Below is a statement read during the march against the Western Cape Health Facility Boards and Committees Bill must involve communities. It was published in the Cape Times of 15 December 2015.
On 10 December 2015, concerned residents, members of community health forums and NGOs marched to the Provincial Legislature in protest of the Health Facility Boards and Committees Bill. The National Health Act provides a framework for a structured health system, which takes into account the obligations imposed by the Constitution. This Act gives power to the people to take ownership and responsibility of health services in partnership with health care workers, through community participation. Community participation is universally acknowledged as a pillar of effective primary health care and it underpins the right to health.
The Western Cape Health Facility Boards and Committees Bill was drafted with the intention of enhancing peoples’ involvement in the governance processes of hospitals and primary health care facilities, and was described by MEC Professor Nomafrench Mbombo as a “significant milestone in strengthening community involvement in PHC services”. The intention of the Bill was to provide an explicit policy framework to allow for community involvement and oversight in the provision of health services especially at primary health care level.
Community members place trust in these health forums, some of which have been in operation for more than 20 years. These forums strive for quality services and client-provider relationships, dignified and humane treatment of patients, opportunity for feedback on services and they promote the sense of responsibility and ownership of health services by the community. Therefore it is no surprise that community participation through these structures has been linked not only to improved health outcomes, but a strengthened health system.
The People’s Health Movement South Africa (PHM-SA) stands in solidarity with the Cape Metro Health Forum in voicing a grave concern for the implications of the Bill. First, an apparent top down approach by Provincial Government to appointing these committees without due community involvement in their election, will lead to decision-making outside of community control. Furthermore, the proposed clustering of the health committees at a level higher than that of the community will undermine the unique representation that each committee currently has, and this approach will ultimately work against strengthening the health system through community participation. This threatens the very essence of and rationale for community participation in the right to health.
PHM-SA is dismayed that the proposed new Western Cape Health Facilities Boards and Committees Bill will change the type of community engagement and representation currently allowed, through increased dictatorship to communities regarding who is permitted to service on their respective health committees. MEC Professor Mbombo herself mentioned that health is about the lives of our people, and it cannot be turned into a political football. However, the Bill seems to have become this.
Communities must retain the right to be involved in and inform appropriate models of health care, to be able to hold authorities accountable and to ensure that their health needs are met at community level, and that these needs are recognised and dealt with within the overarching social and economic determinants of health. Without this, we will fall short of creating a health care system that serves the needs of the people.
Dr Kathryn Stinson
Chair, The People’s Health Movement South Africa
Email southafrica.phm@gmail.com
www.phm-sa.org