South African legislation, such as the Bill of Rights, the White Paper on the Transformation of the Health System, the National Health Bill, and the Patients’ Rights Charter provide the policy framework towards obtaining equitable access to health care services for all South Africans. On a practical level, however, this goal can only be fully realised through provision of an equitable distribution of health care providers. Such a system can help to ensure equity of access, and could also be used as a mechanism to evaluate and monitor the quality of care given.

To this effect, in 1996 the Department of Health introduced a two-year community service programme for doctors to increase the numbers of newly qualified doctors working in the public sector. At the same time, extension of community service to other health personnel, such as dentists and pharmacists, was placed on the department’s agenda. The community service programme for doctors, begun in 1998, is generally seen as working well and has resulted in a reduction of the shortage of doctors in under serviced areas.

The government also launched its National Drug Policy (NDP) in 1996. The NDP was particularly concerned with improving the pharmaceutical sector, including the rendering of pharmaceutical services. In 1997, the Pharmacy Amendment Act, No. 81 was passed by Parliament in order to bring the existing Pharmacy Act (No. 53 of 1974) in line with the provisions of the NDP. It is within this broader context that the Pharmacy Amendment Bill (No. 51 of 1999) has been promulgated. The Bill aims to redress inequity by ensuring that pharmacists perform community service in the under-serviced areas where they are most needed. The Department of Health consulted with the South African Pharmacy Council and all the provinces during the drafting of the Bill. The community service programme is scheduled to start in January 2001.

The main objective of the Bill is to amend the Pharmacy Act (No. 53 of 1974) to include a provision for the performance of community service for a period of one year for persons registering for the first time as pharmacists. Specifically, the Bill provides that any person registering for the first time as a pharmacist shall:

• perform remunerated pharmaceutical community service for a period of one year; and
• be entitled to registration to practise as a pharmacist on the completion of such service.

Community service pharmacists will be employed by provincial departments of health, and will be remunerated by them. However, the Minister of Health, after consultation with the South African Pharmacy Council, reserves the right to make regulations regarding (amongst others) the place at which community service is to be performed and the conditions of employment.

3. Response to the Bill

NPPHCN welcomes and supports this Bill as it proposes changes that will help redress the present maldistribution of pharmacists. It is a necessary mechanism for rectifying inequity in health care services in under serviced areas. It is also highly important in terms of the development of human resources as outlined in the White Paper for the Transformation of the Health System in South Africa. The Bill’s provisions will help to build and sustain an effective team of health care providers deployed in district health systems throughout the country. This is especially important within the context of the district health system's aim to provide comprehensive primary health care for every person in each district on the basis of need.

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