ROLE OF THE OHSC IN NATIONAL HEALTH INSURANCE

With the country facing numerous healthcare costs and service challenges, President Cyril Ramaphosa, signed the National Health Insurance Act (No. 20 of 2023) into law in May 2024. The Act represents a significant milestone for South Africa’s healthcare system. The NHI is a centralised, national insurance fund from which the government will buy healthcare services from healthcare providers in both public and private sectors. All eligible South African residents, as defined in the NHI Act, will be able to visit these providers whenever they need healthcare, without any payment. The NHI will make healthcare more affordable, by reducing the cost of healthcare due to the economies of scale that can be achieved by purchasing healthcare for the entire population.

The OHSC is the regulatory body for healthcare services. The entity is mandated to protect and promote the health and safety of healthcare service users by monitoring and enforcing compliance by health establishments with the prescribed norms and standards. NHI Act, 2023 Section 39(2)(b) states that a health care service provider or health establishment must possess and produce proof of certification by the OHSC to be accredited by the Fund. Section 39(12) states that the Fund may grant conditional accreditation to a health care service provider or health establishment as prescribed by the Minister after consultation with the OHSC.

For the OHSC to fulfill its role as prescribed in implementing the NHI, increasing the OHSC compliance inspection coverage in the healthcare sector is imperative. It is also vital to note that the OHSC’s importance lies not only in its role under the NHI but also in the overall improvement of healthcare quality in South Africa as it relates to healthcare establishments.