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National Health Act, 2003 (Act No. 61 of 2003)


National Health Insurance Policy towards Universal Health Coverage

Chapter 6 : Reorganisation of the Health Care System and Services under NHI

6.2 Improving Leadership and Governance

6.2.5 Role and management of other levels of public hospitals


171. As is the case for central hospitals, the roles, functions and responsibilities of management and governance structures for the district, regional, tertiary and specialised hospitals will have to change. Hospitals will be contracted to render quality health services in accordance with the norms and standards as determined by the Office of Health Standards Compliance (OHSC) and in line with healthcare services that will be determined by the NHI Benefits Advisory Committee.


172. In order to improve accountability, quality of health services, performance and effectiveness, managers will be provided with more decision making space in critical management domains. This will include delegations on the management of human resources, finance and supply chain/procurement. Strengthened management will also be vital in the areas of facility management, cost centre management, and management and maintenance of essential equipment and infrastructure. This will be achieved through enhancement of management competencies in these areas and strengthening the role of Hospital Boards. For establishment of minimum competency requirements and continuous professional development of health managers, all health facility managers will be required to have a health management qualification.


173. The NHI Fund will contract directly with the hospitals. The hospitals will be required to assume increasing degrees of managerial autonomy in preparation for NHI.