government gazette republic of namibiano. 4459 government gazette 15 april 2010 3 “follow-up...

N$5.40 WINDHOEK-15April2010 No.4459

GOVERNMENT GAZETTEOF THE

REPUBLIC OF NAMIBIA

CONTENTSPage

GOVERNMENT NOTICE

No.73 Regulationsrelatingtoclassificationofstatehospitals,admissionofpatientstostatehospitals,andfees payablebypatientreceivingtreatmentin,atorfromstatehospital:HospitalsandHealthFacilitiesAct, 1994...................................................................................................................................................... 1

________________

Government Notice

MINISTRY OF HEALTH AND SOCIAL SERVICES

No.73 2010

REGULATIONSRELATINGTOCLASSIFICATIONOFSTATEHOSPITALS,ADMISSIONOFPATIENTSTOSTATEHOSPITALS,ANDFEESPAYABLEBYPATIENTRECEIVINGTREATMENTIN,ATORFROMSTATEHOSPITAL:

HOSPITALSANDHEALTHFACILITIESACT,1994

Undersection38oftheHospitalsandHealthFacilitiesAct,1994(ActNo.36of1994),readwithsections2(2)and19ofthatAct,Ihave-

(a) madetheregulationsassetoutintheSchedule;and

(b) repealedtheregulationspublishedunderGovernmentNoticeNo.43of1993,GovernmentNoticeNo.199of1995andGovernmentNoticeNo.12of2001,

effectivefrom01April2010.

R.N. KAMwIMINISTER OF HEALTH AND SOCIAL SERVICES Windhoek,30March2010

2 GovernmentGazette15April2010 No.4459

SCHEDULE

ARRANGEMENTOFREGULATIONS1. Definitions2. ClassificationofStateHospitals3. Furnishingofinformationbypatient4. Payment of hospital fees by medical aid schemes and funds, written undertaking, cash

depositorbankguarantee5. Classificationofpersonasprivatepatientorstatepatient6. RectificationofincorrectclassificationofpatientbyPermanentSecretary7. Statepatientbenefitsandresponsibilities8. Feespayablebypatientreceivingtreatmentin,atorfromstatehospital9. Freeorsubsidisedtreatment10. Freetreatmentofstatepatient11. Patientclassifiedintermsofrepealedregulations12. Rectificationoffeesincorrectlycalculated13. Appealagainstfeespayable14. Receiptofbodyatmortuaryatstatehospital15. Burialofunclaimedbodyinmortuary16. Unclaimedpropertyofpatientafterdischargefromstatehospital17. Soiledorinfectedpropertyofpatient ANNEXURE

Definitions

1. In theseregulations,unless thecontextotherwise indicates,awordorexpressiondefinedintheActhasthatmeaning,and-

“admission”meansthereceivingoracceptingofpersonintoastatehospitalfortreatmentaseitheranout-patient,acasualtyoranin-patient,and“admit”hasacorrespondingmeaning;

“admittingofficer”meansthepersontowhomthedutiesandpowersinrelationtotheadmissionofpatientstoastatehospitalhavebeenassigned;

“child”meansapersonwhoisundertheageof16years;

“classify”meanstoclassifyorre-classify-

(a) apatientaseithera statepatientoraprivatepatient,as thecasemaybe,and“classifiedpatient”or“classofpatient”hasacorrespondingmeaning;or

(b) astatehospitalintoanyofthecategoriesofstatehospitalsprescribedbyregulation2,and“classifiedhospital”or“classofhospital”hasacorrespondingmeaning;

“dependant”meansanypersonwhoisdependentuponanyotherpersonforhisorhermaintenance,andthatotherperson,inthediscretionoftheMinister,isresponsibleforthemaintenanceofthatfirst-mentionedperson;

“firstvisit”,inrelationtoanout-patient,meanstheadmissionofapersonforthefirsttimeinorataparticularstatehospitalforthetreatmentofanillnessorailmentafteraperiodduringwhichthatpersonhasnotreceivedtreatmentforthatillnessorailmentinoratthatparticularstatehospitaloranyotherstatehospital,butanycontinuedtreatmentwithinaperiodof24hoursafterthatadmissionmustbeconsideredtobepartofthefirstvisit;

No.4459 GovernmentGazette15April2010 3

“follow-upvisit”, in relation toanout-patient,means theadmissionofaperson,duringworkinghours,atanytimeafterthefirstvisit,inoratastatehospitalforthetreatmentofanillnessorailment;

“free treatment” includes the supply of the care, investigations, services, accommodation,pharmaceuticalandmedicalsupplies,agents,prosthesis,orthosis,conveyanceandothertreatmentanditemsprescribedbytheAnnexuretotheseregulations,freeofcharge;

“headofthefacility”meansthesuperintendentofastatehospital,oranyotherpersondesignatedbythePermanentSecretaryasthepersoninchargeofthatstatehospitalorotherstatehealthfacility,and“headofthestatehospital”hasacorrespondingmeaning;

“not applicable”means that the relevant treatment, servicesor amenities arenot available at thehospital,and“N.A.”hasacorrespondingmeaning;

“medicalcare”meansmedicalcareasdefinedbytheMedicalandDentalAct,2004(ActNo.10of2004);

“midwiferycare”meansmidwiferycareprescribedundertheNursingAct,2004(ActNo.8of2004);

“nursingcare”meansnursingcareprescribedundertheNursingAct,2004;

“police”meansanymemberoftheNamibianPoliceasdefinedinthePoliceAct,1990(ActNo.19of1990);

“privatepatient”meansanypersonclassified,orre-classified,asaprivatepatientinaccordancewiththeseregulations;

“publicholiday”meansapublicholidayreferredtoin,ordeclaredunder,section1of thePublicHolidaysAct,1990(ActNo.26of1990);

“socialcare”meanssocialcareasprescribedundertheSocialWorkandPsychologyAct,2004(ActNo.6of2004);

“socialworker”meansapersonregisteredassuchundertheSocialWorkandPsychologyAct,2004;

“speciality”meansaspecialityinmedicineordentistryprescribedundertheMedicalandDentalAct,2004(ActNo.10of2004);

“statehospital”meansastatehospitalclassifiedunderregulation2intotheapplicablecategoryofstatehospitalsprescribedbysubregulation(1)ofthatregulation,andincludesastatehealthfacility;

“statepatient”meansanypersonclassified,orre-classified,asastatepatientinaccordancewiththeActandtheseregulations;

“sub-speciality”meansasub-specialityinmedicineprescribedundertheMedicalandDentalAct,2004;

“theAct”meanstheHospitalsandHealthFacilitiesAct,1994(ActNo.36of1994);and

“workinghours”meansthehoursbetween07h00and17h00onaweekdayandbetween07h00and13h00onaSaturday,excludingaweekdayoraSaturdaythatisapublicholiday.

Classification of State Hospitals

2. (1) ThePermanentSecretarymayclassify, subject to theotherprovisionsoftheseregulations,everystatehospitalorstatehealthfacilityaseither-


(a) a“ClassA”StateHospital(CentralHospital);

(b) a“ClassBLevel1”StateHospital(IntermediateHospitalLevel1);

(c) a“ClassBLevel2”StateHospital(IntermediateHospitalLevel2);

(d) a“ClassC”StateHospital(DistrictHospital);

(e) a“ClassD”StateHealthFacility(HealthCentre);

(f) a“ClassE”StateHealthFacility(Clinic);or

(g) a “Class F” State Health Facility (Mobile Clinic or Outreach Service Point orCommunityHealthPost).

(2) Whenclassifyingastatehospitalorstatehealthfacilityundersubregulation(1),thePermanentSecretarymusttakeintoconsiderationandbeguidedby-

(a) thenatureoftheaccommodation,amenities,humanresources,medicaltechnology,treatment,servicesandfacilitiesprovidedby;

(b) the capital invested in and the expenses, including running costs, incurred inconnectionwith,

thatstatehospitalorstatehealthfacility;and

(c) thefollowingserviceprovisionat-

(i) a “Class A” State Hospital (Central Hospital): Essential, advanced andhighlysophisticatedmedicalspecialistservices,includingawiderangeofsub-specialities, general and specialisednursing andmidwifery care, andpromotive,preventative,rehabilitativeandsocialcare,for24hoursperday,sevendaysperweek,includingpublicholidays;

(ii) a“ClassBLevel1”StateHospital(IntermediateRegionalReferralHospital):Essentialandadvancedmedicalspecialistservices,includingalimitedrangeofsub-specialities,generalandspecialisednursingandmidwiferycare,andpromotive,preventative,rehabilitativeandsocialcare,for24hoursperday,sevendaysperweek,includingpublicholidays;

(iii) a “Class B Level 2” State Hospital (Intermediate Regional ReferralHospital): Selected essential medical specialist services, restricted tomain specialities, general nursing and midwifery care, and promotive,preventative,rehabilitativeandsocialcarefor24hoursperday,sevendaysperweek,includingpublicholidays;

(iv) a“ClassC”StateHospital(DistrictHospital):Generalfamilymedicalcare,general nursing and midwifery care, promotive, preventative and socialcare,for24hoursperday,sevendaysperweek,includingpublicholidays;

(v) a“ClassD”StateHealthFacility(HealthCentre):Limitedfamilymedicalcare, general nursing and midwifery care, promotive, preventative andlimitedsocialcareduringthoseworkinghoursdeterminedbythePermanentSecretary;


(vi) a “Class E” State Health Facility (Clinic): Promotive and preventativemedicalcare,generalnursingandmidwiferycareandintermittentfamilymedical care during those working hours determined by the PermanentSecretary;and

(vii) a“ClassF”StateHealthFacility(CommunityMobileClinicorOutreachService Point or Community Health Post): Regular promotive andpreventative services, intermittent general nursing care from Mondaysto Fridays, excluding public holidays, on the days and during the hoursdeterminedbythePermanentSecretary.

(3) ThePermanentSecretary,whenclassifyingastatehospitalundersubregulation(1)-

(a) may-

(i) request that state hospital to furnish him or her with such informationrelatingto;and

(ii) collect any information relating to, or conduct any investigation into theactivitiesof,

thatstatehospitalasheorshemayconsidernecessaryforthepurposesofclassifyingastatehospitalundersubregulation(1);

(iii) re-classifyastatehospitalclassifiedundersubregulation(1),subjecttotheotherprovisionsofthisregulation,asanyotherclassofstatehospital;and

(b) mustinwritinginformeachstatehospitalofitsclassificationundersubregulation(1)oritsre-classificationundersubparagraph(iii)ofparagraph(a)ofthissubregulation.

Furnishing of information by patient

3. (1) Ontheadmissionofapatienttoastatehospital,orassoonaspracticablethereafter-

(a) thepatient;or

(b) ifthepatientisadependantofanyotherperson,thatotherperson;or

(c) ifneitherthepatientnorthepersonofwhomthepatientisadependantisabletodosoatthatmoment,anyotherpersononbehalfofthepatientorofthepersonofwhomthepatientisadependant,

mustfurnishtotheadmittingofficerparticularsofthepatientrelatingtohisorher-

(i) fullnames,surname,maidenname(whereapplicable)andidentitynumber;

(ii) dateofbirthandage;

(iii) citizenship;

(iv) residentstatus;

(v) residentialaddressandbusinessaddress;


(vi) telephonenumberandcellphonenumber(ifany);

(vii) employer(ifany),includingthenameandaddressoftheemployer;and

(viii) nextofkin,includingthename,addressandtelephonenumbersofthatpersonorthosepersons.

(2) Ifthepatient-

(a) is a private patient, subject to regulation4, thenameof themedical aid fundofwhichthepatient,orthepersonofwhomthepatientisadependant,isamember,andhisorhermembershipcardormembershipnumber,mustbefurnishedintermsofsubregulation(1);

(b) isadependantofanyotherperson, it isnotnecessary to furnish the informationrelatingtothepatientprescribedbyparagraph(vii)ofsubregulation(1).

(3) Ontheadmissiontoastatehospitalofapatientwhoisadependantofanyotherperson,or as soonaspracticable thereafter, thepersonofwhom thepatient is adependantmustfurnishtheinformationprescribedbysubregulation(1)relatingtohimselforherselftotheadmittingofficer.

(4) If the person of whom the patient is a dependant is not able to comply withsubregulation(3),anyotherpersonmayfurnishtheadmittingofficerwiththeprescribedinformationonbehalfofthepersonofwhomthepatientisadependant.

Payment of hospital fees by medical aid schemes and funds, written undertaking, cash deposit or bank guarantee

4. (1) Ifapersonisadmittedtoastatehospitalasaprivatepatientinaccordancewithsection18oftheAct,andifheorsheisabletosubmitprooftotheadmittingofficer-

(a) that thefeespayableinrespectof thetreatmentof thatpatient in,atorfromthatstatehospitalispayableonbehalfofthatpatientbythePublicServiceEmployeesMedicalAidScheme(PSEMAS),managedandcontrolledunderthePublicServiceAct,1995 (ActNo.13of1995), thennotwithstanding the feesprescribedby theAnnexuretotheseregulations,thefeespayableinrespectofthetreatmentofthatpatientmustbecalculatedinaccordancewiththebenefitspayablebyPSEMAS;

(b) that-

(i) heorsheisamemberofanymedicalaidfundregisteredundertheMedicalAid FundsAct, 1995 (ActNo. 23 of 1995) and that the fees payable inrespectofthetreatmentofthatpatientin,atorfromthatstatehospital ispayableonbehalfofthatpatientbythatregisteredmedicalaidfund;

(ii) the feespayable in respectof the treatmentof thatpatient in, at or fromthatstatehospitalispayableonbehalfofthatpatientbytheSocialSecurityCommission in accordancewith theEmployeesCompensationAct,1941(ActNo.30of1941),orispayablebytheMotorVehicleAccidentFundinaccordancewiththeMotorVehicleAccidentFundAct,2007(ActNo.10of2007,

thatstatehospitalmustcharge,inrespectofthetreatmentofthatpatientin,atorfromthatstatehospital,thefeespayablebyprivatepatientsprescribedbytheAnnexuretotheseregulations.


(2) If the person referred to in subregulation (1) is unable to submit proof to thesatisfactionoftheadmittingofficerthatheorsheisapatientreferredtoinparagraph(a)or(b)ofthatsubregulation,thenheorshemustpay,uponadmissiontothestatehospital,acashdepositequaltotheamountofthetotalestimatedcostsoforrelatingtothetreatmentofthatpersonin,atorfromthatstatehospital,orsubmittotheadmittingofficeravalidbankguarantee,tothesatisfactionoftheheadofthatstatehospital,forpaymentoftheestimatedcostsoftreatment.

(3) Notwithstandingtheseregulations, ifapersonisadependantofanyotherpersonanddesiresadmissionto,ortreatmentin,atorfromastatehospitalasaprivatepatient,thepersonofwhomheorsheisadependantneednotfurnishtheinformationreferredtoinregulation3(1)(vii),orhavesuchinformationfurnishedonhisorherbehalf,if-

(a) awrittenundertaking,tothesatisfactionoftheheadofthatstatehospital,thatthepatientortheotherperson,asthecasemaybe,willpayforthetreatmentconcernedin,atorfromthestatehospitaltowhichthatpatientdesiresadmission,atthetariffoftheprescribedfeespayablebyprivatepatientsreceivingtreatmentin,atorfromthatclassofstatehospital;or

(b) acashdepositorvalidbankguarantee,tothesatisfactionoftheheadofthatstatehospital, foranamountadequate tocover the fullamountof the fees that, in theopinionoftheadmittingofficer,willbecomepayableinrespectofthattreatment,

isfurnishedbyoronbehalfofthepatient,orthepersonofwhomthepatientisadependant,totheadmittingofficer.

(4) Theheadofastatehospitalmayrequire,notwithstandingtheseregulations,fromanyprivatepatientwhodesiresadmission to,and treatment in,ator fromthatstatehospitalasaprivatepatient,orifthatpatientisthedependantofanyotherperson,fromthepersonofwhomheorsheisadependant,acashdepositorbankguarantee,tothesatisfactionofthatheadofthatstatehospital,inanamountadequatetocoverthefullamountwhichintheopinionofthatheadofthatstatehospitalmaybecomepayableinrespectofthattreatment.

(5) Ifadepositismadetoastatehospitalintermsofsubregulation(2)or(4),andifthefinalamountofthehospitalfeespayablebyaprivatepatientislessthantheamountofthedepositsomade,theheadofthatstatehospitalmustrefundthesurplustothepersonwhomadethedeposit,withinaperiodofnotmorethantwocalendarmonthsafterthedischargeofthatpatientfromthatstatehospital.

Classification of person as a private patient or a state patient

5. (1) Theadmittingofficermust classify, inaccordancewith section18of theAct,anypersonwhodesirestreatmentin,atorfromstatehospitalaseitherastatepatientoraprivatepatient.

(2) Whenclassifyingapatientundersubregulation(1)ofthisregulation,orre-classifyingthatpatientunderregulation6,aseitherastatepatientoraprivatepatient,thefactthatthepatient,atanypointintimepriortotheclassificationorre-classification-

(a) wastreatedbyaprivatepractitioner;

(b) receivedtreatmentinaprivatehospital;or

(c) wasconveyedinanambulancelicensedasaprivatehealthfacilityundertheAct,

maynotbetakenintoconsideration.


(3) Forthepurposesofsubregulation(1),adependanthasthesameclassificationastheclassificationofthepersonofwhomheorsheisadependant.

(4) ThePermanentSecretarymust resolveanydisputeas towhetherornotapatientisaNamibiancitizenorhasbeenlawfullyadmittedtoNamibiaforpermanentresidencethereinasrequiredbysubsection(2)ofsection18oftheAct.

Rectification of incorrect classification of patient by Permanent Secretary

6. (1) ThePermanent Secretary, of his or her own accord or on an applicationintermsofsubregulation(2),mayre-classifyaseitherastatepatientorasaprivatepatient,asthecasemaybe,anypersonclassifiedasastatepatientoraprivatepatientundersubregulation(1)ofregulation5,ifthePermanentSecretaryissatisfiedthattheclassificationofthepatienthasbeendoneincorrectly.

(2) Anypersonreferredtoinsubregulation(1)whodesiresare-classificationaseitherastatepatientoraprivatepatient,asthecasemaybe,ortheheadofastatehospitalwhoisnotsatisfied,foranyreason,withtheclassificationofapatientadmittedtoastatehospital,mustapplyinwritingtothePermanentSecretaryforthere-classificationofthatpatient.

(3) Beforere-classifyingapatientundersubregulation(1),thePermanentSecretarymayobtainfromthepatient,orifthepatientisadependantofanyotherperson,fromthatotherperson,orfromtheheadofthatstatehospital,theadmittingofficeroranyotherperson,suchinformationrelatingtothematterasthePermanentSecretarymayregardasnecessaryforconsideringthere-classificationofthatpatient.

State patient benefits and responsibilities

7. (1) Apersonreceivingfreeorsubsidisedtreatmentinaccordancewithregulation9or10,orapersonclassifiedunderregulation5(1),orre-classifiedunderregulation6,asastatepatientandwhoisreceivingtreatmentin,atorfromastatehospital-

(a) mustreceiveessentialhealthcare-

(i) that is reasonably affordable and available, and that is required anddeterminedby,andisappropriatefor,hisorherhealthcondition;

(ii) regardless of his or her socio-economic status, race or ethnicity, culture,religionorbelief,sex,gender,ageorpoliticalaffiliation;

(b) hasnochoice-

(i) as to which practitioner employed by that state hospital must providetreatmenttohimorher;or

(ii) astothestatehospitalthatheorshemustbetreatedin,atorfrom;

(c) must-

(i) betreatedwithrespectandcourtesyatalltimes;

(ii) be accorded privacy and confidentiality during consultation, physicalexamination,counsellingandtreatment;

(iii) be provided physical, emotional and psychological safety at the statehospital;


(iv) begivendetailedinformationontreatmentavailableatthestatehospitalatthetime;

(v) have access to the full range of preventative and promotive treatmentavailableatthestatehospitalatthetime;

(vi) beprovidedwithemergencycare treatmentatany timeasandwhenthattreatmentisavailable;

(vii) beinformedthatprioritytreatmentmustbegiventoemergencycasesandotherparticularprioritycases;

(viii) beexaminedandtreatedassoonasreasonablyandpracticallypossible;

(ix) beinformedoftheidentityoftheattendingpractitioner;

(x) beprovidedwithclearandrelevantinformation-

(aa) relatingtohisorhercondition;and

(bb) theavailabledifferenttreatmentoptionsforhisorherconditionandtheimplicationsofthosetreatments,

andbegrantedtheopportunitytoconsiderhisorheroptionsandtoobtainasecondopinion;

(xi) havetherighttodecideon,andparticipatein,hisorherowntreatmentandcare;

(xii) havetherighttogiveinformedconsentto,ortorefuse,treatment;

(xiii) begivenaccesstohisorherpersonalhealthfileandtherelevantmedicaldocuments,inthepresenceoftheattendingpractitioner,fortheclarificationofhisorherenquiries;

(xiv) bereferredtothenextlevelofcareortreatment,ifconsiderednecessarybythepractitioner;and

(xv) beprovidedaccesstoapatientrelationshipofficialofthestatehospitaltoenablehimorhertoofferfeedbackandsuggestionsforimprovementofthetreatmentorsubmitacomplaintrelatingthereto;

(d) must,andhastheresponsibilityto-

(i) familiarisehimselforherselfwiththePatientCharteroftheMinistry;

(ii) respectandappreciateallthepractitionersandtherightsofotherpersonsatthestatehospital;

(iii) fully-

(aa) co-operatewiththepractitionerregardingtheagreedtreatment;and

(bb) complywithandadheretotheprescribedmedicinesandtreatment,


andregularlyandpunctuallyreturntothestatehospitalforfollow-uptreatmentasrequestedbythepractitioner;

(iv) attendandparticipate inhealtheducationandhealthpromotionactivitiesarranged by the practitioner, and to commit towards changing his or herlifestyleinordertoimprovehisorherpersonalhealth,familyhealthandcommunityhealth;

(v) maintainacceptablestandardsofpersonalhygiene;

(vi) respecttherulesandregulationsoforrelatingtothestatehospital;

(vii) be honest and provide correct, true and complete information to thepractitioner;

(viii) respectandsafeguardallthepropertyoftheMinistry;

(ix) contributetowardstheprovisionoftreatmentbypunctuallypayingthefeesfortherenderingofthetreatmentprescribedbytheseregulations;

(x) keephisorherpersonalhealthpassportsafe,haveitinhisorherpossessionatalltimesduringhisorvisittoastatehospital,andpresentitatthestatehospital, together with his or her identity document, passport or driverslicence,whenseekingtreatmentatthatstatehospital;and

(xi) signthe“refusaloftreatmentform”beforeleavingthestatehospital,whenheorsherefusestoreceivetreatmentatthatstatehospitalandleavesthatstate hospital at his or her own risk, after having been informed of thepossibleconsequencesofhisorherrefusaltosoreceivethetreatment.

(2) Inthisregulation-

“personalhealthpassport”means thepersonalhealthpassport issuedby theMinistry toapersonwhenheorsheisseekingtreatmentatastatehospitalforthefirsttime.

Fees payable by patient receiving treatment in, at or from a state hospital

8. (1) Subject to these regulations, a patientwho is admitted and treated in, atorfromastatehospital,orifthatpatientisthedependantofanyotherperson,thepersonofwhomheorsheisadependant,mustpayfor thetreatmentthefeesprescribedintheAnnexuretotheseregulationsinrespectofthattreatmentofthatclassofpatientinthatclassofhospital,unlessheorsheisexemptedfromthepaymentofthefeesunderregulation9.

(2) Thefeespayablebyapatientreceivingtreatmentin,atorfromastatehospitalmustbecalculated,subjecttoanorderbytheheadofthatstatehospitalmadeunderregulation13(3),inaccordancewiththatpatient’sfinalclassificationorre-classificationunderregulation5or6,asthecasemaybe,aseitherastatepatientoraprivatepatient,andwhichisthevalidclassificationofthatpatientonthedateofhisorherdischargefromthatstatehospital.

(3) Whendetermining the feespayable for the treatmentofan in-patient, thedayofadmissionandthedayofdischargemustcountasoneday.

(4) Ifapatientisreferredtoastatehospitalbyaprivatepractitionerfortreatmentin,atorfromthatstatehospital,orthesupplyofanymedicineorothermedicalsuppliesonprescription,thatpatientmustpaytheapplicableprescribedprivateout-patientfees.


(5) Pharmaceuticalandmedicalsuppliestoprivateout-patientsprescribedbyparagraph(n)ofitem3(“Tariffoffeesforspecificinvestigationsorservices”)-

(a) must be limited to those included in the current Ministry of Health and SocialServicesofNamibiaEssentialMedicineList;and

(b) whensuppliedonprescription-

(i) notmorethanthequantityrequiredbythepatientforaperiodofonemonthmustbesuppliedatanyonetime;

(ii) when theprescription is a repeatprescription, theapplicableprivateout-patientfeesmustbepaid, inaddition to thefeesprescribedby theabovementionedparagraph(n)ofitem3,foreveryrepeat.

(6) Aprivateout-patientmayconsultwithaprivatepractitioner,obtainaprescriptionandmaybesupplied,subjecttosubregulation(7),withpharmaceuticalandmedicalsupplies-

(a) byaClassCorClassDstatehospitalonly;

(b) subjecttosubregulation(5);

(c) duringnormalworkinghoursonly;and

(d) againstpaymentof theprescribedprivateout-patient fees, inaddition to the feesprescribedbytheabovementionedparagraph(n)ofitem3.

(7) Whenpharmaceuticalandmedicalsuppliesaresuppliedundersubregulation(6)-

(a) theprescriptionmustutilisegenericmedicinetermsonly;and

(b) notmorethanfiveitemsofpharmaceuticalandmedicalsuppliesmaybesuppliedonasingleprescription.

(8) Pharmaceutical and medical supplies to private in-patients prescribed by theabovementionedparagraph(n)ofitem3mustbelimitedtothoseincludedinthecurrentMinistryofHealthandSocialServicesofNamibiaEssentialMedicineList for the relevantClassof statehospital.

Free or subsidised treatment

9. (1) Notwithstandingtheseregulations-

(a) apersonmaynotberefusedadmissiontoastatehospitalfortreatmentin,atorfromthathospitalonthegroundsthatheorsheisnotabletoaffordthepaymentoftheprescribedfeesfortreatment;

(b) apersonwhoisadmittedtoastatehospitalbecauseheorshesuffersfrommalnutrition,orsuffersfromorhasbeenincontactwithapersonwhosuffersfrom,acuteflaccidparalysis,anthrax,borreliosis,brucellosis,cholera,diphtheria,haemorrhagicfever,Hepatitis A, B or C, human immunodeficiency or acquired immune deficiencysyndrome, leprosy,malaria,measles,meningococcalmeningitis,neonatal tetanus,pertussis, plague, polio, rabies, schistosomiasis, sexually transmitted infections,tetanus,typhoidfever,tuberculosis,worminfestationsoryellowfever;oranyotherdiseasedeterminedbytheMinisterinwriting,mustreceivefreetreatmentinthatstatehospitalinrespectofthatdiseaseorcondition;


(c) afull-timescholarorstudentataschoolorothertrainingoreducationalinstitutionmaintainedbytheState,whoisadmittedtoastatehospitalforemergencytreatmentrelating toany injuryheor she sustainedduringanyactivityorganizedbyoronbehalfoftheschoolorinstitution,mustreceivefreeemergencytreatmentinthestatehospitalinrespectoftheinjury;

(d) apersonwhodonateshermilk,hisorherbloodortissue,oranorganfortransplanting,andwhoisadmittedtoastatehospitalforthepurposeofthatdonation,mustreceivefreetreatmentinthatstatehospitalforthatpurpose, if thedonationisconsidereddesirablefortherapeuticoracademicreasons,orforthepurposeofresearch,bytheheadof that statehospitalorbyanyothermedicalpractitionerauthorisedby theheadofthatstatehospitalforthatpurpose;

(e) apersonwho,byreasonofthefactthatheorshesuffersfromaparticularillnessorailmentandwho,withhisorherpermission,isadmittedtoastatehospitalundersuchconditionsastheMinistermayimposeintheinterestofmedicalresearchandtraining,mustreceivefreetreatmentinthatstatehospitalinrespectofthatillnessorailment;

(f) apersonwhoatthedirectionofthePermanentSecretaryis treatedin,atorfromastatehospitalforthepurposeofthepreventionofthespreadingofacontagiousdisease,mustreceivefreetreatmentforthatdisease;

(g) awell-baby, ante-natal, post-natal, family planning or immunization services, oranyotherservicesofferedaspartofapreventativeorpromotiveservice,includinghuman immunodeficiency virus and acquired immunodeficiency syndrome (HIVandAIDS) counselling and testing and conducted in, at or froma statehospital,mustbeprovidedfreeofcharge,butanytreatmentreceivedduringthatpreventativeorpromotiveservicewhichisnotroutinelyofferedaspartofthatservices,mustbechargedforinaccordancewiththefeesprescribedintheAnnexure;

(h) apersonwhoisreceivingabasicstatepension,ablindperson’spensionoradisabilitypensionundertheNationalPensionsAct,1992(ActNo.10of1992),andwhoisnotentitledtoanyofthebenefitsreferredtoinparagraph(a)or(b)ofregulation4(1),mustreceivefreetreatment;

(i) achildunder theageof16years,whoiskept inachildren’shomeoraplaceofsafetyundertheChildren’sAct,1960(ActNo.33of1960),orwhohasbeenfoundbyachildren’scourtunderthatActtobeachildinneedofcare,orwhois,intheopinionof thePermanentSecretary,anorphan,avulnerablechild,anabandonedchildorachildwithoutvisiblemeansofsupport,mustreceivefreetreatment;

(j) arefugeeasdefinedinsection1oftheNamibiaRefugees(RecognitionandControl)Act,1999(ActNo.2of1999),mustreceivefreetreatment;

(k) aveteranorthedependantofaveteranasdefinedinsection1oftheVeteransAct,2008(ActNo.2of2008)mustreceivefreetreatment;

(l) a person sentenced to a term of imprisonment by any court in Namibia, whileservingthattermofimprisonment,oranydetaineeawaitingtrial,mustreceivefreetreatment;and

(m) a person referred by the police, or any similar law enforcement agency, for anymedico-legalconsultationortests,mustreceivefreetreatment.


(2) Whenapatientprescribedbyparagraph(h),(i),(j),(k),(l)or(m)ofsubregulation(1)isadmittedfortreatmentin,atorfromastatehospital, thatpatientmustfurnishproof, tothesatisfactionof theadmittingofficer, thatheorsheisapatient thatmustreceivefreetreatment inaccordancewiththatsubregulation.

(3) Ifapatientreferredtoinsubregulation(2)failstofurnishtheadmittingofficerwiththeproofprescribedbythatsubregulation,heorshemustnotreceivefree treatmentbutmustbeclassifiedasastatepatientoraprivatepatientinaccordancewithregulation5.

(4) Apatientreferredtoinsubregulation(1)maynotbechargedanyfeesforadmissiontoastatehospital.

Free treatment of state patient

10. (1) Theheadorthepersoninchargeofastatehospitalmaydetermineinwriting,onanapplicationbyastatepatientorhisorherguardianintheformdeterminedbytheMinister,thatthatstatepatientmustreceivefreetreatmentin,atorfromthatstatehospital,iftheheadofthatstatehospitalisoftheopinionthatthatstatepatientisunabletopaythefeesprescribedforthattreatment.

(2) Theheadofthestatehospitalreferredtoinsubregulation(1)mayrequest,beforemaking a determination under subregulation (1), a social worker, a church official or any otherpersonwhomaybeconversantwiththeapplicant’sfinancialposition,tofurnishtheheadofthatstatehospitalwitharecommendationregardingtheapplicant’srepeatedandongoinginabilitytopaytheprescribedfees.

Patient classified in terms of repealed regulations

11. (1) Notwithstandingtheseregulations,thefeespayableforthetreatmentofanin-patientinastatehospitalwhoatthecomingintooperationoftheseregulationsisalreadybeingtreatedasanin-patient,mustbecalculatedinaccordancewiththetariffoffeesapplicabletothatin-patientimmediatelypriortothecomingintooperationoftheseregulations.

(2) Thepersonwhoisliabletopaythefeesforthetreatmentofanin-patientreferredtoinsubregulation(1)afterthedateofcomingintooperationoftheseregulations,mayapplyinwritingtotheheadofthestatehospitalthatthefeesmustbecalculatedinaccordancewiththetariffoffeesprescribedbytheseregulations.

(3) Theheadofthestatehospitalreferredtoinsubregulation(2)maygrantanapplicationintermsofthatsubregulationsubjecttosuchconditionsasheorshemaydetermine.

(4) Notwithstandingtheseregulations,thefeespayablebyanout-patientwhoisreceivingtreatmentin,atorfromastatehospitalatthecomingintooperationoftheseregulations,mustbecalculatedinaccordancewiththefeespayablebyout-patientsprescribedbytheseregulationswitheffectfromthedateofthatcomingintooperation.

Rectification of fees incorrectly calculated

12. (1) Ifthefeespayableforthetreatmentofapatientin,atorfromastatehospitalhavebeenincorrectlycalculatedforthereasonthat-

(a) theinformationfurnishedintermsoftheseregulationsisincorrectorinsufficient;

(b) theadmittingofficererredintheapplicationorinterpretationoftheseregulations;or

(c) thepatient,afterhisorherinitialclassificationaseitheraprivatepatientorastatepatient,isre-classified,underregulation6,aseitherastatepatientorprivatepatient,asthecasemaybe;


(d) thepatientmustreceivefreeorsubsidisedtreatment,intermsofregulation9or10;or

(e) the head of the state hospital, when allowing an appeal under regulation 13,determinedundersubregulation(3)ofthatregulation,thefeespayablebythepatient,

theadmittingofficermustmakethenecessarycorrectiontothefeespayable,determinethecorrectamountpayableintermsoftheseregulationsandinforminwritingthepersonliableforpaymentofthefeesofthecorrectamountsodetermined.

(2) Thepersonreferredtoinsubregulation(1)-

(a) isliabletopaythefeescorrectedunderthatsubregulation;or

(b) isentitledtoare-fundofanyamountpaidinexcessofthefeessocorrected.

Appeal against fees payable

13. (1) Anypersonliabletopayanyfeesintermsoftheseregulationsandwhoisaggrievedbyanysuchfeesmayappealtotheheadofthatstatehospitalinwriting,statinginfullthegroundsuponwhichtheappealisbased.

(2) Theheadofthestatehospitalreferredtoinsubregulation(1)-

(a) mustdulyconsiderall theinformationathisorherdisposalrelatingtoanappeallodgedwithhimorherinaccordancewiththatsubregulation;

(b) may-

(i) dismiss the appeal, if he or she finds that the fees referred to in thatsubregulationhavebeencorrectlycalculatedandthatthepaymentthereofdoesnotplaceanunreasonablefinancialburdenontheapplicantinviewofhisorhersocio-economiccircumstancesasassessedbyasocialworker;

(ii) allow the appeal, if he or she finds that the fees referred to in thatsubregulation have beenwrongly calculated, or that the payment thereofplacesanunreasonablefinancialburdenontheapplicantinviewofhisorhersocio-economiccircumstancesasassessedbyasocialworker;and

(c) mustinformtheadmittingofficerandthepersonwholodgedtheappealintermsofthatsubregulationofhisorherdecisioninwriting.

(3) Iftheheadofthestatehospitalallowsanappealunderparagraph(b)ofsubregulation(2),heorshemustdeterminethetariffaccordingtowhichthefeesmustbere-calculated,ordetermineunderregulation9or10thatthepatientmustreceivefreeorsubsidisedtreatment,andthepersonliabletopaythefeesinquestionmustpaythefeesodeterminedorthepatientmustbetreatedfreeofcharge,asthecasemaybe.

(4) Iftheheadofastatehospitaldismissesanappealunderparagraph(a)ofsubregulation(2),orifthepersonreferredtoinsubregulation(1)isnotsatisfiedwiththedeterminationmadebytheheadofthatstatehospitalundersubregulation(3),heorshemayinwritingappealtothePermanentSecretaryagainstthedecisionoftheheadofthatstatehospital,statinginfullthegroundsuponwhichtheappealisbased.


(5) ThePermanentSecretary-

(a) maydismisstheappeallodgedwithhimorherintermsofsubregulation(4),ifheorshefindsthatthetariffaccordingtowhichfeesmustbecalculatedasdeterminedby the head of the state hospital under subregulation (3) is correct and that thepaymentthereofdoesnotplaceanunreasonablefinancialburdenontheapplicantinviewofhisorhersocio-economiccircumstancesasassessedbyasocialworkerin conjunctionwith a church leader of the community inwhich the applicant isresident;

(b) mayallowtheappeallodgedwithhimorherintermsofsubregulation(4),ifheorshefindsthatthetariffaccordingtowhichfeesmustbecalculatedasdeterminedbytheheadofthestatehospitalundersubregulation(3)isincorrectorthatthepaymentthereofplacesanunreasonablefinancialburdenontheapplicantinviewofhisorhersocio-economiccircumstancesasassessedbyasocialworkerintermsofparagraph(a);and

(c) mustinformthepersonwholodgedtheappealintermsofsubregulation(4)ofhisorherdecisioninwriting.

Receipt of body at mortuary at state hospital

14. (1) Thebodyofapersonwhohasnotdiedinastatehospitalmaybereceived,withthewrittenpermissionoftheheadofthatstatehospital,forstorageinthemortuaryatthatstatehospital.

(2) Anystorageorpostmortemoforonabodyreferredtoinsubregulation(1),orofaprivatein-patient,issubjecttothefeesprescribedintheAnnexureandispayabletothestatehospitalbyanypersonwhoappliesforcustodyofthebodyintermsofsection14(5)oftheAct,priortothehandingoverofthebodytothatperson.

Burial of unclaimed body in mortuary

15. Ifthebodyofapersoninamortuaryatastatehospitalisnotclaimedbyanypersonreferredtoinsection14(5)oftheActwithintheperiodof14daysprescribedbythatsection,theheadofthatstatehospitalmaydirectinwritingthatthatbodybeburiedinacemeterynearesttothatmortuary.

Unclaimed property of patient after discharge from state hospital

16. Anyprivatepropertyofapatientwhohasbeenadmittedtoastatehospitalandthatremainsatthatstatehospitalafterthatpatienthasbeendischargedtherefromandnotclaimedwithinaperiodofthreemonthsafterthedateofthedischarge,becomesthepropertyoftheStateandmaybedealtwithasthePermanentSecretaryconsidersappropriate.

Soiled or infected property of patient

17. Anysoiledorinfectedpropertyofapatientadmittedtoastatehospital,whichmaycauseahealthrisktoanyperson,mustbedestroyedbythatstatehospitalifnorelativeorbona fide friendofthatpatientclaimsthepropertywithinaperiodof24hoursaftertheadmission.


ANNEXURE

TARIFFOFFEESFORTREATMENTOFPATIENTIN,ATORFROMSTATEHOSPITAL(Regulation 8)

General tariff of fees for treatment:

(a) State in-patient:

Fortheadmissionandtreatmentofastatein-patient,excludingthosementionedinitem2(a),thefollowingsingleamountispayable:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N$50,00 N$30,00 N$20,00 N$20,00

ClassD ClassE ClassF N$20,00 N$10,00 N.A.

(b) Private in-patient:

Fortheadmissionandtreatmentofaprivatein-patient,thefollowingfeesarepayableperdayorpartthereof,inadditiontotheapplicablefeesprescribedbyitems2and3:

Statehospital:



(c) State out-patient:

(i) First visit consultation and treatment during working hours: Thefeespayablebyastateout-patientforaconsultationandtreatmentatanytimeduring

workinghours:Perconsultationandtreatment:

Statehospital:


ClassD ClassE ClassF N$8,00 N$4,00 N$3,00

(ii) Follow-up consultation and treatment during working hours:

Thefeespayablebyastateout-patientforafollow-upconsultationandtreatmentatanytimeduringworkinghours:Perconsultationortreatment:


Statehospital:


ClassD ClassE ClassF N$4,00 N$2,00 N$2,00

(iii) First visit or follow-up consultation and treatment after working hours:

Thefeespayablebyastateout-patientforaconsultationandtreatment(firstvisitorfollow-upconsultationandtreatment)atanytimeafterworkinghours:Perconsultationandtreatment:

Statehospital:



(d) Private out-patient:

(i) Treatment during working hours:

Thefeespayablebyaprivateout-patientforaconsultationandtreatmentatanytimeduringworkinghours:Perconsultationandtreatment:

Statehospital:



(ii) Treatment after working hours:

Thefeespayablebyaprivateout-patientforaconsultationandtreatmentatanytimeafterworkinghours:Perconsultationandtreatment:

Statehospital:



2. Tariff of fees for in-patient maternity treatment:

(a) State patient:

Thefeespayablefortheadmissionandtreatmentofastatein-patientrelatingtomaternityanddeliverytreatmentandservices:


Statehospital:



(b) Private in-patient:

Thefeespayablefortheadmissionandtreatmentofaprivatein-patientrelatingtomaternityanddeliveryservices:Thefollowingfeesarepayableperdayorpartthereof,inadditiontotheapplicablefeessetoutinitems3:

Statehospital:



3. Tariff of fees for specific investigations or services (private patients):

Theapplicablefeeprescribedfortheservicesandamenitiesspecifiedbelowmustbechargedifanyprivatepatientusesanyofthoseservicesoramenities,andispayableinadditiontoanyotherfeeforwhichthatpatientmaybeliableintermsofitem1(b)or1(d),asthecasemaybe:

(a) Use of intensive care unit, per day or part thereof:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N$1000,00 N$900,00 N$800,00 N.A.

ClassD ClassE ClassF N.A. N.A. N.A.

(b) Use of high-care ward, per day or part thereof:

Statehospital:



(c) Accommodation by an in-patient of in a single room, without ablution facilities, or a two bedded room, at a request by or on behalf of the patient, per day or part thereof, in addition to the fees prescribed by items 1(b) and 2(b):


Statehospital:


ClassD ClassE ClassF N$75,00 N.A. N.A.

(d) Accommodation by an in-patient in a single room, with bath and toilet amenities, at a request by or on behalf of the patient, per day or part thereof, in addition to the fees prescribed by items 1(b) and 2(b):

Statehospital:



(e) (i) Basic fee for the use of a casualty or outpatient department, operating theatre or main theatre for the purpose of an operation under anaesthetic: basic flat rate:

Statehospital:



(ii) Fee per minute for administering anaesthetic, in addition to the fees prescribed by subparagraph (i):

Statehospital:


ClassD ClassE ClassF N$20.00 N.A. N.A.

f) Diagnostic services: flat rate per procedure (in-patients and out-patients):

(i) Audiogram;

(ii) Lungfunctiontest;

(iii) Electrocardiogram;

(iv) Electrocardiogramwithworkload;

(v) Bronchoscopy;


(vi) Gastroscopy:

Statehospital:



(vii) Generalultrasoundinvestigation:

Statehospital:



(viii) Cardiacultrasoundinvestigation:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N$1000,00 N.A. N.A N.A.


(ix) BasicX-rayprocedure:

Statehospital:

ClassA ClassB1 ClassB.2 ClassC N$165,00 N$150,00 N$150,00 N$120,00

ClassD ClassE ClassF N$120.00 N.A. N.A.

(x) SpecializedX-rayprocedure:

(aa) BASwallow;

(bb) BAMeal;

(cc) BAEnema;

(dd) I.V.P/Cystogram;

(ee) Cholecystogram;

(ff) Hysterosalpingogram;or

(gg) Mammography:


Statehospital:

ClassA ClassB1 ClassB2 ClassC N$450.00 N$400,00 N$400,00 N$250,00


(g) Dialysis (per session):

Statehospital:



(h) Cardiology services:

(i) Arteriogram:perinvestigation(in-patientsandout-patients);or

(ii) Heartcatherization:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N$1000,00 N.A. N.A. N.A.


(i) Computer Tomograph (CT) imaging:

Statehospital:



(j) Magnetic Resonance Investigation (MRI):

Statehospital:




(k) Nuclear Medicine investigation:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N$500,00 N$500,00 N.A N.A.


(l) Radiation Oncology Service:

(i) GraphicPlanning:

Statehospital:



(ii) Simulationorlocalization:

Statehospital:

ClassA ClassB ClassC N$200,00 N.A. N.A.


(iii) RadiationTherapy(perday):

Statehospital:

ClassA ClassB ClassB2 ClassC N$250,00 N.A. N.A. N.A.


(m) Total Parenteral Nutrition (TPN) (per day) (in-patients and out-patients):

Statehospital:

(i) Adult:




(ii) Child:



(n) Pharmaceutical and Medical Supplies:

(i) to private out-patients: per monthly supplies:

Statehospital:

ClassA ClassB1 ClassB2 ClassC N.A. N.A. N.A. N$60,00


(ii) to private in-patients: per day:

Statehospital:



(o) Chemotherapeutic or Cytostatic Agents (in-patients and out-patients):

Statehospital:



(p) Specialised Medical Supplies for private patients: (Including heart valves or internal prosthesis, artificial knee or hip):

Statehospital:

ClassA ClassB1 ClassB2 ClassC Atcostpriceplusanadditionalhandlingfeeoftenpercentofthecostprice.



(q) Orthopaedic prosthesis or orthosis for private patients:

Statehospital:



(r) Occupational health services:

(i) Occupational medical consultation of employees (private patients):

Feespervisitforaconsultationbetween07h30and16h30onaweekdaythatisnotapublicholiday:

(aa) Pre-employmentmedicalexaminations:

ClassA ClassB1 ClassB2 ClassC N.A. N$190,00 N$190,00 N$190,00


(bb) Annualorperiodicorfollow-upmedicalexaminations:



(cc) Endofemploymentmedicalexamination:



(ii) Occupational medical special investigation (private patients):

(aa) Electrocardiogram(resting):



(bb) StressElectrocardiogram:




(cc) LungFunctionTest:



(dd) ChestX-ray:



(ee) Audiometric(Hearing)Test:



(ff) Visiontestfordriversandoperators:



(gg) Bloodandurinetests,basedonthenatureoftheemployee’sworkandexposuretohazards, arecharged separatelyanddirectlyby the respectivemedical laboratoryserviceprovider.

4. Occupational medical examination for self employed state patients, including people involved in the charcoal industry:

Thisserviceincludesconsultation,treatmentandspecialinvestigationsbetween07h30and16h30onaweekday,excludingapublicholiday:




5. Forensic psychiatry daily observance fee for patients referred by a court, (minimum of 30 days), including electroencephalograms, blood tests and computed tomography scans



6. Alcohol or drug rehabilitation treatment fee for full treatment course (Fee charged according to monthly income level of the person responsible for payment)

Themattermustbereferredtoasocialworkerinvestigationrelatingtotheincomeofthepatient,whomust furnisha reportonhisorherfindings, includingproofof thepatient’sincome.

• MONTHLYINCOME • FEEPAYABLE• N$0,00–N$499,00 • N.A.• N$500,00–N$999,00 • N$350,00• N$1000,00–N$1999,00 • N$450,00• N$2000,00–N$2999,00 • N$550,00• N$3000,00–N$3999,00 • N$650,00• N$4000,00–N$4999,00 • N$750,00• N$5000,00andabove • N$1000,00

7. Tariff of fees for conveyance of patients or bodies:

(a) Private patient

Conveyanceofaprivatepatient,orthebodyofadeceased privatepatient,fromortoanypointPerkilometre: N$4,00

(b) State patient

conveyanceofastatepatient,orthebodyofadeceasedstate patient,toorfromthereferringstatehospitalorstatehealth facility: freeofcharge

8. Tariff of fees in respect of the use of a mortuary:

(a) In respect of the body of a person who was a patient in a state hospital and who died in that state hospital:

(i) Privatepatient:

Forthestorageofthebodyofthatprivatepatient: perdayorpartthereof: N$100,00

(ii) Statepatient:

Forthestorageofthebodyofthatstatepatient:


(aa) firstfivedays: freeofcharge

(bb) fromdaysix:perdayorpartthereof: N$10,00

(b) In respect of the body of a person who did not die in a state hospital:

(i) Privatepatient:

(includingabodydeliveredtothemortuaryby funeralundertakers)

Forthestorageofthebodyofthatprivatepatient: perdayorpartthereof: N$150,00

(ii) Statepatient:

Forthestorageofthebodyofthatstatepatient: perdayorpartthereof: N$10,00

(c) For a post mortem conducted in a mortuary at the request of the next of kin of the deceased:



(d) Legal post mortem and cases investigated by police:

Storageofabodyinastatemortuaryforthepurposeofa legallyrequiredpostmortemorotherpoliceinvestigation: freeofcharge

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government gazette republic of namibiano. 4459 government gazette 15 april 2010 3 “follow-up...

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