| Summary |
The Department of Health adopted the district health system as the vehicle to render primary health care in 1995/6. This policy is reflected, inter alia, in the White Paper on the Transformation of the National Health System published in April 1997. In addition, the view that local government should govern health districts as capacity is developed at municipal level, was also expressed a few years ago and continues to be the policy of the Department.
The link between local government and health districts is a logical one given the need for local accountability, the importance of community participation and the need to meet local health needs. These and other principles are listed in the district health system policy document published towards the end of 1995. In addition, the Constitution makes provision for municipalities to render various services, either as delegated or assigned functions or, as in the case of municipal health services, as core functions. |
| More Details |
The link between local government and health districts is a logical
one given the need for local accountability, the importance of community
participation and the need to meet local health needs. These and other
principles are listed in the district health system policy document
published towards the end of 1995. In addition, the Constitution makes provision
for municipalities to render various services, either as delegated or assigned
functions or, as in the case of municipal health services, as core functions.
Unfortunately, these policies have not been very easy to implement.
There are a host of reasons for this, including:
- the incomplete transformation of local government with respect to
both the redemarcation of local government boundaries as outlined by the Municipal
Demarcation Act (1998) (a PDF document) and the creation of new
categories and types of municipalities as envisaged in the Municipal
Structures Act (1998) (also a PDF document).
- the large number and varying capacities of the current transitional
local councils
- the current health legislation as embodied in the National Health
Act of 1977, which empowers municipalities to render certain health services
- the fact that municipal employees are on different salary scales
and conditions of employment compared to their provincial counterparts.
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