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What are your rights?
Your right of access to healthcare is protected in the s. 27 of the Constitution. While provincial government has most of the responsibility for providing healthcare services, local government plays a role in primary healthcare (clinics).
What primary health care services should you expect in your district?
At a minimum, the following services should be available at a clinic or health centre near you:
- Non-emergency services at a clinic for at least eight hours a day, five days a week. Services here should include: immunisation services, contraception, termination of pregnancy, antenatal care, services for infants and children, treatment for sexually transmitted infections, testing and treatment for HIV, testing and treatment for TB, treatment for chronic conditions such as diabetes and high blood pressure.
- Emergency and in-patient care at a district health centre or district hospital 24 hours- a-day, seven days a week.
- Referral and patient transport from a primary health care facility, to a provincial or tertiary hospital, should you require complex procedures, such as surgery.
Local government is in part responsible for the delivery of those services in the area of prevention of communicable diseases, water quality monitoring, waste management and pollution control, funeral regulation and in some instances primary health care. It is local governments’ responsibility to ensure that you live in a safe and healthy environment (s. 152 (d) of the Constitution; s. 3(l) of the Municipal Systems Act; s. 84(i) of the Municipal Structures Act; s. 32 (1) of the National Health Act).
Local government has a duty to ensure safe water, to prevent water borne related diseases, manage solid waste and air pollution. Municipalities are required to include environmental health in their strategic plans (s. 23 of the Municipal Systems Act) and ensure that there is funding available for this purpose in its budget.
Delivery of health care is the responsibility of provincial government. However, some large municipalities run municipal clinics that provide primary health care services. These municipal clinics are paid for by the provincial government, based on an agreement between the province and the municipality (s. 32 (3) of the National Health Act).
District health system
Primary health care includes doctors visits, check-ups, and immunisations. Most primary health care services are provided at the local level through the district health system, which is part of the provincial health system.
The district health system is divided into health districts and sub-districts. The boundaries of these districts should match those of the district and Metropolitan municipalities (s. 29 (2) of the National Health Act) while the boundaries of the sub-district should match the boundaries of your local municipality (s. 30 of the National Health Act). Health districts and sub-districts are responsible for the delivery of primary health care at clinics, district health centres and district hospitals within their boundaries.
District health managers are responsible for the development and management of district health budgets and strategic plans, including a district human resource plan (s. 33 of the National Health Act). These plans and budgets must be made available to you upon request.