Coming soon: nowhere to hide for hospital managers.

Hospital and health care managers and administrators will in future be measured against mandatory core standards and judged on outcomes, with little place to hide and less room to shift responsibility, the country's new standards certification chief warned last month. Dr Carol Marshal, Director of the Office of Healthcare Standards Compliance (OHSC), in the national Department of Health has the full backing of her Director General, Precious Matsotso. This emerged in a speech the pair co-wrote for a health care safety conference in Cape Town last month. It became clear from the speech, delivered on Matsoso's behalf by Marshal and in a later interview with Marshal, that the 'slap on the wrist' approach – driven by a plethora of patient safety policies/guidelines and the absence of a uniform, credible means of probing health care delivery problems – could soon be history. She and her start-up team of 20 have spent nearly three years criss-crossing the country, consulting patient safety experts locally and overseas to set up national core standards for both private and public health establishments in advance of the National Health Insurance (being targeted for next year). Last month they briefed provincial leaders on how to use the new measurement tools for these core standards, so that once the National Health Amendment Bill is passed making the OHSC a statutory regulatory body, there can be no easy excuses. National Health Minister, Dr Aaron Motsoaledi, wants Marshal's office legally functioning by September this year, but is dependent on Parliament first passing the bill, which may take longer. It will be the first time local public hospital and provincial managers are legally (besides the millions of taxpayer rands paid out annually for patient liability claims) called to account for health care outcomes at their facilities. In the speech Matsoso said government was 'deeply concerned' by dissatisfied patients complaining of rude and uncaring staff, dirty and unsafe hospitals and clinics and of waiting in long queues when seriously ill, often returning home without their medicine or any treatment. 'We have excellent policies and guidelines but we don't implement them, neither at the level of management nor even at the level of patient care, ' she admitted. Poor quality, poor reliability in following best practices and a lack of accountability for poor results persisted – aggravated by responsibility being diluted 'among many different people at different levels of the system'. 'When there are …