Ruling on doctors infringes on citizens' right to healthcare

Refilwe Moloto spoke to the director of the Rural Health Advocacy Programme Russell Rensburg about the threats posed to healthcare in rural areas now that the Certificate of Need has been deemed unconstitutional.

The High Court in Pretoria has declared that Section 36 to 40 of the National Health Act unconstutional, scrapping the much-contested need for healthcare professionals to have a Certificate of Need (CoN).

This has sparked debates on the potential consequences the ruling will have on healthcare in the country - particularly for citizens in rural areas.

The high court ruling means healthcare professionals will not be required to obtain a CoN from the Department of Health before they establish a practice in a specific area.

While this posed a host of advantages, it also came with serious disadvantages to consider, said the director of the Rural Health Advocacy Programme Russell Rensburg.

Rensburg argued that the removal of the CoN could impact the number of healthcare professionals in rural areas, potentially infringing on their right to access healthcare.

He added that even though the the state has a constitutional obligation to provide healthcare to all citizens, it could not do so if there weren't practitioners working in those healthcare facilities.

If the state can have all the facilities in the world, but if healthcare practitioners don't want to work in those facilities, then you can't deliver the healthcare services... the right for the healthcare professional to practice their trade where they want to, then impacts on the rights of citizens to be able to access those services in areas they don't want to practice [in].

Russell Rensburg, director - Rural Health Advocacy Programme

For Rensburg, it's not just the CoN that's the issue, but its consequences on patients who may now suffer due to a potential decrease in practitioners working in rural areas.

The actual application has very little to do with the Certificate of Need. If you afford that right to a healthcare professional to be able to choose what they want to do, where they want to do it, without considering the rights of the patients... then you have a situation where there's conflict of rights.

Russell Rensburg, director - Rural Health Advocacy Programme

While rural areas were tough posts to fill due to many practitioners preferring to work in urban areas Rensburg said the demand should be placed on the patients and not the areas of practice.

Healthcare is not like opening a spa. Healthcare is a life or death business and we have to put the patient at the centre of it. I think the Certificate of Need is imperfect, but the right to health isn't.

Russell Rensburg, director - Rural Health Advocacy Programme

Listen to the full interview above.

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