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Community nursing bill under microscope
Tamar Kahn
2005-10-11

CAPE TOWN - The politically sensitive issue of community service for nurses is set to come into the spotlight today, when Parliament begins public hearings on the draft nursing bill. However, critics warn that clumsy implementation of the health departments plans for compulsory community service will drive nurses overseas.

SA cannot afford to lose more nurses. The 2005 Health Systems Trust Review, a joint study by the trust and the health department, last month quantified the shortfall. The number of enrolled nurses declined from 59,7 for every 100000 patients in 2000 to 51,5 this year.

Last year the health department acknowledged that 60% of primary health-care facilities had no nurses with appropriate training. 

Health Minister Manto Tshabalala Msimang took the profession by surprise last year when she announced that community service, originally pegged to begin in 2007, would start this year.

The plans were shelved after it became apparent that the nursing bill, which contains the legal mechanisms to make this happen, would not be passed in time. 

Although student nurses say they are not opposed to doing a year of compulsory community service before they qualify, they have previously expressed concerns about how the programme is put in place.

The Democratic Alliance (DA) has questioned the departments ability to manage the process. 

The structure and mandate of the South African Nursing Council, which oversees the nursing profession is also set to be scrutinised. The nonracial statutory council was created by various amendments to the 1978 Nursing Act. 

The draft bill strengthens the watchdog role of the nursing council, giving it greater powers to investigate the quality of nursing or midwifery provided by hospitals and clinics. Under the current act, the council can only probe the standards of individual practitioners.

But more controversially, the bill also proposes reducing the size of the council from 39 members to 25, all of whom will be nominated by the health minister. At the moment, 18 members of the council are elected by the nursing profession. 

The DA has criticised this proposal, saying it gives too much power to the minister.

However, South African Nursing Council registrar Hasina Subedar said it was an important change, because members were not on a council to promote the interests of a professional group, but were there to maintain the standards of the profession.

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