Department of Health's readiness to implement Section 1 of Social Assistance Amendment Bill [B5-2010] & consideration of Bill with Deputy Minister

Social Development

16 May 2010
Chairperson: Ms Y Botha (ANC)
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Meeting Summary

The meeting was attended by around forty HIV/AIDS activists, Treatment Action Campaign supporters, members of the Black Sash and other parties that had made submissions to the Committee on the Social Assistance Amendment Bill. Members were informed that the Minister of Health could not be present due to his attending the World Health Assembly. The Deputy Minister of Social Development arrived during the course of the meeting. The Department of Health reported to the meeting that, should the Bill be passed, the Department would not be able to fulfil its function of assessing grant applicants to determine whether they were disabled and eligible for a social assistance grant in terms of the new definition of disability using the Harmonized Assessment Tool.

The Department of Health’s focus at this stage was to strengthen primary health care. Overhauling the health care system and the implementation of national health insurance were measures to this end. Part of the process of strengthening primary health care was a new chronic health care model that the Department was busy implementing. According to this model, chronically ill people would be treated in their homes, and their medication would be delivered there. The level of service delivery to them would improve and the pressure on the clinics would decrease. Doctors’ visits would be as infrequent as possible, without compromising the health of the patent.

The biggest challenge that the Department of Health faced in the implementation of this Bill was the human resources problem. Large numbers of physic- and occupational therapists had to be recruited, mobilised and trained to use the Harmonized Assessment Tool. At this stage the Department did not have access to those resources.

A Democratic Alliance Member strongly expressed her dissatisfaction with the Department of Health’s not being ready to implement the Bill. She was extremely unhappy that so many health projects and hospitals, especially in rural areas were so under-resourced.

Three African National Congress Members of the Committee thanked the Department of Health for being honest enough to say that the Department was not ready to implement the Bill. They said that the barriers to the implementation of the Bill should be addressed by the two Departments, but the Bill could not be passed in its current form.

The Department of Social Development then suggested that the clauses dealing with the definition of disability be removed, but that the remaining clauses had to be retained. This was the course of action taken by the meeting. Clauses 1, 3, 4, 5, 6 were taken out. Clause 2 was an important correction of a wrong reference and clause 7 dealt with the right that a grant applicant had to appeal to the
South African Social Security Agency (SASSA) to reconsider his application and then to appeal to the Minister if he was still unsuccessful. So the Bill would contain Clause 2 and 7 only. The rejected clauses would be referred back to Cabinet for reconsideration. The Democratic Alliance objected to the changed version of the Bill, because it was not was agreed to in the caucus.

The Committee discussed oversight visits to the Easter Cape as well as the North West where Members would visit youth centres, drug rehabilitation centres, and other facilities.

The Chairperson also informed the Committee of a study tour to the Netherlands and the United Kingdom, where the PC would examine social assistance and social welfare systems. The Committee would spend two weeks at Oxford University learning the principles of facts-based social policy decision making. Three Members of the Committee would also go on a trip to Brazil to observe and learn from that country’s social programmes.

The Chairperson announced that she had received a letter from the Minister informing her that the Minister had nominated her and the Chairperson of the Portfolio Committee on Water and Environmental Affairs to attend a lead programme in three modules on Climate Change in Population, Environment and Development.

Meeting report

The Deputy Minister of Social development, Dr Bathabile Dlamini, attended the latter part of the meeting.

The Department of Social Development had been preparing the Social Assistance Amendment Bill over the last two months to be signed into law. One of the requirements that emerged during the discussions was that the implementation of the Bill would lean heavily on the state of readiness of the Department of Health (DoH) to fulfil its role in the implementation.

Dr Yogan Pillay, Acting Director-General, DoH, briefed the Committee on the Department’s readiness to implement the Social Assistance Amendment Bill.

Dr Pillay relayed the apologies of the Minister, who was attending the World Health Assembly. The DoH was represented by himself and the Parliamentary Officer for the DoH. He proceeded to address the issue of disability from the perspective of the DoH.

There were two categories of disability, permanent and temporary. The challenge was how to define the two types of disability. The responsibility of the DoH was to treat the patient with temporary or permanent disability in order to ensure the optimum quality of life for that patient. Other Government departments had roles to play, for example the National Treasury and the Department of Agriculture, Forestry and Fisheries. People could become indigent as a result of especially permanent disability. To benefit maximally from treatment, they required additional assistance from the state in the form of food and transport.

The DoH has developed a 10 point plan, which was part of its Strategic Plan to strengthen the health system over the next five years. This involved strengthening the leadership, finances and service provision of the DoH.

Dr Pillay wanted to focus on two of the ten points. The first point of focus was the National Health Insurance (NHI) System. Currently the ratio of spending per patient in the private sector versus the public sector was 8:1. Another area of concern was human resources where the private sector offered staff better salaries with the resultant constant flow of staff from the public to the private sector. However the public sector serviced 80% and the private sector 20% of the population. The NHI was an attempt to finance public health better and to create a mechanism to distribute access to quality health care more evenly amongst the population and by extension to people with disabilities.

The second out of the ten points that he wanted to focus on was the overhauling of the healthcare system. There was an article in The Lancet in 2009 about the progress in efficacy that the healthcare system in South Africa had made since 1994, but also pointing out its remaining challenges. In broad strokes, that explained the planned changes that the health care system would undergo in the near future.

The Bill would require that the DoH used the new Harmonized Assessment Tool (HAT) and the new definition of disability to define and treat disability. This meant that a single homogeneous standard in terms of definition and assessment would be applied throughout the country. From the perspective of the DoH, that was what the Bill sought to achieve. In terms of the Bill, the DoH would also have to ensure easy access to diagnosis and treatment. That implied that many more professionals had to be available to diagnose and assess grant applicants. While the tool had been piloted, the DoH had not embarked on the task of training the different categories of health professionals needed to implement the Bill. The availability of physio and occupational therapists was a huge problem. The DoH would need time to prepare to be able to be in a position to use the tool in a way that was credible, reliable and valid. The DoH would have to mobilize and train a huge amount of health professionals in order to get to that position. The bigger challenge was to provide the best possible care outside of medical treatment, in other words increasing access to treatment and decreasing barriers to care.

In 1994 the Government adopted the primary health care (PHC) approach. The provision of health care at a primary level remained one of the biggest challenges of the DoH up till today. Although significantly more people accessed the health care system, access was uneven. One of the 20 deliverables that the current Minister of Health had to deliver was reviewing of the model the strengthening of the service delivery platform at PHC level.

This could be done in two ways. Firstly, more clinics could be built which was necessary, but not sufficient. The PHC approach prescribed for service provision at closest point of contact with communities, which implied services at household and community level, not just at PHC facility level.

Secondly, this implied significant community participation and involvement in the planning, monitoring, and rendering of services.

Thirdly, the provision of services should be in an inter-sectoral manner. At community level there should be an integrated service across Government departments in terms of the provision of for example treatment, food and transport.

The Government had put some of these aspect mentioned in place, but not all that was needed to implement the Bill. The intention was to improve. At this stage there were still barriers to treatment, whether it was acute or chronic treatment, in many parts of the country. This challenge was best illustrated by the difficulties the DoH still had in providing emergency care in rural areas. The unacceptably high number of women dying during childbirth in the rural areas was a sign that these services were not available everywhere.  The DoH could not lament its challenges forever. It had to address them.

These measures would be rolled out over the next three years in an attempt to address the challenges mentioned. Dr Pillay pointed out a few of the measures due for implementation to strengthen PHC and chronic care.

On pages 86-88 of the Strategic Plan, the DoH listed a number of key initiatives that it had started to implement. These measures ranged from the review of the model of PHC through to an audit of services, facilities and human resources. This was done to identify the problem areas and what needed to be done specifically. The new approach of the DoH was to assess each individual situation and determine what needed to be done in order to take the services to the remote rural areas.

Seen against the background of the model for PHC, the DoH currently had 60 000 community health workers in communities. There were the care givers from the Department of Social Development (DSD) and community development workers. There were extension workers in agriculture and thus a plethora of community level workers, working with and alongside many government departments, but often in “silos” [isolation]. The key challenge was at community and household level to integrate these categories of workers in order to render a consistent service reaching all levels of communities. There were good models to draw from in this country and elsewhere for example Brazil. Brazil had reduced the infant mortality rate within 10 years from unacceptably high to very low. They did this trough a change in the way in which they delivered services. From the setup point of view, they had a unit of three health professionals responsible for a catchment area. The DoH was assessing that model to see whether it was applicable to the South African situation.

Health Promotion, the prevention of disease and disability should be the mainstay of the intervention of the DoH. The Strategic Plan included a number of health promotion initiatives that included immunization. The Doh had just completed a national immunization campaign that included vaccinated against polio. Polio had the potential to make people disabled. South Africa had no instances of polio in recent years, but because it was still in circulation on the African continent, the DoH continued to vaccinate against it.

The DoH had had many campaigns promoting healthy lifestyles and there was a need for more. There were programmes around diabetes, cardio-vascular disease, hypertension, some cancers as well as obesity amongst school going children. There were interventions that the DoH could influence and promote in the home situation as well the school situation.

Many South African indulged in risky behaviour. The country had very high incidences of HIV/AIDS and Tuberculosis which were in many cases contracted through risky behaviour. Despite good legislation and campaigns many were still smoking as well as drinking alcohol irresponsibly. In the Western Cape there was a huge drug addiction problem currently. All of these activities contributed to disability, or constituted disabilities in themselves. The challenge of risky behaviour was something that had to be addressed by society at large, but the DoH had a role to play there too.

The elderly were robbed of their eyesight through cataracts. This could be remedied by cataract surgery which would restore and improve the quality of life of these people immeasurably. The DoH, in partnership with a number of other organisations, some international, had a programme in place to increase the rate of cataract surgery.

The DoH had a programme for diabetes control in the country. The incidence of diabetes and hypertension had been increasing over time. Uncontrolled diabetes often led to amputation of one or more limbs. This resulted in a permanent disability. Instead of just being focused on providing a wheelchair once the patient had an amputation, the Department had to intervene at a much earlier stage. It could do something about diabetes and by extension hypertension.

The DoH was in the process of finalising the model of chronic disease service delivery. This came about because the DoH was dealing with an epidemic of chronic diseases, namely diabetes, hypertension and cancers and by definition HIV/AIDS has become a chronic disease, because patients would need treatment forever. By definition it was not a disability.

In taking the disability aspect away from chronic disease, the DoH had to ask itself how it should respond to chronic disease. It should of course help to prevent new instances of it and it should treat the patients suffering from it. It should also help to prevent people with disabilities from sliding into poverty. People became impoverished because of an inability to work, social stigma, and the cost of accessing health care services because of the opportunity costs rather than the cost of treatment itself. Illness could be catastrophic to the extent of making sufferers very poor. To prevent this scenario, social assistance was needed. Poverty could not be treated with a health intervention. The right tools and the right remedies had to be aimed at the right challenges. An integrated approach was clearly needed. This was what the DSD and the DoH were trying to achieve.

The new chronic disease model aimed to ensure that people with chronic diseases had treatment and medication delivered to them at home.

In the Western Cape the DoH was already providing medication closer to home. It would start piloting the programme in other provinces. Where medication could not be delivered to patients, the aim was to extend the periods in between visits to day hospital from monthly to two and three- monthly or as infrequent as possible. The DoH was planning to complete the process within three years.

It would cost on average R22 a visit to deliver medication to the patient’s home. This model was piloted and extended.

The DoH was of the opinion that it was not ready to use the Harmonized Assessment Tool for the reasons suggested, but also for the reason that it was in the middle of this process of strengthening the PHC system as well as its services to people with chronic illnesses.

Ms H Lamoela (DA) commented that the fact that the DoH was not ready to fulfil its role in the implementation of the Social Assistance Amendment Bill was a sad state of affairs. She asked why the DoH was embarking on new plans. Her opinion was that new plans and strategies were embarked on regularly, but when they were evaluated at the end of the allotted period, they were found to have achieved nothing. It had happened numerous times in the past. People were migrating to the Western Cape at a rate of 63 000 people per year, from the Eastern Cape and KwaZulu-Natal, because the services, including medical services were so poor in those areas. Certain hospitals in the Eastern Cape were operating with 30% or 26% of the operational budget they needed. She asked the DoH not to change what was working well.

On an oversight visit to Mpumalanga the Committee found that the community development health workers did not have rubber gloves. They had to use condoms instead of gloves to perform certain tasks. They could not be counted as fully functional. Was it because they were poor people living in rural areas that they were treated like that? She asked whether the DoH would be able to implement the plans that it set out before the Committee. Brazil was more advanced than South Africa and it could not be compared. There was a shortage of doctors nationally and the training of these health professionals had to happen first. She asked who would determine whether grant applicants were disabled or not, specialists or general practitioners.

The Chairperson pointed out that Dr Pillay was the Acting Director-General in the national Department of Health, and was not directly responsible for health in the provinces.

Ms P Tshwete (ANC) thanked the Chairperson for the leadership she provided on this matter. Due to some of the issues raised during the submissions, it became clear that the Department of Social Development had to meet the DoH before the passing of the Bill. She thanked the Acting Director-General of the DoH, Dr Pillay, for his honesty in saying that the DoH was not ready. Ms Tshwete used to be a Member of the Portfolio Committee on Health. The DoH was losing its pharmacists to Clicks. She was aware of the human resources crisis that the DoH was experiencing. She agreed with Dr Pillay on the integrated approach to service delivery. People depended on the grant, because of poverty and unemployment. She said that it was clear that the Bill could not be passed unless the DoH was ready. She also agreed with Dr Pillay that the HAT was not applied uniformly across the country. She was aware of the medication shortages in the clinics. Ms Tshwete appealed to the Director-General of the DSD and Dr Pillay that the Bill be postponed until the DoH was ready.

Mr V Magagula (ANC) agreed with Ms Tshwete. The DoH said that it was not ready. The Committee could not go ahead with the passing of the Bill. He thanked the Chairperson for arranging the presentation by the DoH. The two Departments had to sort out the outstanding issues.

Ms H Malgas (ANC) said that she could see that the DoH was not ready for the implementation of the Bill. She was interested to see how far the model was. She asked that the next time the DoH came to present to the Committee, it stipulated time frames.

The Chairperson asked Dr Pillay as well as the Director-General of the Department of Social Development to respond to what had been said.

Dr Pillay responded to Ms Lamoela’s statements and said that he did not want to raise issues outside the presentation. He said that the issues that she raised were true. There was both a qualitative and a quantitative difference in the current leadership at all levels and changes would soon be visible. When working with systems, even with the best intentions, some things took time. There were some interventions that yielded quick results and those had to be identified and implemented, for example, the MEC for Health in Gauteng had appointed a new manager at Chris Hani-Baragwanath Hospital. The patients noticed an immediate change. The hospital was cleaner and the queues were shorter. The right kind of manager was needed at the coalface, as well as more resources.

The health system as a whole was severely under funded and there was an urgent need to create a flow of resources into the health sector. In the discussions with Treasury this was acknowledged and it was agreed that something had to be done about it. The reality was that the DoH was competing with many other departments that were also under funded. There were small changes and improvements all over in the health sector. There were concerns, but a sense of optimism with the new leadership, that things were moving in the right direction. With HIV/AIDS and tuberculosis (TB), the shifts were more pronounced.  The difference in the infant and maternal mortality rates would soon be apparent as well. The DoH had set itself steep targets in this regard.

Ms Lamoela asked who would assess grant applicants for disability. The idea with the HAT was to improve access and reduce the time that people had to wait to be assessed. The HAT was designed to allow any trained health professional (it did not have to be a medical doctor) to do the assessment. That was one of its advantages. There had to be checks and balances in place to ensure that it would be done reliably and validly. It was a valid tool, so that took care of the validity. There had to be reliability and an inability to crook the results. Currently what happened was that the health professional was confronted with the poverty of the patient. Even if the patient was not disabled from a medical point of view, some doctors would declare him/her disabled so that he/she could access a grant. With the HAT there had to be checks and balances in place that would ensure that it was not misused. So various health professionals of various categories would be assessing grant applicants for disability.

Dr Pillay had discussed timeframes with the Minister who had said that whatever was in the Strategic framework would be implemented with speed. The Chronic Disease Model was being designed and would be implemented in three districts in this country within this financial year. By the next financial year the Department would know what worked and what did not. It was already within the operational plans. Whenever the DoH would present on any legislation to this PC in the future it would make sure that it had time frames attached and that it was ready for implementation.

Mr Vusi Madonsela, Director-General, Department of Social Development, said that whether his Department was ready or not was of no consequence. The Department and SASSA did not assess grant applicants for disability. That function belonged to the DoH. If the DoH was not ready, it meant the DSD was not ready. The Government was not ready.

From the perspective of the DSD, the Department had thought that it had put systems in place to give effect to a definition of disability that had been passed by Cabinet in 2005, but it was clear that in this regard, the DSD had to act in concert with the DoH. He said that various clauses in the Bill related to the new definition of disability. That definition had consequences for clauses 1, 2, 3, 4, 5 and 6 of the Bill. He made a special appeal to the Committee, while it was considering its views on issues relating to disability, that perhaps those clauses had to be held back. He further appealed that the Committee should consider clause 7 of the Bill, dealing with the reconsideration by SASSA and the appeal system. The DSD believed that while Government was still getting its house in order in relation to the definition of disability and assessment the Bill should still allow applicants for social grants administrative justice. The same clause re-affirmed the right of appeal which was in the current legislation. In this regard SASSA had systems in place to reconsider its own decisions, before an aggrieved applicant may exercise their right of appeal.

The Chairperson thanked both Departments.
Formal Consideration of Social Assistance Amendment Bill
Clause 1 dealt with the definition of disability. A Member proposed that the Committee not proceed with it. If Clause 1 could not be passed, none of the others could be passed.
The Chairperson asked whether there was a contrary proposal

Ms Lamoela replied that everything had to be revised.

The Chairperson returned to the Bill. She said that clauses 1-6 dealt with disability and its definition. Section 7 dealt with the appeals process and administrative justice.

The Chairperson asked the State Law Advisor to comment.

The State Law Advisor said that Clause 2 did not refer to disability either. It was a correction of a mistake that was made earlier in the law. He said that it was a big mistake and advised that Clause 2 be kept in the Bill.

The Chairperson said that Clause 2 of the Bill was not an amendment; it was a correction to align this law with the Bill. She asked for permission to include it in the Bill.

Ms Lamoela said that she could not agree with any changes that had not been through the DA caucus.

The Chairperson said that there was no amendment. It was in the Bill itself.

Ms Tshwete suggested a clause by clause process of reading through the Bill for the sake of understanding.

The Chairperson drew members’ attention to Rule 249 Subsection 3g. This provided that the Committee may recommend approval or rejection of the Bill or present with its report an Amendment Bill or a redraft of the Bill as a rule.

She asked the legal advisor and State Law Advisor to assist the Committee in terms of how the decision that had been taken previously influenced the short title for the Bill.

She started the clause by clause process, but stopped it due to a slight misunderstanding. It had been agreed that the meeting would not go ahead with the definition of disability. She asked the legal advisor to assist.

The legal advisor said that Clauses 1, 3, 4, 5 and 6 had to be omitted. Sections 2 and 7 would remain and there would be a consequential amendment to be inserted in terms of clause 7 of the Bill.

She asked the meeting, in terms of progress to accept what the legal advisor said and asked him to repeat it.

The Chairperson referred to clause 7 and asked the legal advisor and State Law Advisor to assist in terms of an amendment that the Committee had asked for when discussing the Bill.

The State Law Advisor referred to section 14, subsection 3b, paragraph 3 of the Principal Act, which stated that if the applicant did not qualify for social assistance SASSA would have to inform him of his right to appeal in a letter written to his address. As a result of the new arrangement that the applicant could appeal to SASSA for re-consideration, this paragraph in the Principal Act had to be adjusted to state that SASSA should inform the applicant in writing of his right to be re-considered by SASSA, and then, if he was still unsuccessful, his right to appeal to the Minister for re-consideration and the mechanism and procedure to invoke that right.

The Chairperson said that that insertion was to protect the right of the applicant to appeal and to be notified. She asked whether Members were happy with the amendment.

The Members indicated that they agreed.

The Chairperson asked the State Law Advisor whether it was necessary to amend the short title of the Bill.

The State Law Advisor said that the short title of the Bill could stay the same, but that the long title of the Bill had to be adapted to accommodate the changes that were proposed, in other words the words “so as to insert a definition; to further regulate the eligibility for a disability grant” had to be omitted from the long title.

The Chairperson summed up the decisions made during the meeting. The short title would stay the same, but the long title needed to be changed. Clause 2 remained; clause 7 remained with an amendment on clause 7. The DA’s objection was noted. (Ms Lamoela said that the DA caucus had discussed the Bill as it was, and she could not agree with any changes, without consulting the caucus again.)

The report of the Portfolio Committee on Social Development would then read: “The Portfolio Committee on Social Development having considered the subject of the Social Assistance Amendment Bill [B5-2010] National Assembly, Section 75 referred to it and classified by the joint tagging mechanism as a Section 76 Bill and not a Section 75 Bill, reports the Bill with Amendments.”

She asked the legal advisor whether the report was correct and whether the report could include the rejected clauses for it to be referred back to Cabinet for reconsideration.

Mr Pillay said that the Bill would return to the Portfolio Committee on Social Development when it was ready.

Preparations for the Committee’s study tour and areas to be visited for oversight: Discussion
The Chairperson had asked the Director-General, DSD, the advisor to the Minister, the Deputy Director-General for Social Security, the Acting Chief of Staff of the Minister and the Chief Executive Officer (CEO) of SASSA to remain.

The Committee would have time available from 19 July to the 09 August 2010 to do oversight visits. The Chairperson asked the Members to think about possible areas, institutions or projects to visit, stemming from the resolutions taken in Committee meetings. These suggestions would be discussed at the next Committee meeting. From 04 June - 19 July 2010 it will be constituency time. This was the period in which the 2010 FIFA world Cup Soccer Tournament would be taking place. The Committee Secretary and her team would remain behind and would be able to start making arrangements for the oversight visits

Ms Tshwete suggested that the Committee go and visit the offices of SASSA in the North West and Eastern Cape. At a presentation to the Committee, SASSA had said that all was well. She wanted to ascertain whether it was indeed the case.

Ms Lamoela wanted to do unannounced visits to the SASSA offices, she told the CEO of SASSA, with respect. She felt that it was the only way to see the true state of affairs and not window dressing. This would help SASSA to improve.

The Chairperson said that Constituency Weeks would be from 07June - 16 July 2010. 19 July to 06 August would be the time to do oversight visits. This implied local oversight visits. This Committee would only take a few days, leaving some days during this period for visits as part of other committees the Members were part of. The Chairperson said that individual members could do unannounced visits during Constituency Weeks. When the Committee did oversight as a committee, it needed to be more organized. Real problems in the systems could not be hidden completely, and the Committee would pick them up on an oversight visit.

If the Committee visited secure care centres, it needed to touch base with the provincial committee for social development. For this reason unannounced visits would not work in this case as these visits had to be arranged and coordinated.

The Chairperson asked the Committee Secretary to make arrangements for short visits to drug rehabilitation centres in Cape Town and surrounds. The Committee then would also have to meet with the provincial committee for social development.

If one looked at the programme structure of the Department and its key priorities the most rural communities in the Eastern Cape and North West were the correct areas to visit in terms of service delivery. The Committee agreed. She assigned Members to assist in identifying places to visit in the provinces where they came from and were familiar with.

Every Committee could go overseas twice during the five years of the Parliament as part of a study tour. The Researcher was in the process of compiling a profile on the Netherlands. The country had good systems of social development in terms of services to families, social assistance, youth centres, and care for the aged, child- disability- and sickness benefits. The National Council of Provinces (NCOP) was also planning a similar visit. The Chairperson spoke to the chairperson of the NCOP and they thought it would be a good idea to combine the visits, especially to the Netherlands. It would mean that the Netherlands parliament would have to host the South African delegation only once. Also the Committee Members could interact with their colleagues in the NCOP.

The Chairperson said that the United Kingdom (UK) also had a good welfare system. She had asked the Director-General, DSD, to inform the Committee about the Oxford programme on social policy. It was a programme that the DSD had been running in conjunction with Oxford University. There were huge potential benefits for the Members of the Committee.
The Director-General, DSD said that the School of Social Policy and Social Work at Oxford University had established the Centre for the Analysis of South African Social Policy (CASASP). This conducted research in South Africa with institutions like the Human Sciences Research Council (HSRC) as well as with South African students studying social policy in the UK, especially at Oxford.

CASASP was running a Social Policy Programme which was also extended to staff of the DSD. One programme could be tailored for politicians like Members of the Committee. Previously it was presented to Members of Executive Councils (MECs) for Social Development from all provinces. It could be done over two weeks. The essence and aim of the programme would be to help people understand evidence-based policy decision making. Policy decisions should be made on the basis of facts, not anecdotes as was sometimes the case at executive level or in Parliament sometimes.

The Programme would cover the principles of the British Welfare State. It would illustrate the differences between Developmental Studies and Social Policy. Developmental studies assumed that the state had failed and that other people then had to take charge of development in a country as it was under Apartheid. In terms of Social Policy, the state was the driver of development in the country, making policy decisions based on evidence with a view to bring about the desired change in society.

The Programme would offer textbooks by erudite scholars in the field of social policy. One such was Kanda Wire, originally a Malawian national, now a Swedish national, who had written extensively on social welfare. He has been the head of the United Nations Research Institute. This Programme allowed for interaction with a number of experts from various parts of the UK to provide insight on social policy and how it worked which was relevant for this particular Committee. The Members of the NCOP could also benefit from the course if they wished .It would be tailored according to the needs of the consumers. There would be no translation services, but the programme could include South Africans who worked for CASASP. The DG could provide the Chairperson with a list of the modules for perusal by the prospective participants.

The Director-General, DSD, was planning to put the new Minister and Deputy Minister through the same programme; otherwise the Committee would be more empowered than the Minister and Deputy Minister.

The Director-General, DSD, said that previously he thought that the Portfolio Committee on Social Development could join the DoH on the trip to Brazil, but he had since learnt that the trip was happening next week and thus he was not sure whether it gave the Committee enough time to plan.

He was aware that the DSD was planning its own trip to Brazil, but he felt that a joint trip would have been good, because the issues that were important for the two departments were inextricably linked. The DSD would for example look at the Zero Hunger campaign which was launched successfully in Brazil. For the Zero Hunger Campaign, the Department of Agriculture, Forestry and Fisheries needed to participate, because it was necessary to see how family farmers, producer co-operatives and food banks interrelated.

The Chairperson said that the Committee had received no correspondence regarding the DoH trip to Brazil. She requested that the Committee be included in the DSD trip to Brazil. The period 19 July to 6 Aug 2010 would suit the Committee for the trip to Brazil. The Chairperson explained that Parliament provided for two trips in the five year period. Other trips needed to be sponsored.

The Director-General, DSD, said that it would be conceivable if only three members went along on the DSD the trip to Brazil. He was not sure whether the round trip to the Netherlands and the UK would be regarded as one or two trips.

The Chairperson announced that she received a letter from the Minister informing her that the Minister nominated her and the Chairperson of the Portfolio Committee on Water and Environmental Affairs to attend a lead programme in three modules on Climate Change in Population, Environment and Development. She asked whether the Members agreed. They did.
The Chairperson reminded Ms Malgas and Ms Tshwete to forward suggestions for oversight visits in the Eastern Cape, Ms Lamoela for the Western Cape and Ms Nelson for the North West, to the Committee Secretary. She said that the Committee would visit SASSA in both provinces.

The meeting was adjourned.

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