Regulations on Prevention of and Treatment for Substance Abuse Act: briefing by Deputy Minister & Department of Social Development

Meeting report

Election of Acting Chairperson
Ms D Rantho (Eastern Cape, ANC) was elected Acting Chairperson in the absence of Ms R Rasmeni (North West, ANC) who was unable to attend.

Department of Social Development (DSD) Presentation
The Hon. Ms Maria Ntuli, Deputy Minister of Social Development,  said that it was the week of Children’s Protection. The Department had, along with the President, launched the Children Protections Week on Sunday in Kimberly.  This issue also dealt with substance abuse. The point of the presentation was to brief the Committee on the development of regulations in terms of the Prevention of and Treatment for Substance Abuse Act (No. 70 of 2008). The Department had requested comments from the Committee on the proposed regulations. The Department also requested the Committee support the Minister on the development of these regulations. The legislation had been passed in June 2008 and was assented to in 2009. R350 million  had been allocated by National Treasury to begin the process of implementation. It had been allocated to all the nine provinces to establish treatment centres. These had been established in five provinces. These were the Western Cape, North West, KwaZulu-Natal, Gauteng and Mpumalanga.  There were, however, still provinces without centres.  The Department hoped that in the near future there would be centres established in all those provinces so that it could continue with its work.

Ms Conny Nxumalo, DSD Chief Director: Families and Social Crime Protection, said it was best to give a background of where the Department was as there had been a gap of two years since the legislation was assented to by the President. The Department had had to consult extensively and the Act also required the Minister to consult with certain specific ministers in terms of the legislation. When the legislation was costed previously the Department had come up with three scenarios. In terms of the initiation process the Department came up with the measures that it sought to put in place before full implementation.  The Department envisioned that the Act itself would be implemented by 1 October 2012. According to the Department this was to be the full implementation because at the moment it was implementing certain parts of the legislation. It was not being implemented in full as the regulations had not been finalised.  The Department thus welcomed input within the meeting so that the regulations could be finalised. This would allow the Minister to approve them before implementation in October.  This was part of the consultation process.

Deputy Minister Ntuli had indicated that there had been challenges in terms of other provinces which had no treatment centres. The legislation was not only about treatment centres but broad services, however, the thorny issue had been that of the centres as they were infrastructural in nature.  If funds were allocated in provinces they were sometimes diverted to other priorities within those provinces. There was the example of Northern Cape. Funds had been allocated to build a treatment centre but those funds had been diverted.

Deputy Minister Ntuli said that she wanted to indicate that the provinces that had centres were really a drop in the ocean. In the Western Cape there were three centres, North West had one centre, KwaZulu-Natal had two, Guateng had one, and Mpumalanga had one. In Gauteng there was one private centre for children and one public centre, in Mpumalanga there was one private, in KwaZulu-Natal there was one private, in the Western Cape there was one public and two private, and in the Free State there was a one private. There was thus still a huge gap that needed to be closed by the Department in conjunction with civil society. 

Mr Luyanda Mtshotshisa, DSD Specialist in Legislative Drafting and Review, presented on progress in the development of regulations, why there were regulations, Chapter II of the Act which covered minimum norms and standards, Chapter III which covered the manner for entering into the contracts with service providers, Chapter V - conditions and requirements for registration, Chapter VII which covered the guidelines for the functioning of community based services, Chapter VIII & XI which covered requirements and conditions for registration of treatment centres and halfway houses, Chapter X which covered appeals against certain decisions of Director General, Chapter XII which covered integrated after-care and reintegration services, and  Chapter  XV which covered transfer and re-transfer of service user from prison, health establishment youth care centres and alternative care, and recommendations.

Discussion
Emerging centres
Ms B Mncube (Gauteng, ANC) asked how many years would the Department estimate that an emerging centre would have to be in existence to be accredited. Would it show that it had met the standards? She also asked if there was a mechanism for mentoring those who were emerging so that after a while they could be accredited.

Ms Nxumalo replied that the Department was encouraging community based interventions because the current legislation was silent on the matter. She thought that all present knew treatment was expensive. The Department thus promoted community intervention as it thought this was where services could be accessible. Thus in terms of experience one needed to prove that centres would use people with knowledge, such as retired professionals. The Department would check their credibility in terms of accreditation. For example, if the person was a retired social worker it would be investigated if  he or she was a registered social worker and if not what was his or her standing? The same would be done for nurses. This was because in a community based intervention there was a need for these professionals so they would even be able to assist with referees. The centre would also have to register as a non-profit organisation (NGO) at a community base. The Department would assist with registration and ensure that the company was eventually registered. The Department would assist in any way possible. The Department also prioritised funding in terms of the community based organisations as they needed to be nurtured in order to attain a certain level. There was also a coaching and nurturing programme for emerging or up- coming organisations.  They would be subjected to this so centres found themselves functioning properly and not subject the service users to abuses of human rights and the likes. There was thus no stipulated amount of years that an organisation needed to be operational. If they came forward and stated they were interested and wanted to do something the minimum requirements were indicated.

The Acting Chairperson asked about the centres that had been established by private people who worked with less experience. Would the regulations accommodate their training?

Ms Nxumalo replied that these private centres were covered as training was going to happen across the board. The regulations regulated both private and public entities.  All would be subjected to the provisions of the regulations.

 Mr Mogototsi Kalaeamodimo, DSD Director: Substance Abuse & Central Drug Authority, replied that training would commence and centres who were rendering the treatment service would be capacitated as if they knew nothing about what happened in treatment centres. After all the capacity building had been done the Department would follow up with monitoring and evaluating of those treatment centres to ensure that they were in line with the prescripts of the legislation and regulations.

Ms Nxumalo stated, in terms of each and every treatment programme or half way house, that there was requirement in terms of the Act and the regulations that the Department would not register a facility if there were no professionals such as a nurses and social workers. The Department was lenient in saying that psychologists could be outsourced but one needed to indicate how often this happened. The Department had realised this was a scarce skill.

Capacity to implement
Ms Mncube asked if, according to the costing done, the Department thought that this could be implemented in all provinces. Was there the capacity to ensure that this service was available even in the poorest areas?

Ms Nxumalo replied that the Act had been promulgated in 2008 and received the President's assent in 2009. By this time the Department had costed the legislation. Treasury had already allocated funds around 2007 which totalled to around R250 million across the provinces. The purpose had been for the provinces to start preparing for the implementation. This was because one could not have said that on the day of implementation all were ready to implement without back planning. This was especially in the case of infrastructure as this could take three to four years to put in place and resource properly. The Department was disappointed by the fact that there were some provinces, such as the Northern Cape, that had not yet built treatment centres. It was true the province had not allocated funds to the centres but diverted them.

 Mr Kalaeamodimo replied that the Department had already started with programmes/models to facilitate the implementation of both the regulations and the legislation. The legislation had prescribed services including prevention, treatment, early intervention, after care and community based services. There had already been models developed in all those services. The Department was finalising the treatment model as most treatment centres came up with different treatment programmes and that was when they became unmanageable. To ensure uniformity the Department had come up with a model as they could not prescribe a model for every specific person but the model would guide as developmental power for those programmes. All that was needed was for the Department to approve this model. The other service models had already been approved and implemented in some provinces.  Implementation of the legislation had begun as one could not wait while people wanted service.  The Department had already been rendering those services ahead of the approval of the regulations.

Deputy Minister Ntuli replied that implementing in all the regions would difficult as one would never have enough funds. However as time went on the Department would be able to ask the provinces which were the areas in need. Eventually the Department would be able to work with provinces so that it knew where to start.

Northern Cape
Mr W Faber (Northern Cape, DA) said he was disturbed by the redistributed funds in the Northern Cape. He was disturbed by the fact that the funds for a centre had been diverted to something else. He asked how this was possible as these centres needed to be there. Someone needed to be held accountable. How had this happened and what action was being taken? How many people had been employed to the programme?

Ms Nxumalo replied provinces and national had concurrent functions. The issue of the provincial treasury was that if it was given an equitable share it had the right to distribute its funds according to the priorities of that particular province. Thus when a bid had been placed at national level it had been specific. It had been stated that it was for a certain piece of legislation - more specifically for building treatment centres. That year it had been specific for the Northern Cape and the North West. Unfortunately those funds had been diverted to other provincial priorities.  This had been raised as an issue at the national level; however, the provincial level had overridden what had been said.  The Department was thus in a bind as it relied on provinces to push for various things. It was sometimes discouraging to continue to bid for funds as they arrived in the provincial treasuries and could go anywhere despite being requested at National Treasury in the name of substance abuse. 

The Acting Chairperson wanted to know, when it had been said that the provincial treasury could do with funds as it pleased, if the Department had not, upon identifying drug abuse treatment as priority, spoken to the provincial legislature so that the latter could also supported this as a priority of the province. She stated that there was a great deal of substance abuse in the Northern Cape. She did not understand how someone could take the money from this programme and put it in another programme.

Oversight in terms of Regulations
Mr Faber said someone needed to see to it that these regulations were followed. Someone needed to be appointed for this. How many people would be employed and what training would they be given so assessments were done accordingly?
Deputy Minister Ntuli replied that there had been no people employed to that programme. One could not say how many were employed as the funds had been diverted in the Northern Cape.

Drug Action Committees
Mr S Plaatjie (North-West, COPE) asked about the processes to ensure that people appointed in the Local Drug Action Committees were competent and knew what was going to be expected of them. Maybe there was a need to look at the skills these people had.

Ms Nxumalo replied that the regulations were clear in terms of Local Drug Action Committees and Management Committees. There were proposals at the municipal level of who should be a part of these committees. Each and every municipality needed to have a local drug action committee. The Department stipulated who should be providing leadership in that area. In terms of the management structure, according to the regulations, the Department proposed what type of people that should be looked for in terms of skills and competences. The Department believed not just anyone could serve in management and if one wanted to structure to function optimally there were certain skills and qualifications that needed to be considered when filling management positions for halfway houses, treatments centres and out-patient and community based structures.

Staff at centres
Mr Plaatjie said there had been no mention of infrastructure within norms and standards. There was also a need to state what type of staff one wanted to attract within these treatment centres. Did the Department make sure that it attracted professional people in terms of staffing in treatment centres?

Ms Nxumalo replied that in all provinces, when costing had been done, resources had been looked at in terms of personnel. The Department had proposed that in each district there should be a certain type of personnel within each of the types of centres. It had also proposed structures and allocations had been based on that. Some provinces had created directorates that dealt with substance abuse; however, in other areas one would be hard pressed to find substance abuse within the structure.  The national Department did not just sit back, however. The Department had proposed a new structure to those provinces in which the province considered putting substance abuse as a separate unit so that there were dedicated personnel who dealt with issues within that area. The same applied with certain aspects such as violence and victim empowerment. The Department had asked provinces that did not have these as separate aspects if they did not want to separate them and determine them as focus areas with dedicated personnel. The Department would keep urging and requesting. The Minister had also done so when she had met with Members of the Executive Councils (MECs) and the Director General also did so through meetings with Heads of Departments (HODs). The Department had done so when it met with its counterparts. The numbers that needed to be employed had been given.  The issue was -  could the Department force the provinces as provincial treasuries had told the Department that they, the provincial treasuries, could not exceed a certain amount to hire personnel.  The Department thus relied on the Committee to push and assist in implementing the mandate.

Sexual Offences and Child Abuse Register
Mr Faber asked if the Department would check the sexual abuses register and the child abuse register. One could not let people who had abused children enter the system again. Would these registers be checked? It was very important that there were no people previously convicted of sexual assault or child abuse being involved in these centres, working in the centres or running them. There was a need to look at the children and he was sure there was common ground on this issue amongst those present. He needed to know if these registers would be looked at as he knew these registers were not up to date. He also wanted to know if the Department would go and look at the background of the people appointed in these institutions. He felt that this was important.

Ms Nxumalo replied that she agreed with Mr Faber. She stated that, if within the legislation this was not explicit, there was a need for a requirement that people needed to be screened or checked.  Currently for child and youth centres people were screened. However, in terms of the legislation, there was a need to make sure that this was there as a check point. She subsequently confirmed that it was there.

Learners
Ms M Boroto (Mpumalanga, ANC) said her concern was with learners within the centres. It had been said that Chapter II dealt with this. She could not find the regulation on what was going to happen to learners. There was a need to get deeper into this. A lot of people utilising these services had been learners and it was important not to break the connection they had with learning. It had been stated that maybe there was a need for trained counsellors for these learners or maybe trained tutors for them. She wanted to know what was the plan for those learners.
Ms Nxumalo replied stated that maybe Ms Boroto had missed the part of the presentation that indicated what should be done if there was a learner accessing treatment. This had been outlined in terms of homework or making sure the child did not miss exams or tests or anything else pertaining to their schooling.  This ensured their recovery. She argued that the child could be removed if the addiction was so severe that they could not concentrate in school.  However if it was an area in which out patient treatment could be given then this type of treatment was recommended for learners.  However if the addiction was so severe that the learner had to be committed to in-patient care then the learners' schooling programme needed to be taken into consideration so that learners did not miss schooling.

Community Services
Ms Boroto said she felt there was a need for community services to be educated on this. She wanted to know where these resources would come from. Also who would make sure follow-up was done in this respect?

Non-registered services
Ms Boroto said that the Committee was aware of the out-patient services that were illegal and called themselves private but were not registered. These centres had their methods which sometimes were dangerous to beneficiaries. Was the Department aware of their existence? Did the Department have statistics on these practices that were not registered but doing the same work? What she had read and heard was that these centres were sometimes dangerous to the beneficiaries and sometimes even made them worse.

Ms Nxumalo replied that the current legislation being utilised did not make provision for the registration of out-patient services. This was why there were a great number emerging without registering. Unfortunately the Director-General and Minister could do nothing about it as there was no legislation. She argued that, if this legislation came into effect on 1 October 2012, this was one of the areas that were to be prioritised. This legislation forced out-patient treatment facilities to register with the Department so they could be regulated.  There were currently minimum norms and standards for out-patient care. However those who were legally knowledgeable often argued that these were norms and were not enforceable as they were not in the legislation. These were the challenges faced; however, on 1 October 2012, if there was full implementation, this was the area that was to be prioritised. There was registered data in terms of the number of treatment centres registered.  Unfortunately some were not registered. The Department relied on communities to state that there was a treatment centre functioning within their area. Unfortunately, due to their vulnerability, people used the unregistered treatment centres as they did not know better. One only found out later when there was a problem.  Maybe what the Department needed to do was inform the public better and maybe publicise the list of registered treatment facilities occasionally so people could see which were credible.

Mr Pierre Viviers, DSD Social Work Manager, replied that the Department wanted to get to a situation where it did not tolerate any unregistered facility. The Department had a backlog and needed to move beyond that point.

Mr Kalaeamodimo replied that the Department did not instantly close unregistered centres but instead aided them in putting their services together and registering the services. There were cases where the Department failed as there were instances where people did not want to meet norms and standards for in-patient and out-patient centres as they were not yet enforceable in terms of the law. The Department did manage to register some. The new legislation ensured the right foundations so that people did not invest in centres hoping that they would be registered and find that they did not comply with various regulations.  The intention was that if someone thought of establishing a centre then the person should approach the Department which would guide that person.

Centres in Provinces
Mr Plaatjie said that he supported regulations to support the smooth running of a system. He asked who decided where the centres would be located.

Ms Nxumalo replied that this was a provincial competence. The Department said to the provinces ‘there were the resources; you know your hotspots, province and geographical spread.’ Provinces knew where there were services not provided. It was up to provinces to state where the centres should go and all the national department did was provide technical support and any other support that was needed.

Ms Nxumalo replied that the Department stipulated the specifications of a treatment centre or a halfway house.  The Department did have a blueprint for treatment centres and halfway houses. Each area had its own blueprint.
Ms Boroto asked if it was possible to get a document stating which provinces had centres and which did not. This was a serious problem.

Ms Nxumalo replied that this information could be provided to the Committee.

The Acting Chairperson said there were provinces that had these centres (five provinces to be exact). Had the remaining four provinces not been budgeted for or had there not been good coordination with these provinces?

Ms Nxumalo replied that when the allocation had been provided, these provinces had been supposed to establish centres. This was the same challenge as had been experienced in the Northern Cape which was the first to divert funds instead of establishing a centre. There was now an improvement as all the provinces which had previously not had centres had begun to build them. She gave the example of Limpopo which would possibly have an operational centre by the next financial year. She had indicated that this could take a year or two so the provinces were at different levels. She wanted to indicate that the Department had not just ‘folded its arms’ on the issue of diverted funds. The Department had approached National Treasury on the issue and suggested that a conditional grant for specific legislation. The Minister had asked the Director-General to attend to the situation before it got out of hand as the Department had already heard that funds for other projects had already begun to be diverted.  The Department hoped that National Treasury would listen to the suggestion of making it a conditional grant or earmarking the funds so that no-one could touch them.

Ms Mncube stated there seemed to be ‘arms length’ approach to provinces. There was legislation and now the Department was dealing with regulations. There was a need to be more heavy handed with provinces as funds were now being rolled out.

Ms Nxumalo replied there would be an attempt to be more heavy handed with the provinces. However in terms of the Constitution and other procedures there was only so far that the Department could go. The Department would also engage its political principles to find out how best to engage with this in terms of legislation.

Ms Gigi Gosnell, DSD Chief Director: Intergovernmental Relations & Executive Support, replied these issues were being addressed and discussed. The Minister had expressed the need to develop a social development council that would strengthen the enforceability of decisions taken. This was not just an issue of substance abuse but other issues such as victim empowerment amongst others.  The Department was hoping that if there was a legislated Social Development Council it would force provinces to comply. She wanted to indicate that it was not the provincial treasuries that allocated resources from social development projects to other priorities but it was the provincial executive committees. She had witnessed, whilst working in the office of the premier in Mpumalanga, that some decisions had been taken due to political imperatives. There were dynamic tensions that prevailed within provinces. Sometimes provincial departments supported the national Department; however, there were certain political decisions taken at provincial level that provincial departments had to concur with.  She urged the Committee to engage with the provincial legislatures and executive committees to say how they could strengthen the social services so the social services were not the first sacrificed when there were other pressing Government priorities being addressed in provinces.

Deputy Minister Ntuli replied that there was nothing national in terms of coordination. That was why MinMECs were held. However, these were not enforceable and MECs attended if they wanted to. It was very dicey. There was a need to have a system of forcing MECs to come to MinMECs  as if they did this then they spoke on what was happening in the provinces. This allowed the Department sections at national and provincial to work together and coordinate in getting the work done.  It was sometimes difficult to be in the situation the Department sometimes found itself in.

Media
The Acting Chairperson asked if, in terms of the media, the Department had considered the local radio stations and not just the national media. People were often listening to these as they were interested in local happenings.

Ms Nxumalo replied the Department had noted this but said that usually the national media was targeted. It did not always reach the right people. Fortunately next week the Department would be going on air in the 65 community radio stations about the green paper on families. The Department would then have to link it to the issue of substance abuse as families were impacted negatively around the issues of substance abuse.

Clarification
The Acting Chairperson asked for clarification of Chapter II, more specifically the provision termed ‘aim at creating developmental opportunities’.

Ms Nxumalo replied that, if someone provided a prevention service, one needed to remember that one was dealing with people who had never experienced drugs or did not know anything about drugs or had an affected family member. What was meant by the term was giving information in a way that assisted people to manage their own lives by educating their own parents. This was because at any given time one would not reach everyone in the family or community.  When it was said that it was a developmental opportunity it meant that the person was able to develop and run his or her own life using the information given. One could even link a person to skills or training opportunities. This allowed them to also roll out training as family members and community members. It did not end in giving information there was a need to ensure that one invested in the capacity of people so they could lead their own lives.

 Mr Kalaeamodimo replied the legislation prescribed that each and every province needed to have at least one treatment centre and halfway house.  When the Department indicated what needed to be in the half way house it had included an emphasis on the issue of skills development whereby workshops needed to be present.  This was important especially in the case of young people who were forced to use drugs as they did not have any other skill which they could use in the market place. These centres sought to cater for that. This was why programmes were said to be developmental.

Deputy Minister Ntuli replied she wanted to indicate that these children did not start as addicts. They started as drugs mules to other users. Because they wanted money they did this and ended up using drugs. The Department had realised that to encourage them not to go back to drugs, the Department needed to impart skills to them. One saw evidence of this in Correctional Services. Whilst service users were being rehabilitated then they needed to be given skills.

Starvation as a punishment
The Acting Chairperson said that, also in Chapter II, it had been stated that the Department discouraged those working with children from punishing them by withholding food. She said that encouraging people did not always work, and that there should be an explicit prohibition of denying children their food as a punishment.

Ms Nxumalo replied that this was something to consider as when negotiations happened they sometimes did not go well. Thus maybe the Department would consider reviewing the wording as this was the main concern here. The drafter was present and was probably thinking how best to reword this as a mandatory instruction.

Persons with a history of Drug abuse
The Acting Chairperson asked about Chapter IX (conditions and requirements for registration) and stated that a candidate must not be person with a history in dealing with drugs. Did this apply to a person who wanted to open the centre or did this apply to people interacting with persons who were dealing with drugs and were caught using drugs? Maybe they wanted to educate and be part of the centres combating this type of crime. Were they not allowed to be part of the centre also?

Ms Nxumalo replied the Department acknowledged that many of the current centres were run by recovering addicts without the assistance of professionals. The Department was therefore now going to require that professionals be employed and that those running centres could not run them on their own.  The Department did not want to say that recovering drug addicts should not contribute as they could share experiences. All the Department was saying was that these persons could not run the facility on their own. They needed professional input.  Fortunately the regulations and legislation advocated for professional input.  This was the case in all areas including the community based centres.  There was a move to utilise retired professionals as they could assist and were willing to assist.

Management structure of Community Based Services
The Acting Chairperson asked about Chapter VII which stated that the management structure of community based services must determine and develop policies. She asked if they were going to develop their own policies or was the policy to be based on a national policy that was to be presented to them. She had a problem with people running private centres who had their own policies and would say they had been running the centre for many years and the policies they had were better than the policies that the Department had. Were the centres supposed to have their polices based on national norms?

Ms Nxumalo replied that the policies needed to mirror the national ones. Sometimes departments came up with a broad policy framework. The Department asked how a community facility was going to be run based on the framework.  It was not about these community based services coming up with new policies.
Mr Viviers replied that the Department wanted to see that there was a mutual responsibility between national and provinces for the implementation and the monitoring of implementation.  The National Department had an obligation to see that the legislation was implemented in the spirit in which it was meant to be implemented. There was a responsibility to make sure that this was implemented in the provinces in a uniform manner.

Marketing strategy
Ms Mncube said there was also a need for a marketing strategy. There were people tired of struggling with drugs and did not know where to go. She suggested working with the Health Department and also in schools. There had already been intervention from the Health department and the Department could work with them.

Ms Nxumalo replied that this input was noted. She agreed that maybe there was a need to market the services better so that people knew what was available.

Safety and security in Centres
Ms Mncube said the issue of safety and security within those centres needed to be part of the minimum standards.

Debate on Child Protection in the National Council of Provinces (NCOP)
Ms Mncube said there would be a debate in the NCOP on 29 May 2012 on Child Protection. She asked if the Department could pick up the issues about which it had been telling the Committee as some of them needed to be debated. She wanted that noted.

Coordinating Mechanisms
Ms Nxumalo said that there were strong coordinating mechanisms, even though there was room for improvement.  There was the Central Drug Authority and Cabinet had also appointed an inter-ministerial committee to look at the issue of substance abuse. Substance abuse also included alcohol. This had been prioritised as consumption of this was seen as acceptable. Thus most of the engagement was surrounding alcohol but the Department did not neglect the other hard drugs. The mechanisms were brought in such a way that the Department worked with other departments such as those of Health, Economic Development, Sports and Recreation, as well as with Basic and with Higher Education and Training, which were key. They were all part of the Intern Ministerial Committee and the Central Drug Authority.  There had been a push to use existing buildings that were not being utilised as building new structures would take time. Using these existing buildings would prove quicker.

 Mr Kalaeamodimo said that the utilisation of existing buildings was a wise suggestion.  The North West had not built a treatment centre but was utilising a ward. This showed that North West was committed. He felt that other provinces should be encouraged to follow suit.

The Acting Chairperson said that the Committee supported and welcomed the regulations. The Committee would always support the Department. The Committee did not have any problem with the Department. Even if there were clashes, the Committee worked well with it. She thanked Deputy Minister Ntuli for always availing herself to the Committee. She thanked the Department for its cooperation.

The meeting was adjourned.