Social Cluster Implementation of Government Programme of Action

Q: The Minister was asked what the hold-up was with the publication of the Ante-Natal Clinic Survey, as it had been mentioned in the Budget Speech of the Department. She was also asked, assuming there was no problem with the report, when it would be publicised.

A: The Minister said there was no problem with the Ante-Natal Survey results, and the announcement regarding this report had been made in the Budget Speech, with subsequent interaction with the media. This report and announcement showed the start of a decline in the prevalence of HIV in the country. It would take a bit of time,  but information was posted on the website.

Q: The Minister was asked what the Telefood project was.

A: The Minister said that the Telefood projects were always on television. She noted that it was not always necessary to spend time in the classroom in learning, as communication through the television was another major communication tool.

Q:  The Minister was asked for an update on progress regarding the Medicines Amendment Bill, and the Health Amendment Bill, and if these Bills were expected to be passed through parliament this session.

A: The Minister said that the Medicines Amendment Bill was before parliament. The Public Hearings had taken place and the Bill was being fine-tuned. The last sitting for the Portfolio Committee would be held the following day, and there was no doubt it would go smoothly, with a few changes that the Portfolio Committee would like to see.

Q: The Minister was asked, in regard to the Cluster’s investigation of the effect on the ordinary citizen of rising interest rates, fuel prices and food prices, whether any recommendations were available yet, and, if not, when they could be expected.

A: The Minister said that recommendations had been made to Cabinet and had been discussed by Parliament. The part that still required strengthening concerned food prices. This should, however, be made available on the website of the Department of Agriculture.

Q: The Minister was asked if the Ante-Natal Survey had indeed been finalised, and if it could be made available today.

A: The Minister said she had already answered the question and was going back to the Department to make sure that the necessary work was being done.

Q: The Minister was asked if there was any encouragement for doctors in rural Kwa-Zulu Natal, as there was a hospital there that now had only 10 of its original 16 staff, and even this was much better off than other hospitals in that area.

A: The Minister responded that doctors had taken an oath and they should do the work they were supposed to do. This loss of staff was not only a South African challenge, but was part of a much broader issue. There was an international challenge with regard to the shortage of human resources in the health sector. There was a need to underscore and emphasise that this was not a challenge for South Africa alone.

The measures taken by the Department of Health included embarking on a hospital revitalisation programme, and also making sure that doctors and health professionals had a particular mindset or attitude towards their patients.

The Minister added that the Department of Health has just completed a Core Standard Audit in which standards were being assessed across the board.  This exercise had been completed in Kimberley and the report had been released.  There were limited management skills in the country.  There was also a huge recruitment drive under way by the Department of Health.

Another programme was launched, which complemented other programmes which it was agreed would be implemented in the Department, around training mid-level health workers. This programme, named Clinical Associates, would assist especially in district hospitals, in increasing the pool of health professionals in the country, so that there was delivery of quality healthcare services to the citizens of this country.

The briefing was adjourned.

Social Cluster media briefing on the implementation of Government Programme of Action
25 August 2008

Introduction

The mid-year Cabinet Lekgotla met from 22-24 July 2008 to review the implementation of the Government Programme of Action (POA) and adopt the Medium Term Strategic Framework.
The Social Sector cluster submitted its report detailing progress made in the implementation of the government POA as well as challenges encountered in this regard. In the report, the Cluster
focused on the following areas:
* comprehensive social security
* promotion of national identity and social cohesion
* comprehensive healthcare
* housing and human settlements
* food security
* education

Comprehensive social security
The report on the Comprehensive Social Security system included amongst others: progress on finalising proposals on the National Health Insurance as well as retirement reform. As we indicated in previous briefings, the Cluster established an Inter-Departmental Task Team which meets monthly to discuss the various reform options. Based on the findings of the Task Team a discussion paper on retirement reform has been finalised for stakeholder comment during this year. At the same time, we are looking at various modelling exercises to determine the impact of various reform options on the fiscus.

With respect to proposals on the National Health Insurance System, we tabled a document to the last but one Cabinet meeting. Cabinet decided that the Department should finalise the cost of the proposal and that the proposal should also be discussed by the InterMinisterial Committee on Social Security. In addition, the proposal has been circulated to selected government departments and other stakeholders for comment. We will soon begin a process of consulting key stakeholders in the health sector soon.

Another intervention that the Cluster is dealing with is the implementation of the common tool that will assist us to assess disabilities. The implementation of the tool has been put on hold at this stage pending the amendment of the Social Assistance Act in the 2009 Parliamentary cycle. In the meantime though, the Department of Social Development has appointed 40 members to panels of tribunals to deal with appeals submitted for all grants, especially those of disability benefits.

The Cluster is also developing measures aimed at reaching vulnerable children over the age of 14 years and to increase the age of child support grant beneficiaries to 15 years. So far, a draft strategy has been developed, recommending amongst others:
* the development of a national child poverty measure and interventions to strengthen programmes to reduce poverty; and
* interventions to improve service delivery for children between 14 and 18 years of age.
In addition to this we are concerned about the rising cost of food as was noted by the President in his post Lekgotla briefing. As a Cluster we will be looking at ways to strengthen food security in particular.

Promotion of national identity and social cohesion
National Identity and Social Cohesion remain some of the key issues as far as our future and stability as a country is concerned. The key programmes that the Cluster has embarked upon include an educational campaign on the importance of the national flag which includes the production and distribution of leaflets aimed at raising awareness on this important issues. As you would know, we have also installed flags in various schools throughout our country as part of fostering this national identity especially among our youth.

In addition, we are also continuing with the Intergenerational Men’s Dialogue aimed at encouraging people to engage in dialogue regarding critical issues that affect men of all ages, in particular as part of addressing feelings of marginalisation (which may have economic and social roots) that end up leading to violence directed at women and children in particular.

Earlier this year, the Department of Arts and Culture in partnership with civil society organisations developed a tool kit to promote “UNITY in diversity”. Amongst other issues, the tool kit assists users to explore issues of diversity, multiculturalism and human rights. This tool kit will also be useful in analysing our individual and collective responses to refugees.

Regarding place names, the South African Geographical Names Council is in the process of facilitating and conducting nation-wide public hearings aimed at encouraging national dialogue on the issues of geographical names. The dialogue will involve communities identifying names they would like to see transformed as part of the broader change our country is going through.
Comprehensive healthcare

The Cluster approach in dealing with comprehensive healthcare in the country is guided, amongst others, by health promotion, reduction of communicable and non-communicable diseases, trauma and injuries and the finalisation and implementation of a government-wide programme on health promotion targeting the youth.
 
On tobacco control, the Tobacco Control Amendment Bill is being processed by Parliament and it’s likely that the Bill will be enacted soon. This will further strengthen our ability to manage violations of the current Act. We hope to complete a survey on tobacco use soon which we hope will show that the implementation of the Act has helped to further reduce the number of smokers, especially amongst the youth.

In June this year, five schools in the Thabo Mofutsanyana District in the Free State were launched as Tobacco Free as part of our collaborative effort to discourage the use of tobacco products among our youth. These five schools have signed pledges to be Tobacco Free and have developed their own institutionalised school-specific tobacco control policies. Programmes in these five schools will be evaluated in six months with a view to scaling up to other provinces in the country.

South Africa will in November this year host the third Session of the Convention of the Parties on Tobacco Control in Durban. The honour to host this meeting is in recognition of the work that South Africa has done in decreasing the use of tobacco products. At the meeting guidelines will be finalised that will assist countries to control tobacco use.

Regarding care for people with non-communicable diseases we are moving with speed to strengthen our interventions aimed to reduce the incidence of diabetes in the country through the implementation of the Diabetes Declaration that we adopted last year that will commit all of us to addressing this disease.

On tuberculosis (TB) control and the implementation of the TB Strategic Plan we are encouraged by the fact that 20% of our health facilities now have TB tracing teams as part of our efforts to reduce the TB defaulter rate from 10% to 7% in line with the target set by the President in the State of the Nation Address. We can already report that the defaulter rate is currently at 9% and in the districts that we strengthen the defaulter tracing teams, we have found more than 90% of defaulters and more than 60% of them are back on treatment. Equally, in the Msinga sub-district where the first cases of extreme drug-resistant TB (XDR-TB) were identified a few years ago, the defaulter rate is zero and the latest figures show that the rate of new cases of multi drug resistant (MDR) and XDR-TB have decreased significantly.

Also, we can report that, again as directed by the President in the State of the Nation Address, we have trained a number of health professionals on TB management. 128 people have been trained on infection control, 604 on the use of the electronic TB register, 177 on data management and 2211 on the clinical management of TB.

We did not present the 2007 Antenatal Survey results (of pregnant women using public health facilities) to Cabinet but can report that, like 2006, in 2007 the survey found another 1% reduction in the prevalence of HIV. The current prevalence rate is 29%. Further good news is that the rate of increase amongst the youth in particular has slowed further as well in women between 20 and 24 years of age. Given that these trends have been found over a two year period we think that our prevention strategies are beginning to make a difference to behaviour.

Housing and human settlements
On housing and human settlements the Cluster can report that to date financial institutions indicate that over R38 billion has been released for financing housing development and to finance ownership. The upward movement of interest rates along with other factors such as increases in the fuel prices have had a negative effect on the affordability of housing. As reported previously, final steps regarding the transformation of the National Home Finance Corporation (NHFC) are being implemented in the context of a government-wide review of Development Finance Institutions. The NHFC’s offering of end-user finance for home ownership targets 8000 loans in townships and “sterile” areas.

Amendments to the Rental Housing Act have now been finalised and we foresee improved regulation of the tenant-landlord relationship. The establishment of the Social Housing Regulatory Authority is now imminent as the Social Housing Bill is nearing finalisation in the National Council of Provinces (NCOP). The Social Housing Regulatory Authority is an agency aimed at improving the functioning of the Social Housing sector.

Food security and nutrition
In our view, food security and nutrition are key to the overall well-being and health of our people and communities in general. To this end, the Cluster is proceeding with its programme of using household food production interventions as part of our strategy of improving food security amongst the most food insecure and vulnerable communities. To date, 15 765 production packages have been distributed. Further, the first three Telefood projects (with FAO funding) have been implemented in the country.

We are also accelerating our interventions to develop financing requirements for the farmer support programme (MAFISA) focusing mainly on areas of large concentrations of farm dwellers and those with high eviction rates.

On the revival of agricultural state and state-supported community schemes to help communities, from January to April this year eleven farmers were settled.
Our programme on the establishment of food gardens is also gaining momentum with 6 390 schools having active gardens. We are accelerating our plans regarding the implementation of the National School Nutrition Programme, with over 6 million children receiving meals in more than 18 000 public schools.

Access to education
Among the key programmes that we are implementing in this area are the support for education and skills development in support of economic growth and the recapitalisation of FET colleges ensuring their relevance to the economy. The third and final year of recapitalisation began in April 2008 and detailed plans from all 50 FET Colleges for expenditure of R795 million on infrastructure, equipment and human resources have been approved. R397,5 million was transferred to these colleges in May 2008 and the first monitoring visits to assess progress took place in June and July this year. So far, R220 million has been awarded to students enrolled on scarce skills programme.

The Cluster is also forging ahead with government’s plan to double the number of matric Maths passes to 50 000 by 2009. This year for instance, all matriculants are offered either mathematics or mathematical literacy as subjects so that we increase the pool of potential candidates who pass maths. Intensive support is being provided to all matriculants including the weekly Study Mate newspaper supplements containing lessons for students.
 
Regarding the doubling of output of universities in priority sectors, the Department of Education has allocated R439 million to the National Student Financial Aid Scheme to improve the facilities at disadvantaged institutions for the support of key skills areas, including Faculties of Engineering and Technology.

One of the issues that continue to concern us as the Cluster and as government in general is the increasing trend of violence (sometimes fatal) that is tarnishing the image of our public schools. To this end, the Guidelines on Sexual Harassment and Violence in Public Schools are currently being printed and the booklet posted on the Department of Education website (http://www.education.gov.za). The Guidelines were presented to the South African Schools Principals Association in June this year as part of advocacy and awareness-raising on the matter.

Conclusion
Generally, the Cluster is happy with the progress that we are continuing to witness in the implementation of government’s POA despite the challenges that we encounter from time to time.
Presented by Minister Manto Tshabalala-Msimang, MP, Minister of Health: Republic of South Africa.
Issued by: Government Communications (GCIS)
25 August 2008