In spite of migrating through more than 10 drafts and being in deliberation for five years, the National health Bill incorporates little that will improve an unequal, inefficient, confusing, often contradictory and overly centralized health system in South Africa.

The Bill aims to regulate health service in such a way that they are safe and effective and promote equity. But it does so using the tried and failed method of forcing people to do what government decides is good for the country, instead of offering the kinds of incentives that draw personnel to outlying and poor areas or forming private public partnerships that put large private health groups at the disposal of rural people through competitive government contracts.

A major feature of the Bill criticised by many in the private health industry is the Certificate of Need which must be provided by the Director General on the basis of a host of criteria which the director general is in no position to verify accurately because of inadequate information systems. The result will be the loss of skilled young doctors leaving the country as confusing, draconian legislation builds up around them casting uncertainty, and potential for arbitrary decisions and corruption.

The IFP applauds the move by The Prescribing Doctors who have taken government to court for threatening to revoke licenses or issue licenses on the basis of insufficient information to justify its decisions. The Health Professional Council of SA has the same responsibility to its members whose case was eloquently put to the committee by the Registrar's Association.

The Bill provides for numerous new bodies and committees including statutory, advisory, research, consultation and information systems committees, nationally and provincially with duplication of responsibility and the creation of yet more bureaucratic structures to pontificate over health delivery.

Already with the overlap of national and provincial responsibility causing a glaring lack of accountability in public facilities, these added talk shops will add to the confusion. Meantime the Minister can override most of their advice with virtually unfettered discretionary powers over selecting members to committees, appeals against her director general, and most aspects of ethics and research into issues such as stem cells, cloning, forms of fertilization and organ transplants.

Health services must be regulated, not for total control but to ensure that there is compliance with minimum standards in public and private establishments and that when practitioners fail they are held accountable.

With the burgeoning of medical science the issues of ethical research are of vast public interest and should not be relegated to behind the scenes decisions by the Minister in terms of regulation to which parliament has no input. The history of ethics in health policy has left much to be desired in the past and this bill encourages rather than curbs similar practises in future.

Even donor funding goes through the filter of Ministers of Health, nationally and provincially and if the debacle over the Global funds did not warn us of the dangers of such control then we are naive dreamers who believe that politicians only use power for the public good. Reality teaches otherwise. The National Health bill legislates undemocratic practises that should be challenged by all those who will be affected by its arbitrariness.