OHSC Fraud Hotline

Overview of certification process

The twin processes of certifying health establishments that comply with standards of service and enforcing compliance by establishments that persistently fall short of requirements are central to the OHSC's work, as set out in the National Health Amendment Act of 2013.

Legislation provides that inspections conducted by the Compliance Inspectorate lay the foundation for certification and enforcement: they result either in a recommendation for certification or in the issuing of a compliance notice, stipulating improvements that should be made in order to meet the required standards of care.

These standards are set out in regulations promulgated by the Minister. The first regulations setting out proposed standards for public and private hospitals and primary healthcare clinics were published in February 2015 for public comment.

In all instances where the Compliance Inspectorate has determined that the health establishment has met the required level of compliance with regulated norms and standards, the OHSC must issue a certificate of compliance. Normally this certificate would be valid for a maximum of four years and would need to be renewed within that period.

However, in terms of the law, the OHSC has the power to withdraw a certificate of compliance in cases where it has evidence that standards have declined and the establishment no longer meets the required standards.

If a health establishment receives a compliance notice and persistently fails to address its shortcomings, various enforcement measures may be taken by the OHSC. In selecting the course of action, the OHSC will have to take into account the nature of the establishment's shortcomings and their seriousness.

The National Health Amendment Act of 2013 empowers the OHSC to do any of the following:

  • Issue a written warning to the establishment to comply within a specified time.
  • Require a written explanation from the establishment for its continued non-compliance.
  • Recommend to a relevant authority – for example an MEC for Health or head of a municipal health department – that suitable action be taken. This could include disciplinary action against individuals responsible for continued failure to comply with standards.
  • Recommend to the Minister of Health temporary or permanent closure of the health establishment (or a section of it) in instances where its continued functioning would pose a serious risk to service users or the public.
  • Impose a fine on the establishment or on an individual, in accordance with regulations.
  • Refer the matter to the National Prosecuting Authority for prosecution in a criminal court.

The chief executive officer of the OHSC is obliged to inform the head of a national or provincial health department, the manager of municipal health services or the head of a health establishment about persistent failure to comply with standards.

Once an establishment has corrected all the matters mentioned in a compliance notice, a certificate of compliance is issued.

Establishments have a right of appeal against findings of non-compliance by the OHSC.
The appeal must be lodged with the Minister of Health who is obliged to set up an ad hoc tribunal, chaired by a retired magistrate or retired judge of the High Court and comprising one or two other members with relevant knowledge of the healthcare industry. The tribunal may confirm, vary or set aside the decision of the OHSC.

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