1 THE NURSING BILL BRIEFING BY THE NATIONAL DEPARTMENT OF HEALTH CAPE TOWN 15 NOVEMBER 2005

2 HISTORICAL OVERVIEW OF SANC  Before 1944 nurses were regulated under the Medical and Dental Act of  In 1944 the first Nursing Council was established.  In 1957 the second Act followed based on racial lines.  In 1978 the Nursing Act No. 50 of 1978 was passed.

3 HISTORICAL OVERVIEW OF SANC  In 1994 the existing four Nursing Councils were disbanded and an Interim Nursing Council was established to prepare for a democratic permanent Council.  In 1998 the first democratic Council was inaugurated.  The term of office was 5 years.

4 HISTORICAL OVERVIEW OF SANC  The second democratic elected Council was inaugurated in June 2003 and and its term of office ends in May  The Council currently consists of 39 members.

5 BACKGROUND OF THE NURSING BILL  The process to transform the Council was initiated in  In November 2001 the Minister of Health accelerated the process by appointing a task team consisting of members from professional and technical Councils as well as the Department of Health to look at the transformation of Statutory Health Councils.

6 BACKGROUND OF THE NURSING BILL  Some of the recommendations of the TT are as follows: - The main purpose of Professional Councils is to protect and promote the public’s interests, including ensuring delivery of quality care. - Introduction of good corporate governance. - Introduction of the Charter for Council members.

7 BACKGROUND OF THE NURSING BILL - Council to be receptive to community and public interests. - Smaller but more productive Councils - streamlining of Councils.

8 BACKGROUND OF THE NURSING BILL  The Nursing Bill has incorporated these recommendations.  The Bill was published for a period of 3 months for public comments from December 2003 to March 2004.

9 PURPOSE OF THE BILL The primary purpose is to transform the Nursing Council so as to increase the protection of the interest of the public and to promote greater accountability by Council members and the Registrar. The Bill is intended to dovetail with provisions of the National Health Act, 2003 (Act No. 61 of 2003) and other relevant statutes.

10 PURPOSE OF THE BILL The Bill further seeks to promote the constitutional requirement of access to health care services and the right to basic health care, provided in the spirit of protection the health care users right to dignity. The Bill seeks to make consequencial amendments to other legislation in order to update outdated references.

11 PURPOSE OF THE BILL Several workshops were held with stakeholders to brainstorm policies behind the Bill. The Department took into account the outcomes of the workshops in drafting the Bill.

12 OBJECTIVES OF THE BILL The Bill aims to: a. Serve and protect the public in matters involving health services provided by the nursing profession; b. Ensure that the Council exercises its powers and discharges its responsibilities in the best interest of the public and in accordance with national health policy; c. Promote

13 OBJECTIVES OF THE BILL The Bill aims to: c. Promote the provision of acceptable nursing care to the population; d. Regulate the nursing profession and how nurses must conduct themselves in the profession; e. Promote the operations and functions of the Council and the Registrar;

14 OBJECTIVES OF THE BILL The Bill aims to: f. Promote liaison regarding health standards and standards of nursing education and training; g. Ensure that the Council advises the Minister on matters affecting the profession; and h. Provide for registration of nurses and keeping of registers.

15 CHAPTER 1 OF THE NURSING BILL  Deals with definitions in the Bill.  Definitions in line with those in the National Health Act, 2003 (Act No. 61 of 2003).  Important features: - The word nurse to be used only by someone registered with the Nursing Council. - Staff Nurse replaces “Enrolled Nurse” since all nurses will have one register. - “Rolls” for lower categories abolished.

16 CHAPTER 1 OF THE NURSING BILL  Deals with continued existence, objects, functions and powers of the SANC.  Main feature is that Council exists to serve and protect the interests of the public not the nurses.  Section 5 deals with the composition and dissolution of Council. Number reduced from 39 to 25. Members appointed by the Minister but nominated by interest groups.

17 CHAPTER 1 CONTINUES Chairperson appointed by the Minister. Members can serve for a maximum of 10 years.  Minister has powers to dissolve the Council if it fails to comply with the provisions of the Act.  Section 15 deals with the introduction of the disciplinary appeal committee.

18 CHAPTER 1 CONTINUES  Section 29 deals with corporate governance which spells out the responsibilities of the Council and that of the Registrar e.g Registrar as Accounting Officer of the Nursing Council etc.

19 CHAPTER 2 OF THE NURSING BILL  Deals with Education, Training, Research, Registration and Practice.  The main features are to bring Nursing Education and training in line with the National Qualifications Framework (NQF) and related Legislation.  The Council will keep a single register for all practitioners as opposed to a register and a roll.  The revised scope of the profession will be one of the main features.

20 CHAPTER 2 CONTINUES  Section 39 makes provision for the introduction of Continuing Professional Development. (CPD)  Section 40 makes provision for introduction of community service for nurses who are South African citizens registering for the first time.

21 CHAPTER 3 OF THE NURSING BILL  Deals with powers of the Council with regard to unprofessional conduct.  Section 46 deals with powers to institute an inquiry into any complaint against a Director, Manager or owner of an agency registered in terms of this Act.  Section 51 deals with impairment.  Section 52 deals with powers of Council to enter any institution or premises whose learners are trained therein and to confiscate any documents / objects.

22 CHAPTER 4 OF THE NURSING BILL  Deals with penalties for non regulated individuals, false representation and impersonation.

23 CHAPTER 5 OF THE NURSING BILL  Section 56 deals with special provisions relating to certain nurses and midwives.  Section 57 establishes the Appeals Committee against Council decisions.  Section 58 deals with a list of Regulations to be promulgated by the Minister after consultation with the Council.

24 IMPLICATIONS OF THE BILL  If passed into law the present Council will be dissolved and a new Council put in place after the Election Regulations have been promulgated by the Minister.  Section 61 (2) states the old Council to continue functioning until the names of the new Council members are gazetted.

25 REPEAL OF LAWS  Section 60 (1) lists the laws to be repealed.  Section 60 (2) the repeal does not affect the transitional arrangements contained in Section 61.

26 SECTION 60 NO. AND YEARSHORT TITLEEXTENT OF REPEAL No. 50 of 1978Nursing ActThe whole No. 71 of 1981Nursing Amendment ActThe whole No. 70 of 1982Nursing Amendment ActThe whole No. 97 of 1986Transfer of Powers and Duties of the State President Act Section 46 No. 56 of 1987Nursing Amendment ActThe whole No. 21 of 1992Nursing Amendment ActThe whole No. 145 of 1993Nursing Amendment ActThe whole No. 5 of 1995Nursing Amendment ActThe whole No. 88 of 1996Abolition of Restrictions on the Jurisdiction of Courts Act Section 78 No. 19 of 1997Nursing Amendment ActThe whole No. 45 of 1997Extension of Terms of Office of Members of Certain Councils Act Section 6

27 SANC MEMBERSHIP  Statistics as at December 2004 Professional Nurses / Midwives- 98,490 Enrolled Nurses / Midwives- 35,266 Enrolled Nursing Auxiliaries- 50,703 TOTAL- 184,459  On training students - 12,280  Enrolled Nursing Auxiliaries- 8,300