The Office of Health Standards Compliance (OHSC), the watchdog agency charged with inspecting hospitals and clinics, needs a bigger budget if it is to take on new responsibilities under the  National Health Insurance (NHI), parliament heard on Wednesday.

NHI is the government’s policy for implementing universal health coverage, which aims to ensure everyone has access to quality services that are free at the point of care. The first piece of enabling legislation for NHI was tabled in parliament on August 8 and proposed that a central fund buys services from public and private providers that are accredited by the OHSC.

Siphiwe Mndaweni, CEO of the OHSC, told MPs that the organisation was struggling to fulfil its current mandate because of its small budget, which stands at R136.5m for the 2019-20 fiscal year.

The OHSC was established in 2014 and initially only inspected public hospitals and clinics, but since February its responsibilities had expanded to include inspecting private sector facilities, she said.

The OHSC’s budget is set to grow by 5.5% over the next two years, to R144m in 2020-21 and R151.9m in 2021-22.

“It is not possible to undertake all these inspections and resolve complaints to fulfil our legislative mandate because of (our limited) budget,” she told parliament’s portfolio committee on health.

Once NHI is implemented, the OHSC will be charged with not only accrediting hospitals and clinics, but also tens of thousands of private healthcare establishments such as general practitioners and dental practices.

The OHSC has yet to present its 2018-19 annual report to parliament, but Mndaweni indicated it was likely to show the OHSC had failed to meet key targets. The OHSC’s limited budget had placed “extensive constraints” on the targets set, she said.

Documents presented to MPs show that in 2017-18, the OHSC managed to respond to only 38% of the complaints lodged with it within six months. Its target for 2018-19 was to respond to 80% of complaints within this time. During this period it aimed to inspect 687 public and 24 private health facilities.

Mndaweni’s complaint that the OHSC was underfunded echoes the sentiment recently expressed by the head of the medical schemes industry regulator.

Council for Medical Schemes (CMS) registrar Sipho Kabane told parliament in August that the organisation’s capacity to support NHI projects would be “severely compromised” if it did not get additional funding. The CMS budget for 2019-20 is R164.9m.