1. On page 2, in the twenty eighth line, after "of" to insert "quality".

2. On page 2, in the twenty ninth line, after "of" to insert "equity, efficiency,".

1. On page 6, in line 1, after "a" to insert "public".

2. On page 6, after line 12, to insert the following definition:

"essential health services" means those health services prescribed by the Minister to be essential health services after consultation with the National Health Council;

3. On page 6, from line 36, to omit the definition of "health establishment" and to substitute:

"health establishment" means the whole or part of a public or private institution, facility, building or place, whether for profit or not, that is operated or designed to provide inpatient or outpatient treatment, diagnostic or therapeutic interventions, nursing, rehabilitative, palliative, convalescent, preventative or other health services;

4. On page 7, in line 1, to omit "provides" and to substitute "is involved in the provision of".

5. On page 7, in line 22, to omit "control" and to substitute "health surveillance".

6. On page 7, in line 23, to omit "communicable disease control" and to substitute:

surveillance and prevention of communicable diseases, excluding immunisations

7. On page 7, in line 28, to omit paragraph (j).

8. On page 7, after line 62, to insert the following definition:

"primary health care services" means such health services as may be prescribed by the Minister to be primary health care services;

9. On page 8, in line 38, after the "parent," to insert "grandparent,".

1. On page 8, in line 50, after "provides" to insert "in an equitable manner".

2. On page 8, in line 54, after "(c)" to insert "protecting,".

3. On page 8, in line 57, to omit ", within available resources".

4. On page 9, after line 2, to add the following subparagraph:

1. 0n page 9, in line 11, after "services" to insert ", which must at least include primary health care services,".

2. On page 9, in line 14, after "(e)" to insert "equitably".

3. On page 9, from line 14, to omit "taking into consideration health needs and available resources".

4. On page 9, in line 18, after "must" to insert "equitably".

1. On page 9, in line 21, after "Minister" to insert ", after consultation with the Minister of Finance,"

2. On page 9, after line 28, to add the following paragraph and subsection:

(3) Subject to any condition prescribed by the Minister, the State and clinics and community health centres funded by the State must provide—

1. On page 9, in line 43, after "services" to insert "and explain the implications, risks, obligations and consequences of such refusal".

2. On page 9, after line 43, to add the following subsection:

(2) The health care provider concerned must, where possible, inform the user as contemplated in subsection (1) in a language that the user understands and in a manner which takes into account the user's level of literacy.

1. On page 10, in line 3, after "parent," to insert "grandparent,".

2. On page 10, after line 11, to insert the following subsection:

(2) A health care provider must take all reasonable steps to obtain the user's informed consent.

1. On page 10, in line 29, to omit "Where" and to substitute "Subject to any applicable law, where".

1. On page 10, in line 43, to omit "as an inpatient".

2. On page 10, after line 44, to add the following subsections:

(2) In prescribing the information contemplated in subsection (1), the Minister must have regard to—

(3) A discharge report provided to a user may be verbal in the case of an outpatient or a user who is not an inpatient, but must be in writing in the case of an inpatient.

1. On page 11, in line 3, after "that" to insert "appropriate,".

2. On page 11, after line 11, to add the following paragraph:

1. On page 11, in line 27, to omit "Any person working for or on behalf of any health establishment or any" and to substitute "A health worker or".

1. On page 11, after line 40, to add the following subsection:

(2) If the study, teaching or research contemplated in subsection (1)(a) reflects or obtains no information as to the identity of the user concerned, it is not necessary to obtain the authorisations contemplated in that subsection.

1. On page 12, after line 25, to insert the following subsections:

(3) The procedures for laying complaints must—

1. On page 12, in line 33, after "(b)" to insert "Subject to section 14,".

2. On page 12, after line 35, to insert the following paragraph:

3. On page 12, in line 36, after "certificate" to insert "or release of liability".

1. That the following be a new clause:

"Rights of health care personnel

20. (1) Health care personnel may not be unfairly discriminated against on account of their health status.

(2) Despite subsection (1) but subject to any applicable law, the head of the health establishment in question may in accordance with any guidelines determined by the Minister impose conditions on the service that may be rendered by a health care provider or health worker on the basis of his or her health status.

(3) Subject to any applicable law, every health establishment must implement measures to minimise—

(4) A health care provider may refuse to treat a user who is physically or verbally abusive or sexually harasses him or her.

1. On page 13, from line 7, to omit "medical, dental and auxiliary staff" and to substitute "human resources for health".

2. On page 13, in line 11, to omit "emergency" and to substitute "health and".

3. On page 13, after line 26, to add the following subsections:

(3) (a) The Director-General must prepare strategic, medium term health and human resources plans annually for the exercise of the powers and the performance of the duties of the national department.

(b) The national health plans referred to in paragraph (a) must form the basis of—

(4) The national health plans must comply with national health policy.

(5) The Director-General must integrate the health plans of the national department and provincial departments annually and submit the integrated health plans to the National Health Council.

1. On page 14, after line 12, to insert the following subsection:

(2) The National Health Council may determine the time frames, guidelines and the format for the preparation of national and provincial health plans.

3. On page 14, in line 22, after "Minister" to insert "or his or her nominee contemplated in section 21(2)(a)".

1. On page 15, in line 22, to omit "paragraph (b)" and to substitute "paragraphs (b) and (c)".

2. On page 15, after line 23, to insert the following paragraph:

3. On page 15, in line 24, to omit "two years" and to substitute "12 months".

1. On page 15, from line 37, to omit "authorities" and to substitute "councils".

2. On page 15, in line 39, to omit "authorities" and to substitute "councils".

3. On page 15, from line 54, to omit paragraph (m).

4. On page 16, after line 13, to insert the following subsections:

(3) The head of a provincial department must—

(4) Provincial health plans must conform with national health policy.

1. On page 16, in line 36, to omit "intergovernmental".

2. On page 17, after line 5, to insert the following subsection:

(3) A Provincial Health Council may determine the format and time frames for the preparation of district health plans within its jurisdiction.

3. On page 17, after line 8, to insert the following subsection:

(4) The Provincial Health Council may create one or more committees to advise it on any matter.

3. On page 17, in line 10, after "Council" to insert "or his or her nominee contemplated in section 28(2)(a)".

1. On page 17, in line 53, to omit "paragraph (b)" and to substitute "paragraphs (b) and (c)".

2. On page 17, after line 55, to insert the following paragraph:

3. On page 18, in line 1, to omit "two years" and to substitute "12 months".

1. On page 19, after line 7, to insert the following subsection:

(4) A district health council may create one or more committees to advise it on any matter.

1. On page 19, in line 25, after "that" to insert "appropriate".

2. On page 19, in line 26, after "are" to insert "effectively and equitably".

3. On page 19, from line 30, to omit subsection (3) and to substitute:

(3) An agreement contemplated in section 156(4) of the Constitution is known as a service level agreement and must provide for—

1. On page 19, in line 36, after "plans" to insert "and development of district human resource plans".

2. On page 19, from line 37, to omit all the words following upon "district" up to and including "Council" in line 38 and to substitute:

and metropolitan health manager must develop and present to the district health council in question and the relevant member of the Executive Council

3. On page 19, after line 42, to add the following subsection:

(2) The relevant member of the Executive Council must ensure that each health district develops and implements a district human resource plan in accordance with national guidelines issued by the Director-General.

1. On page 20, in line 1, to omit ", location and type" and to substitute "and location".

2. On page 20, after line 6, to add the following subparagraph:

1. On page 20, in line 17, to omit "one year" and to substitute "24 months".

2. On page 20, in line 39, after "providers" to insert "and health workers".

3. On page 20, after line 43, to insert the following paragraphs:

4. On page 21, in line 4, after "provider" to insert "or health worker".

5. On page 21, in line 7, after "provider" to insert "or health worker".

6. On page 21, in line 11, after "provider" to insert "or health worker".

7. On page 21, in line 16, after "must" to insert "within a reasonable time".

1. On page 21, in line 20, to omit "exceed 10 years" and to substitute "exceed 20 years".

1. On page 21, after line 32, to insert the following subsection:

(4) The Minister must within a reasonable time after reaching a decision give the appellant written reasons for such decision.

1. On page 21, in line 36, to omit "promote" and to substitute "ensure".

2. On page 21, in line 36, after "services" to insert:

, with special regard to vulnerable groups such as woman, older persons, children and people with disabilities

3. On page 21, in line 50, after "must" to insert "ensure and".

4. On page 21, in line 51, after "services" to insert:

, with special regard to vulnerable groups such as woman, older persons, children and people with disabilities

5. On page 21, after line 56, to insert the following paragraph:

1. On page 22, in line 30, after "with" to insert:

, in the case of a central hospital, the National Treasury and, in the case of any other hospital,

2. On page 22, in line 32, after "a" to insert "representative".

3. On page 22, in line 36, after the first "a" to insert "representative".

1. On page 24, after line 21, to add the following subsection:

(2) The policy and guidelines contemplated in subsection (1) must amongst other things facilitate and advance—

1. On page 24, in line 25, after "providers" to insert "and health workers".

1. On page 24, in line 35, to omit "(a)" and to substitute "(i)".

2. On page 24, in line 36, to omit "(b)" and to substitute "(ii)".

3. On page 24, after line 37, to insert the following subparagraph:

4. On page 24, in line 50, to omit ", controlled or treated" and to substitute "or controlled".

5. On page 25, in line 27, to omit "ombuds" and to substitute "ombudsperson".

1. On page 26, in line 24, after "establishments" to insert:

at all levels of the national health system, including peripheral facilities,

1. On page 26, after line 46, to insert the following paragraphs:

1. On page 27, in line 6, to omit "and blood fractionation".

2. On page 27, in line 9, to omit "and blood fractionation".

1. On page 32, after line 40, to insert the following paragraph:

1. On page 33, in line 40, after "committees" to insert:

and hear any complaint by a researcher who believes that he or she has been discriminated against by a health research ethics committee

2. On page 33, from line 41, to omit paragraph (e) and to substitute:

3. On page 33, in line 43, to omit "disciplinary action" and to substitute "such disciplinary action as may be prescribed".

1. On page 34, in line 29, after "department" to insert:

which must include a person who acts as ombudsperson in respect of complaints in terms of this Act

2. On page 35, in line 2, after "providers" to insert ", health workers".

3. On page 35, in line 3, after "agency" to insert ", health worker".

4. On page 35, in line 5, after "provider" to insert ", worker".

5. On page 35, in line 17, after "agencies" to insert ", health workers".

1. On page 35, in line 32, to omit "annually" and to substitute "every three years".

2. On page 35, in line 32, to omit ", but" and to substitute "and".

3. On page 25, after line 39, to insert the following subsection:

(3) If the Office for Standards Compliance orders the total or partial closure of a health establishment, the Minister must ensure, within a reasonable period from the date of such closure, that reasonable alternative and accessible health services are available to any community affected by the closure.

4. On page 35, in line 48, after "provider" to insert "or health worker".

1. On page 36, from line 14, to omit ", or of a District Health Council with the approval of the relevant municipal council,".

2. On page 36, after line 16, to add the following paragraph:

1. On page 39, after line 54, to insert the following paragraphs:

2. On page 40, in line 2, to omit "published".

3. On page 40, in line 3, to omit "generally.

4. On page 40, in line 3, after "authoritative" to insert "by internationally recognised health bodies".