Appropriation Bill: hearings with Human Sciences Research Council

Standing Committee on Appropriations

18 April 2011
Chairperson: Mr E Sogoni (ANC)
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Meeting Summary

The Human Sciences Research Council was invited to suggest where money could be better used by shifting it between programmes. The overall budget could not be changed as the amounts had already been approved in Parliament.

The Council felt that the budget for education was sufficient. Attention had to be given to teacher development, although there had to be a balance between development and keeping the teacher in the classroom. The bursary scheme for new students was successful as were the new workbooks. Early education such as Grade R was important for future success. District offices needed to be developed to support schools. Further Education and Training Colleges were important but enrolment was very low.

The budget for health was not sufficient if all the targets set by the Department of Health were to be met in the projected time. Rates of new infections for HIV/AIDS and tuberculosis were decreasing but there were still shortages. There was a lack of clarity on the funding for training of community health workers, a key element of the proposed plan to boost primary health care. There was a lack of management skills in the sector, a lack of maintenance of facilities and a shortage of medical practitioners. There was a serious shortfall in the funding to make the proposed national health insurance scheme viable.

Not enough was allocated to promote food security. More was being spent on agriculture but fewer people were benefiting. Food prices were increasing. People in the rural areas had to pay more for the same product as their urban counterparts. The result was that many households were experiencing hunger.

There was sufficient allocation for cooperative governance. There were still problems with service delivery. Capacity constraints hampered the ability of provincial and local government to put plans into affect. Not enough was being allocated to human settlements given the backlog of housing.

Members were concerned over rising food prices and declining employment in the agricultural sector. Members realised that more needed to be done in the training of health care professionals. Community health workers had a major role to play. There was concern over the role of Sector Education and Training Authorities. Members reported that many students felt that the qualifications offered by Further Education and Training Colleges were meaningless. They did not fit the requirements of the workplace.

Meeting report

The Chairperson explained that the Money Bill process had started in October when the medium term appropriation was announced. It was too late to make changes now. However, the Human Sciences Research Council (HSRC) could still make inputs on the possible moving of finances between programmes. Its assistance was needed in giving the Committee an insight into Government priorities.

HSRC Presentation
Dr Olive Shisana, Chief Executive Officer (CEO), HSRC, said that the HSRC would make a presentation on its view of the budget and would point out where it saw inadequacies.

Dr Vijay Reddy, Executive Director, Education and Skills Development, HSRC, was responsible for comment on the education aspects of the budget. She pointed out that the budget was split between two different departments, namely the Department of Basic Education (DBE) and the Department of Higher Education and Training (DHET). In terms of the DBE there was a further split in that provinces had their own budget. In looking at the DBE budget the figures for the last two years were similar. Of the total budget for 2011/12 of R13.8 billion, R6 billion had been allocated to planning, information and assessment. There were 300 mud schools which had to be upgraded. Spending had to relate to outcomes. There were twelve Government outcomes, of which improved quality of education was the key. The DBE plan was clear and she could see no fault in this aspect.

Dr Reddy did wish to raise some issues. Teacher development was important. There was a clear DBE programme. There was little evaluation of the development programmes. There must be a way to assure Government that the programme was efficient. The system might be harmed by teacher absenteeism. Often teachers were absent due to training and sports programmes. A key recommendation was that teaching time should not be compromised. The second point was the Funza Lushaka bursary scheme to encourage school-leavers to take up teaching as a career. The quality of teaching students was improving. Teaching was no longer been seen as a last career option. The scheme was making a praiseworthy contribution.

Dr Reddy said that the DBE was taking massive strides to improve the quality of workbooks. The HSRC was concerned that the costs of printing these books might not be sustainable. While this improved the credibility of the books the printing costs were high. There were some delays in the distribution of these workbooks. It was another challenge to see that the workbooks were used correctly in the classroom.

Dr Reddy said that the third programme was standardised assessments. In the current year Grades 1 to 6 were being assessed. It was an ambitious project and there had been logistic problems. It was a commendable programme, but district officials also had to participate. There was a decreasing level of capacity moving from national to district level. Not enough support was being given to the schools. There were many vacancies at district level. The DBE had also made regional commitments. It was important to have an international benchmark which would provide an objective assessment of the country's achievements. The DBE was committed to a number of international programmes.

Dr Reddy said that another programme was introducing a universal requirement to attend Grade R. It was essential to invest in education from the earliest stages. There was a question over the quality. Class sizes were an issue. The qualifications of foundation phase teachers were also a consideration. Early research, both in South Africa and internationally, showed that there was a correlation between achievement at basic level with achievements at matric level.

Dr Reddy said that Outcome 5 dealt with the provision of a skilled workforce. The National Skills Fund was used to finance the Sector Education and Training Authorities (SETAs). SETAs had been placed at the centre of this outcome. Supply and demand had to be considered. A credible mechanism was needed for skills planning. Once the skills forecasting exercise was complete agreements could be reached with the SETAs on numbers and quality of training. Each SETA operated independently at present. A coordinated approach was needed. Another key component was the Further Education and Training Colleges (FETs). There had been much activity in the area but there was a lot of uncertainty. The colleges were designed for an enrolment of 1.2 million, but there were at present only about 460 000 students enrolled at the FETs. There was a move at present to move the salaries of FET academic staff to the national budget. The opinion was that there was a lack of capacity in the DBE. There were many vacancies that needed to be filled. There was an issue regarding the governance of SETAs. The National Student Financial Assistance Scheme (NSFAS) grants had to be sorted out.

Dr Shisana reminded Members that Health was a concurrent function between national and provincial government. The whole Health function was about R100 billion. There had been an agreement with African governments to contribute 15%. The Department of Health (DoH) had produced a ten point plan, but some of the strategies needed improvement despite being clear. Government might need to shift resources within the total budget.

Dr Shisana said that the first output was a long and healthy life for all South Africans. There was some improvement in the situation regarding HIV/AIDS and tuberculosis (TB). There was a decrease in new infections. This fact had been acknowledged internationally. A ground-breaking campaign had been launched. Some 10 million people had been tested to date. More anti-retroviral (ARV) treatment was being conducted. More tests were being conducted. However, for three people becoming infected only two were receiving treatment. This was still a problem despite the reduced new infection rate. Regarding TB treatment, the number of treatment defaulters was increasing. There was still a high infection rate which was concerning. Cases were not being diagnosed quickly enough. Solutions had been proposed . The Minister was advocating a new approach to prevent infection rather than simply focussing on treatment. This needed to be done in high population density areas. New technology was being introduced that would perform a diagnosis within two hours. There was a programme to check for infections at schools.

Dr Shisana said that a major outcome of Government was the long and healthy life objective. From 2002 to 2005 the rate of new TB infections had been reduced by half. It was encouraging to see this tendency. The rate of HIV infections had been reduced by the campaign to encourage the use of condoms. The HSRC felt that the Government should encourage local manufacture of female condoms rather than rely on a single international supplier as was the current situation.

Dr Shisana said that R43.6 million was being invested in some non-governmental organisations (NGOs). These organisations were performing good work and needed more financial support. Funds should be made available to the South African National Aids Council (SANAC). The programme had lost a number of people mainly due to the uncertainty over continued funding. More resources were needed. AIDS groups were still highly reliant on international funding, particularly from the United States of America (USA). If this funding stopped local organisations might find themselves in a very difficult position.

Dr Shisana said that a lot was being allocated to bio-medical preventative methods. Particular attention had to be given to women who were often not able to control the use of condoms or other preventative devices. It was important to finance these activities.

Prof Arvin Bhana, Acting Executive Director: Human and Social Development, HSRC, focussed on primary health care. This was a key focus area of the DoH. The planning cycle was geared to four outputs. These were increasing life expectancy, reducing maternal and infant mortality, combating HIV/AIDS and TB, and strengthening the effectiveness of the health system. An objective had been set of establishing fifty primary health care teams encompassing a range of medical disciplines. These teams would travel throughout the country. This was a key area. The cadre of community health workers (CHWs) would provide services to the community at large. The problem was that it was not clear what proportion of the training budget would go to these workers who would be the backbone of the programme. It was important to know what would be allocated.

Dr Shisana said that the objective was to increase life expectancy for males from 53 to 58 and females from 57 to 60. Child mortality rates would be decreased from the 2009 baseline of 69 children per 1 000 live births in 2009 to 30 – 45 in 2014/15. Maternal mortality would be reduced from the 2009 figure of between 400 and 625 per 100 000 live births to 100. A target had been set for HIV prevalence. She did not think these targets could be met without a massive increase in funding. Child mortality would not reach these targets by 2014. She felt that 2020 would be a more realistic target date.

Dr Shisana said that the health budget would increase to R112 billion in the 2011/12 financial year (FY). The HSRC felt this was still inadequate given the goals the DoH had set itself. There were capacity challenges in the health sector. The HSRC was pleased to see that an infrastructure grant had been set aside to build new and upgrade existing facilities. Historically the budget had not been spent. The HSRC was looking forward to seeing more effective spending. Five hospitals were under construction, but human resources were needed to operate the hospitals. It was not possible to train medical practitioners overnight. The state would have to find people to do the job. 40 000 community health workers had to be trained to supplement the current figure of 65 000. R1.2 billion had been allocated for all training. There was some confusion on where the funds for training would come from. The budgeted funding could only cover a certain number of districts, not the whole country. A training programme was needed. A large number of new nurses was required. Colleges would have to be opened. To do this, accommodation would be needed for students. Another 12 600 doctors were needed. Some tasks of the current doctors should be transferred to nurses.

Dr Shisana said that the health care system was impaired by a number of factors. The first was a lack of management skills. Public service laws made it difficult to remove incompetent people from office and needed to be addressed. There was a lack of induction and in-service training. Deficiencies had to be addressed swiftly. Not enough attention had been paid to artisan training. Maintenance of facilities was essential. Supply chain management was needed. Corruption and theft were major problems. Better control of assets was needed. Good management was needed. The country needed to move away from a culture of blame to one of helping. Accreditation was also a challenge.

Dr Shisana said that the budget speech made it clear that the first step for a national health insurance (NHI) was in place. Improved basic health care was the first phase. The Office of Standards and Compliance would decide on the conduct of medical institutions. The budget left out essential funds for the presentation of the NHI. More technical work was required. The ministerial advisory committee had to be paid for its services. Resources would be needed for the public consultation process. Feedback workshops would be needed. Communication would be needed through various media. A road show was recommended. The HSRC recommended that R45 million should be allocated from within the current budget to achieve this.

Food Security
Dr Peter Jacobs, Chief Research Specialist, Economic Performance and Development, HSRC, dealt with Outcome 7 which dealt with the development of agricultural and food security. It included land reform and the creation of jobs in the sector. There had to be access to affordable food sources. Other outputs dealt with job opportunities in rural areas. Almost R13 billion had been allocated to the Department of Agriculture, Forestries and Fisheries (DAFF) and the Department of Rural Development and Land Reform (DRDLR). The funds allocated to these outputs were inadequate. There was an incremental increase over the medium term, but it was too slow.

Dr Jacobs said that there had been a high level of spending on farmer support. This had increased dramatically since 2004 and was now about 77% of the Agriculture budget. There was a steady increase in the budget for agriculture and farm development. While spending on the Comprehensive Agriculture Support Programme (CASP) was rising, it was reaching a smaller number of emerging farmers. Government objectives were not being met.

Dr Jacobs looked at the spending in the Agriculture component. The vast majority of funding (72%) was being spent to address food security. He was not sure exactly how the issue was being addressed, but it was a progressive step. The focus was not limited to food security. There was an important issue regarding the support of agriculture. This was now outlined as a major focus area. In the current budget, there was a nice increment in the allocation. There had been a shift to agricultural extension. This would give longer term support to emerging farmers. This was in line with the previous year's discussion. The dialogue had two elements. He asked if appropriate models were being used. Lessons could be learnt from what was happening on the rest of the continent.

Dr Jacobs looked at the DRDLR. The war on poverty programmes fell under this Department. The main focus of their budget was land reform, restitution and rural development. The latter category was not clearly defined. Most of it would go to the National Rural Youth Service Corps (NARYSEC) programme to develop rural youth. There seemed to be a shift towards redistribution rather than restitution. It would be more expensive to restore property than to pay restitution.

Dr Jacobs said that there had been an economic downturn in 2008/09. At the same time there was an increase in food prices. Low income households were finding it difficult to afford food. There was also an ongoing decline in agricultural employment. This was at odds with the Government outputs. Sustainable employment creation had not resulted despite the economic recovery.

Dr Jacobs said that interventions to support low income households had to be increased. Household food security appeared to have worsened. In 2008 15% of households experienced hunger. The questions were changed for the 2009 survey, but Statistics South Africa reported that 20% of households were running out of food money. The worst effect was in the Free State. 18% of households were skipping meals to survive. Interventions had to be fast-tracked. Rural households were spending more on food than those in the urban areas. It was a huge discrepancy. 51% of households qualified for social grants but did not achieve them. The raising of the age for the child support grant was playing a significant role. Policies would be focussed on nutrition. It was not possible to define a food security budget. Most of nutrition allocations happened at a provincial level. Urgent policy interventions were needed in a variety of areas. He proposed a number of measures to achieve this.

Dr Jacobs said that the Green Paper should be tabled by May 2011. It would highlight key developments such as the establishment of a Rural Development Agency. More careful interrogation was needed of projects that had benefited from CASP. The last review was inadequate.

Local Government
Dr Udesh Pillay, Executive Director: Democracy, Governance and Service Delivery, HSRC, said that presidential imperatives were to work towards more effective local government. General levels of service delivery had declined. Only 45% of the public were satisfied in 2010. More than two of every five South Africans were dissatisfied with the performance of local government. The proportion of the population living in informal settlements had increased 45 to 60%. Up to 50% of houses had access to piped water and up to 75% had electric lighting. The number of dwellings with flush toilets had increased to 87%. However, only 6% of the Department of Cooperative Governance (DoCG) budget was allocated to local government. Some might say this was too low. There were large amounts of under spending. This was part of a R122 billion allocation for housing and community amenities. This translated into R48 billion in conditional grants. Capacity restraints in terms of municipal management were a factor. A second issue was a lack of transparency. A third was a lack of councillor presence in the community. This impaired on local government's ability to deliver services. There had been increased service delivery protests as a result.

Dr Pillay said that a potential solution was better use of the Municipal Infrastructure Grant (MIG). Secondly, the inter-governmental framework had to be reconsidered. Harmonisation was needed. On the positive side there was a turn-around strategy in place. Several municipalities had been put under administration. On balance, the allocation seemed to be adequate.

Human Settlements
Dr Pillay said that there were some positives regarding human settlements. Four million units had been provided since 1994. An urban housing development grant would contribute R22 billion. The budget was up by 10% on the previous year. The consolidated budget was R122 billion. This included R27 billion for building houses. There was a housing backlog of 2 million. The deficit had been helped by solid private-public partnerships. The Department of Human Settlements (DHS) was well capacitated. Policy was responding to needs of poor households. Security of tenure had been addressed. Reconstruction and Development Programme (RDP) houses were being supplemented by bonded houses for those who could not afford a bank loan. There was also an option of rental stock. Informal settlements would also being upgraded. A number of tenure options were being explored. There seemed to be good planning and governance in the sector.

Public Service
Dr Pillay highlighted some main points in the public service. The budget had increased to R56 billion. A significant portion was to increase service delivery. The Department of Public Service Administration (DPSA) was tasked to support other Government Departments. One of the biggest concerns was the wage bill. It had doubled over the last five years, and was now 7% of total Government expenditure. This was not sustainable. The Committee needed to consider this. The total bill was R70 billion.

Mr J Gelderblom (ANC) asked how the issue of support to schools could be addressed.

Dr Reddy said that the supply side of education had to be addressed. A demand must be created for quality education. Expectations must be raised. She had gone to schools where the principal was not concerned about teachers being absent. In district structures vacancies were an issue. Vacancies were often filled from the schools resulting in more vacancies at school level. There should be a separation of roles. The situation was being improved by setting up district offices.

Mr Gelderblom asked about the decline in employment in the agricultural sector. He asked what the reasons were. People were moving to the cities.

Dr Jacobs said that that agriculture was capital intensive. The question on employment was most complicated. Before the recent economic downturn there had been no dramatic change in employment patterns. Since 2009 the decline in employment had happened. There could be other factors involved, such as changes on the demand side and changes in farming techniques. There was a marked decline in the number of farmers, but the same area was still been occupied. There had been shifts in types of production with farmers moving towards livestock and game farming, which were less labour intensive.

Mr Gelderblom asked how the issue of food security could be addressed. More emphasis must be placed on the training of new farmers.

Dr Jacobs said that recent evidence did not suggest that there was a link between food insecurity and social instability. The HSRC had not conducted any direct research, but the issue was worth exploring. The only recent evidence was the rioting recently in Mozambique over food prices. Similar disturbances had been severe in other parts of the world.

Ms B Ngcobo (ANC) asked about the teaching bursaries. She asked if they would be used to help previously disadvantaged students, particularly from rural areas. The DBE had told the Committee that it would be manufacturing workbooks in-house. She asked if this would lead to a saving.

Dr Reddy replied that the HSRC had not done an analysis on the background of students. The big question was where the students went after completing their studies. A big challenge was on how to make the rural areas attractive to newly qualified teachers.

Dr Reddy said that there had been savings on the production of workbooks. The HSRC had been informed by the Minister that internal printing had led to savings. Children were not being prepared well for university. There was a high pupil to teach ratio. Enrolments to universities were curtailed by a lack of space at residences. The NSFAS had been reviewed and changes had been made. It was apparent that the universities of technology were drawing their students from the poorer households. Such students found it easier to access the NSFAS, but not all could be accepted.

Ms Ngcobo said that LoveLife had never used its budget. She asked what the reason was. Community health workers came from various Government and non-government organisation (NGO) sources. She asked if they would be consolidated.

Ms Shisana said that HSRC was evaluating LoveLife. The lack of spending was only in the third quarter. The National Treasury report indicated that the money had not been disbursed to LoveLife. Community health workers were being incorporated into one body.

Ms Ngcobo said that there was high spending on CASP, but there were few beneficiaries. She asked why this was happening.

Dr Jacobs did not know how many farmers were beneficiaries of land reform. Farmers were defined in different ways. Some had obtained their land through the restitution process.
Dr J Rabie (DA) said that the culture of blame was responsible for a number of problems. He wanted to touch on some issues. He wanted to know how many emerging and subsistence farmers there were in the country. The country could learn from other African countries. One of the constraints was the lack of water resources. He asked the HSRC view on that opinion.

Dr Jacobs explained the difference between the classification of Subsistence and Emerging farmers. Subsistence farmers were defined as those who grew crops mainly for consumption by their own household. There between 2.4 and 3 million of these farmers. Emerging farmers were those who produced a surplus. His estimate was there were between 250 and 300 thousand. The Hon. T M Joemat-Pettersson, Minister of Agriculture, Forestry and Fisheries, had agreed that agriculture was a very thirsty industry. The sector must find alternate methods and strategies to reduce water consumption. The HSRC was looking into a sustainable solution.

Dr Jacobs said that the HSRC had produced a forthcoming book on land reform programmes in Africa. Malawi was the only country in line with the Maputo declaration which determined that every country should allocate 10% of its total budget to agriculture. South Africa was below 2% at present.

Dr Rabie was still alarmed by the infection rates. He asked if there was enough appreciation of the threat posed by HIV and the dangers to the economy. He asked how successful the South African campaign was.

Dr Shisana replied that there had been a 50% decrease in the number of new infections being reported.

Mr M Swart (DA) asked what the findings were on the assessment of teachers.

Dr Reddy replied there were annual assessments of pupils. There had been some of teachers. Some results had been released. The knowledge base of teachers was found to be wanting. It was difficult to get data on teacher absenteeism. Researchers showed that teachers were absent from teaching days for an average of between twenty and 24 days. A third of these days were to attend to official duties. Mondays and Fridays were the most popular days for absenteeism. Three quarters of the absent days were accounted for by one or two days' sick leave, where no medical certificate was required. It was up to the school principal to manage the issue. It was a question of supporting the principal in this task. The pattern of leave-taking should be studied. The HSRC had presented a report to the DBE.

Mr Swart asked if there had been studies on the input costs of production and the effect on food prices and security as well as the effect on employment.

Dr Jacobs admitted that there was a dramatic rise in production costs on commercial farms. Fuel, interest rates, and capital costs of implements were all playing a part. There had been one or two studies on pass through rates. More information was needed especially regarding products purchased by low income consumers.

Mr Swart congratulated the HSRC for their findings on health services.

Dr Shisana said that the DoH was on the right track. There was poor management in the health care sector. Action was being taken in conjunction with the Bank of Southern Africa (DBSA) to improve the management of hospitals. There were cases of duplicated grants between the DoH and the Department of Social Development. She was not sure how effectively the two Departments communicated with each other.

Ms R Mashigo (ANC) was concerned about where ARV treatment was being presented.

Ms Mashigo asked if the question of learner transport had been addressed. The SETAs were being removed from the respective industries to the DHET. She asked if there was still a gap for the industry to play a role. The FETs were claiming that they had many people to train at various levels. She asked if there was enough funding for the maintenance of the current infrastructure.

Dr Reddy did not have a direct answer on the question of transport. Inter-departmental cooperation was needed.

Ms Mashigo asked if the health SETA had a role to play or if it was duplicating the work of the DoH.

Dr Shisana replied that community health workers required more intensive training than could be provided by the SETAs.

Dr Rabie said that the Committee had been told that the NHI would have profound economic repercussions. He asked what the HSRC thought of this.

Dr Shisana replied that there was no single formula for NHI. The number of visits for the population would affect the cost of the system. This number would vary amongst the different sectors of the population. R45 million had been budgeted to develop a costing model. Work still continuing.

Mr Gelderblom asked if there was any research into the rural schools that had no electricity. He asked how many schools had no access to computers.

Dr Reddy replied that the DBE should answer on the question of a lack of school equipment .

Mr Gelderblom asked if there had been transformation in the farming industry. He would like to know where the success and shortages were.

Ms Ngcobo asked if there was adherence to the United Nations (UN) documents.

Dr Shisana said that only Rwanda has been successful in adhering to UN guidelines.

Mr L Ramatlakane (COPE) asked about service delivery issues. So many people were skipping meals. He asked if this problem had been analysed. He asked if there was any correlation between the problems.

Dr Pillay replied that one of the key aspects of service delivery was the water infrastructure. He was encouraged to see the relative reduction in water supply costs. 80% of the budget was going to infrastructure management. The definition of service delivery was a loaded concept. Service delivery protests were often a pretext for the community to raise other issues such as poverty and job creation.

Mr Ramatlakane said the HSRC had spoken about the decline in employment in the agricultural sector. He asked if this was as a result of changing roles of farms. He asked what was to be done about the small number of farmers benefiting from programmes.

The Chairperson said that a lot of resources were going into education. He asked if the outcomes were commensurate with the investment. Teachers were being developed but this resulted in their absence from class. He asked what could be done to alleviate this problem. He asked if the FETs were producing on their mandates. Many students had gone through the FET process but some felt that the qualifications they obtained were meaningless.

Dr Reddy replied that there was a major concern over the FETs. Students enrolled at an FET after either completing Grade 9 or Grade 12. After Grade 12 different qualifications were provided but not higher qualifications. Often students who had completed training after Grade 12 remained in the FET system for further training, following what she termed a “zig-zag” role. The first challenge was low enrolment, and the second was the low throughput rate. Students were not getting proper qualifications. What they learned did not match the requirements of the labour market. There had been a major controversy over the new curriculum. The old curriculum was more aligned to the needs of the workplace.

Dr Reddy added that the SETAs preferred to make use of private FETs rather than the public colleges. The private colleges responded quicker to changing circumstances, and offered a range of short courses rather than full qualification. Subsidies were based on qualifications. The Minister was using the skills levy to encourage the use of public FETs. People were becoming serial learners, going from one qualification to the next. If one qualification could not secure a job, the student would go for another qualification.

The Chairperson asked about nurses. There were always protests about access to higher education. Many were registered but few needy students were awarded bursaries. He asked if the right access model was being used. The Minister had admitted some of the problems were due to the shift away from primary health care. He asked if the new programmes were beginning to address the gap. There was a lot of focus on interventions like condoms. He asked why there was not the same focus on female condoms as on the male condoms. He asked if interventions were making a difference.

Dr Shisana said that South Africa was looking at a primary health care programme similar to the Brazilian model. Child mortality had been reduced by almost half. Family health care teams would consist of a doctor, nurse, and community health workers. The Minister had targeted this proposal. There was a focus on male condoms as they were easier and cheaper to produce. This had resulted in only one company manufacturing female condoms. South Africa should be looking at establishing its own manufacturing capability using newer and cheaper materials. There were other interventions. The policy of preventing mother to child infection was seeing results. The distribution of condoms was high, with 90% of the population having access to condoms. Voluntary counselling and testing was taking place. Ten million South Africans had been tested for HIV. The awareness was high, but behaviour patterns still had to change. The health budget had been improved. The money for HIV/AIDS programmes had been reduced at the height of the epidemic. Treasury had realised this and introduced corrective measures. President Zuma had committed Government's effort to combating AIDS.

The Chairperson said that community workers had been introduced under the Department of Public Works (DPW). He asked what role the HSRC played in the training of health workers. He asked if the HSRC was consulted. Other countries were recruiting South African nurses.

Dr Shisana replied that nurses were badly trained. The cream of the crop emigrated to other countries. This was not a unique situation, as the United Kingdom, for example, was losing its doctors to the USA and Australia.

The Chairperson said that there had been under spending on CASP. He asked why this was so. It was an important programme despite the relatively small size.

Dr Jacobs said that the last report on CASP was inconclusive. Further work was needed in the provinces. Most of the money went to infrastructure development.

The Chairperson said that the Department of Cooperative Governance had introduced a funding model that allowed it to react to unexpected issues.

Dr Pillay said that there was no real evidence that the cooperative governance vehicle used by the Department of Cooperative Governance was working at all. He did not see any synergy in the programmes. The strategies of the Presidency and the Department of Cooperative Governance were not talking to each other. A locality specific analysis was needed to address local problems. The diagnostic assessment must be correct or the solution offered would be flawed.

The Chairperson expressed the need for another meeting. He asked that the HSRC provide some extra statistics as well as the narrative behind the slides.

Dr Shisana said that written responses could be provided.

The Chairperson said there was no undue hurry, as Members would be occupied with the local elections until the end of May. It would be nice if the HSRC could be present when the Financial and Fiscal Commission (FFC) presented its recommendations on the budget.

The meeting was adjourned.


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