not the “user”?

• Is the cover actually liability cover and not insurance cover?

QuestionsQuestions▪▪

Thank YouThank You

Julian Botha

Senior Legal Advisor

South African Medical Association Tel: (012) 481 2060Fax: (012) 481 2100Email: julianb@samedical.org