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SOCIAL DEVELOPMENT PORTFOLIO COMMITTEE
27 August 2004
CHILDREN’S BILL: CONSULTATION WITH RELEVANT DEPARTMENTS
Acting Chairperson: Mr M Masutha (ANC)
Department of Health: Presentation
Department of Labour: Briefing
National Treasury: Briefing
The Departments of Health and Labour briefed the Committee on existing programmes affecting children in their Departments. The Committee was especially concerned with the effect of HIV/AIDS on the question of child-headed households and the implications of this in terms of child labour. The Treasury briefed the Committee on the details required before the Bill could be properly costed and stressed the need for a phased and integrated approach to both costing and implementation of the Bill.
Mr Masutha pointed out that the Committee would not be meeting the following week as it was a training week. A weekend planning workshop was also planned and it was agreed that it would be held on the weekend of 10 September.
Recordings had been made of the public hearings into the Children’s Bill and synopses were being worked on together with synopses of the written submissions. These would have to be looked at and factored into Committee consideration of the Bill. Certain issues needed to be flagged for deliberation, one of which was the chapter on rights. He suggested that a more intensive legal analysis might have to be made to check the jurisprudential implications of the same rights being provided in the Constitution.
He was also concerned about the extent to which the Bill sought to amend or codify common law and possibly customary law. The Child Care Act did not do so. The implications should be checked and the reasons for targeting specific areas and omitting others.
It was not adequate to give only those NGOs able to travel to Cape Town an opportunity to address the Committee. Provincial Committee visits might also be an opportunity to popularise the Bill and get more grassroots participation. It was agreed that, depending on the number of members available for the provincial visits, the Committee should be split into three or four groups.
The first round of Department briefings had not been as comprehensive as the Committee had hoped. The Committee would write to the Departments and explain that it might be necessary to recall them and that very clear data was required. It was essential to ensure an integrated and collaborative approach to the Bill.
Department of Health briefing
Ms A Goga (Directorate: Child and Youth Health) discussed infant, under five and child mortality and pointed out that the main causes of deaths were preventable, e.g. diarrhoea, malnutrition, chest infections and trauma. South Africa was a signatory to a number of international conventions on child health, one of the most important being the Convention on the Rights of the Child (CRC). The CRC offered a number of protections and rights for children and stated that in all actions the best interests of the child should be a primary consideration. Three of the international millennium development goals were also directly related to health. The NEPAD health strategy focused on the poorest and most marginalized, including women and children. The National Health Act had been signed a month previously, but no group had been prioritised, i.e. children were not specifically referred to. Other health-related legislation also impacted on children, including food fortification and tobacco control.
The Department had a ten point plan in its strategic framework that included decreasing morbidity and mortality and improving the quality of care and improving access to health care for all. There was also a strategic plan for HIV/AIDS.
The Department currently had a number of programmes that aimed to increase child survival and improve quality of life for children. There was a shortage of funding for training, facilitators and transport. In the Northern Cape, no training had been carried out in the previous year for these reasons. The Department was above target for baby friendly health facilities. In terms of prevention of mother to child transmission of HIV/AIDS (PMTCT), 99% of HIV exposed infants had received Nevirapine and over 2 800 health care providers had been trained in PMTCT and infant feeding.
The challenges and gaps identified included the fact that children were still dying of preventable conditions and an inequitable distribution of resources meant that socio-economic issues impacted negatively on health. Services for children were not prioritised and poor intersectoral collaboration resulted in poor or non-existent implementation of programmes. The Department saw the Children’s Bill as a unique opportunity to accelerate and improve implementation of health services for children. The Bill needed to elaborate on children’s rights and emphasise the importance of intersectoral and multisectoral co-operation. The cost of the changes suggested would require integrated planning, budgeting and prioritisation for children at district level. The cost of anti-retrovirals was covered by conditional grants, the school health services policy had already been accepted and the cost of immunisation implementation was still to be done but plans were underway for full implementation.
Ms H Bogopane-Zulu (ANC) said that a lot of draft policies remained drafts for a long time. She asked when the draft policy on health would be completed. What was the Department’s rehabilitation policy and what about community-based rehabilitation. This was excellent in Mpumalanga but what about the other provinces.
Ms Goga replied that most policies were awaiting approval and rollout could be expected at the end of the year or early the following year. The Department was trying to support rehabilitation on a province-by province basis.
Ms E de Klerk (Director: Child and Youth Health) said that different provinces were succeeding in different ways. Most provinces were using the primary health care budget to implement rehabilitation. As a national office, the Department supported the provinces and was pushing for rehabilitation.
Ms Bogopane-Zulu asked whether the Department was recommending mentioning children with special needs or making an extended effort to ensure specific services for them. She said that combination therapy using Nevirapine had a direct impact on children and asked whether the Department had elaborated on what the MCC announcement of the possible dangers of using Nevirapine meant to those children.
Ms Goga said that multiple interventions needed to be put in place for children with special needs, one of which was a specific mention in the Bill. In terms of Nevirapine, the MCC statement expressed concern at resistance to the drug. The Department had an extensive consultative forum at which the statement had been presented. The data used were interim results and the Department had decided that sufficient evidence was needed before implementing a change of policy. The Medical Research Council was doing research on the issue.
Ms S Rajbally (MF) asked how the health programme had been taken to schools and communities.
Ms de Klerk replied that the Department was reaching schools specifically through clinic programmes, health workers, social workers and the schools programme. Life skills programmes were presented in schools and teachers and peer education training programmes were run. Home based care was implemented with PMTCT and community members were also trained in primary health care.
Ms J Chalmers (ANC) said that it was critical to have the food nutrition programme in rural areas to enable children to have an appropriate and adequate food supply. She asked how much emphasis and pressure had been put on other Departments to improve the situation. She referred to the development of an NPF and asked whether the Department had any ideas on the best approach to enable it.
Dr L Mpuntsha (Director: Women’s Health and Genetics) replied that the Department had an integrated nutrition programme with food gardens and a primary school programme.
Mr Masutha asked whether the Department of Agriculture was not co-operating and whether food gardens were actually happening as there had been delays with the delivery of food garden starter packs.
Dr Mpuntsha said that there were problems in certain areas of the country and some corruption had been encountered.
Ms Chalmers emphasised that starter packs had not been included in the rollout.
Mr Masutha suggested that the Committee would call the Department of Agriculture to brief them.
Dr Mpuntsha said that the primary school nutrition programme had been transferred to the Department of Education, although the Department of Health still administered some conditional grants. Food-based dietary guidelines were being distributed at a community level.
Ms Goga said that the NPF question was a challenge and that the Department considered it essential to have the NPF legislated for and located in the President’s Office or other similarly high level to enable it to receive special priority and focus.
Mr M Waters (DA) said that the statistics for mortality rates had only been given to 1996. He asked whether, although an increase might be expected because of HIV/AIDS, the rates had actually dropped because of the PMTCT programme. He also asked the Department to explain the methodology of the survey - because AIDS was not a notifiable disease it was difficult to pinpoint the exact number of deaths. He asked whether HIV/AIDS was in fact a bigger cause of death than it appeared. While he was pleased to see health rights for children, the Department had also mentioned social security for children. The child security grant (CSG) limit was to increase to fourteen years next year and he asked whether the Department was suggesting increasing the limit to eighteen.
Ms Goga replied that the data on mortality rates had been obtained from Statistics SA and acknowledged that HIV/AIDS deaths were not usually listed. The Department was looking at a hospital audit system for infant deaths, and preliminary data from seven sites showed approximately 40% of deaths were HIV/AIDS related. This is a blur in the Statistics SA data. The PMTCT programme and ARV rollout was expected to result in a decrease in this rate.
According to the Constitution, a child is any person under eighteen and the Department felt that the grant age limit should be increased to eighteen. There were, however, other grants that also impacted children and the Department was aware that the Department of Social development was trying to improve access to grants.
Mr Masutha said that there was a shortage of social workers but that most children would go through the Department of Health at some time and that was where problems should first be noticed. Health officials needed to be trained as childcare workers as well and problems needed to be channelled into the system.
Ms Goga replied that the Department was trying to train health workers to identify children who were eligible for grants and then channel them through the social system.
Mr Masutha said that this was necessary not just for grants but as an extension of government outreach on social services.
Mr Waters said that the presentation had also mentioned free health care. While children under six currently received free health car, was the Department looking at increasing this age to eighteen for people in need.
Dr Mpuntsha replied that primary health care was free to all persons who were dependent on grants. Health care workers had extensive referral systems for people identified as being in need of social services.
Department of Labour briefing
Ms J Mehlomakulu (Deputy Director: Labour Relations) said that the overall role of the Department was to keep children out of the labour market and assist those children allowed to work (children over the age of fifteen). It was an economic reality that children worked and that there were child-headed households. The Department’s approach to child labour was based on the Constitution and prohibited any work by children under the age of 18 that was exploitative, hazardous and detrimental to schooling and development.
Before 1994, protective mechanisms had existed in the old Basic Conditions of Employment Act. The signing of the CRC in 1995 rectified some omissions and in 1996, Section 26 of the Constitution was introduced to protect children from harmful employment practices. Section 43 of the new Basic Conditions of Employment Act prohibited child labour (children 0 – 15) and made it a criminal offence to employ a child. Protective issues needed to be catered for between the ages of fifteen and seventeen.
South Africa was a signatory to a number of international Child Labour conventions, and in 2000 ratified the Worst Forms of Child Labour Convention of the International Labour Organisation (ILO). This Convention required governments to take measures to effect the immediate abolition of the “worst forms of child labour”. The worst forms of child labour include slavery, child prostitution, using a child for illegal activities, and work which by its nature or the circumstances is likely to harm the health, safety or morals of children, also called hazardous work. What is hazardous work in a specific country must be determined in consultation with organizations of employers and workers, communities and parents.
The Department had commissioned a Survey of Activities of Young People (SAYP) to help their understanding of many of the different kinds of work activities that children engage in, and the possible hazards that they face. The envisaged culmination of research was a Child Labour Action Programme (CLAP).
There were some sectors in which children under fifteen could be employed, specifically the film and advertising industries, and the Department had introduced stricter guidelines with respect to children working in these industries.
She stressed the need for a multisectoral policy. There was a need to identify, prioritise and co-operate with other departments and role players particularly in terms of monitoring child labour. The Department had a healthy budget available for this. The Department was very committed to protecting working children and she felt that the Department fitted in well with the Children’s Bill, but that they would like to see an explicit strategy to address the problem of child labour.
Ms Bogopane-Zulu said that she was concerned about the westernisation of African culture in international conventions like the CRC. She said that fetching water and herding cattle were not work but a part of being an African child. There were real problems with child labour but the Department placed too much emphasis on rights rather than responsibilities. She suggested the Department re-look at its campaign and give real protection to children rather than alienating parents.
Ms Mehlomakulu replied that she felt that even culture evolved. She saw children carrying massive bundles of wood and buckets of water and saw this as stunting growth. The fundamental aim of the Department was to protect the child and chores should be age-appropriate. Awareness raising was to sensitise everyone not to alienate children from their parents. She felt that international instruments could not be allowed to drive the national agenda, but that the country needed to look at the best practices.
Ms Bogopane-Zulu asked whether the Department intended to introduce legislation to unify the age of children in labour legislation, i.e. to retain the definition of a child as a person under 18. She said that children on farms posed a real problem and said that creative ways were needed to acknowledge them as part of the farm community rather than removing them.
Ms Mehlomakulu replied that there were instances where inspectors did not have full access to farms despite having a legislated right of access. The farming sector was a problematic one.
Ms Rajbally asked how it was possible to control child labour where the child became the head of the household when younger than fifteen, and was responsible for other siblings. What assistance was given to that child and the siblings.
Ms Mehlomakulu said that this gap had to be addressed. Inspectors were focused on enforcement. A multisectoral strategy had been drawn up for discussion. Inspectors needed to be sufficiently pragmatic to ask probing questions to lead the child to further services.
Ms Chalmers asked how the Department was working together with the Department of Social Development.
Ms Mehlomakulu replied that the ILO was a partner and assisted. The Department was currently involved in a time-bound programme and was taking the CLAP beyond the national borders. Areas for research had been identified and the Department had held workshops with the Department of Social Development.
Ms F Batyi (ID) said that inspectors seemed to check on child labour during the day. She was concerned that most children worked at night and asked what the Department was doing to address this.
Ms Mehlomakulu replied that there had been occasions where members of the public had alerted the Department and inspectors had been sent out at night. It would possibly be necessary to increase working hours for inspectors.
Mr Waters asked whether the Department had any more recent figures on child labour as the survey had been done in 1999. He wondered whether an increase in child-headed households owing to HIV/AIDS. He also asked for an estimate of child labour in the five major fields.
Ms Mehlomakulu was aware that the survey was outdated. There was a need to revisit the issues of child labour and Statistics SA had been asked to develop a module to do so. A survey had been conducted in 2002, but it had concentrated on children in households. The next survey would go beyond this.
Mr Masutha said he felt that the rollout of the CSG and other programmes should have had an impact on statistics and that, if it had not, it needed to be looked at. He felt that monitoring could involve labour inspectors. He asked what the Department defined as “work”, and hoped that they were not suggesting that toddlers were entitled to work if they were in the film industry. He asked what hours would be acceptable.
Ms Mehlomakulu said that an exchange of money did not necessarily define work as the work could be paid in kind. Work was an agreement to perform a task and receive some reward. Domestic work and chores were included where they impacted on health, schoolwork and so on. Where children performed for no gain, they were not captured on the system. The Department tried to ensure that children were not adversely affected, but the sector was profit driven.
Mr Masutha asked whether the Department also looked at cases where the child was used for long hours and not remunerated. He asked whether the issue of child labour would be retained in the Basic Conditions of Employment Act or would be better in the Children’s Bill.
Ms Mehlomakulu replied that the Department realised the need to regulated the film sector, while acknowledging the need for children to work but with protection. The Department was not involved in the rate of pay. This was better retained in the Basic Conditions of Employment Act.
Mr Masutha said that if children were working owing to social problems, they should be entitled to social grants. He asked the extent to which it was possible to have an intersectoral system to transfer them immediately. He reiterated the need for a comprehensive look at all services rendered to children.
Ms M Ngcobo-Mbere (Director: Children, Department of Social Development) said that a workshop had not yet been held but that a meeting had been held with the ILO. Child sex abuse was a gap in terms of labour work. A pilot study had been commissioned to look at the extent and depth of the problem.
National Treasury briefing
Mr Masutha said that while the s75 Bill did not have far-reaching cost implications, the s76 Bill did carry them and costing had to be addressed.
Mr D Plaatjies (Director: Social Security and Welfare Services, Public Finance) said that it was difficult to be able to define service delivery expectations, how these were to be financed and where responsibility for the delivery fell. It was very complicated to cost one part and then the de facto rollout.
Mr Masutha interjected that he was aware that there were technical flaws in the Bills because of the haste in splitting them. The principle was simply that the first Bill dealt with issues of status with no cost driving effect and the second Bill was the main cost driver.
Mr Plaatjies replied that at the last Committee meeting he had attended, he had heard that the Department expected costing to take ninety days. He called for patience as the Languages Bill had taken 5 months to cost, and it was a far less complex Bill.
He expressed concern that when Departments expressed individual views it might have a negative impact on co-operation. He was further concerned that there was no policy process on a range of issues. He referred particularly to the extension of the CSG to children up to the age of eighteen, which had serious policy implications.
Mr Masutha clarified that the Committee was aware of Government policy on the age limit for the CSG. When Departments were encouraged to express themselves they might go beyond current policy. He appreciated that the Committee’s role was not to formulate policy.
Mr Plaatjies said that there needed to be a clear connection between the obligation of commitments and what was contained in the Bill. He said there needed to be a stronger link between the Children’s Bill, the Child Justice Bill and the Social Assistance Act.
The Children’s Bill raised a number of implications, on service delivery, personnel, administration and finance. In terms of services, it contained a statement of children’s rights and the Treasury needed the different Departments to define the “best interests of the child” in respect of the Bill. The Bill also raised the question of Children’s Courts and this had to be looked at as it introduced a new cadre of personnel and specialisation. The Bill was silent on the location of responsibilities and there was a need to draw a stronger link between Departments and provisions. Chapters 6, 7 and 12 of the Bill only defined services, making it difficult to know who was responsible, for example the provision of early childhood education. The Treasury strongly felt the need to do more in respect of alternative care programmes as well, but needed to know more details.
In terms of personnel, the Bill created an obligation to look at the expansion of government. He asked for personnel plans from the Departments in terms of numbers, skills, knowledge and levels required. He said the Bill required a paradigm shift in the way in which people addressed issues therefore training became a big issue. He asked what level of training would be required.
Unions had been vocal on the need for correctional programmes and these would have to be implemented. There was also a need to develop new ethos and skills in the staffing corps so systems would have to be provided. There was a need to police the requirements of the Bill and thus an explicit need for intersectoral communication. A co-operative framework was essential. The key issue in terms of administration was the question of what the norms and standards would be and how these could be progressively implemented. All issues were multi-departmental.
Financing would have to be addressed on service delivery obligations, on the administration of a child protection system and in terms of human resources. He reiterated the need for a location of responsibility, particularly with early learning. He said that there was a shared responsibility in terms of early learning, which ranged from birth to nine years, involving three Departments in the continuum – Health, Social Development and Education.
His concern with norms and standards was both with input and output. He said that there was a notion that both Bills required input norms as strong drivers of resources. There was a need for stronger emphasis on output norms, i.e. what was required of persons rendering services to children. Additional social workers were required, with Departments requesting thirty cases per social worker, but how would this affect outputs. The Department of Social Development needed to identify the cost issues and who was responsible for them.
Mr Masutha said that one of his concerns was that some Departments had not been clear on this. A distinction needed to be drawn between what specific Departments needed to implement and existing legislation.
Mr Plaatjies concurred and said that this was a problem of location of vertical, horizontal and shared responsibilities. Early childhood development was not the only example, another was forensic medicine.
Mr Masutha suggested first identifying the cost driver, then looking at the value chain and identifying different role players and allowing them to cost collectively.
Mr Plaatjies said that Departments would be asked to consider a phased approach given the tight fiscal framework. It was necessary to define what was currently being offered, what was being added and what the plan was for the years ahead. The Treasury was reluctant to offer services on which it could not delivery. The Treasury needed guidance on what the Bills contained, what had come through the public hearings and how the two were to be joined. Costing at this stage would not address the amended Bills.
Mr Masutha said that he understood that when a Bill was introduced to Parliament, cost implications had to be given. He suggested that question be put to the Steering Committee. Now that the Bills were before the Committee, some shifts had been proposed, some of which had cost implications. These now needed to be costed to assist with decision making. He asked the Treasury to explain its role in the monitoring process.
Mr Plaatjies replied that, in terms of the new proposals, the Treasury was asking for a contingency approach between the Bill as it stood and the new proposals so that it could be possible to define the legislative implications and then cost them. The Departments needed to respond to this as the Treasury was not a service provider.
Mr Masutha emphasised that the law would not be passed until final understanding had been reached on cost aspects.
Mr Plaatjies said that, given the transversal nature of the Bill, it was necessary to consider intersectoral costing. He felt that co-operation could only strengthen the Bill itself.
Mr Masutha said that all affected parties had been invited to all meetings. It was not possible for the Committees to jointly consider a Bill, but it was possible to hold joint conferring sessions.
Ms Chalmers agreed that a fundamental foundation was needed in intersectoral co-operation and pointed out that she felt the Committee also had a duty to influence policy.
Ms Bogopane-Zulu said that at some stage it would be necessary to find a way to have the NPF reside in the Office of the Presidency. She was concerned that if it was in the Department of Social Development, it would just be another Department to blame.
Ms Chalmers said that before a decision was taken, the Office on the Rights of the Child should brief the Committee.
Ms Waters said that the Director General had promised the Committee some soft figures the previous week, and he asked if those were available.
Dr M Mabetoa (Chief Director: Children) said that the soft figures had been a scoping exercise and contained essential elements to identify cost drivers. The next phase was to put figures to the cost drivers.
Mr Masutha said that the costing of existing services should not be an issue as each Department was required to present its budget each year. The only issue might be services not rendered by the government. He asked whether the costing would include private sector contributions and which of these. Would the costs include a total cost and then separate NGO costs. The overseas funding policy for welfare was a related issue as this was vital to determine before the Committee looked at what was being spent.
Mr Plaatjies said that existing costs were not always known. There was a need to separate social grants from welfare services, as there was a sharing of resources, telephones, accommodation and so on. It was only possible to see clearly what was actually paid out in grants. The Treasury was also waiting for details on NGO resources and the funding policy as this was a critical aspect of the Bill. More than 90% of the Social Development budget was allocated to grants and it was also important to look at the historical backlog.
Ms Chalmers suggested that a costing be done of what it would cost not to provide a service.
Mr Masutha asked whether grants were having the required impact and asked who monitored this. He queried whether this should be the sole responsibility of the Department of Social Development. It was the duty of the Department of Health to monitor it, for example if a child visited a clinic.
Mr Plaatjies agreed on the need to invest in children and the long-term effects of such an investment. He repeated that the Treasury was looking for policy and a plan forward.
The meeting was adjourned.