Prevention and Treatment of Substance Abuse Act: briefing by the Department of Social Development

Committee: Social Development

Chairperson: Ms Y Botha (ANC)

Date of Meeting: 11 Sep 2012

Summary

The regulations for the Substance Abuse Act, 2008 (Act No. 70 of 2008) which was passed by Parliament on June 24 2008 and assented to by the President on April 21 2009, had been promulgated to facilitate its implementation. Section 65 of the Act would only be implemented once the regulations had been finalised by the Minister of Social Development.  Proclamation of the Act was planned for October 1 2012.  A non-exhaustive description of the chapters within the Act was also provided.

Members concerns extended to the development of an inspectorate to ensure that the quality of care at treatment facilities complied with standards set by the Act, and that the provision of quarterly monitoring services was rolled out. The extremely poor state of treatment centres was also raised, following oversight visits by Members to Chatsworth and Newlands in KwaZulu-Natal.  The Department of Social Development (DSD) responded by saying that at present, social workers from DSD were performing monitoring functions and the Department was in agreement with Members that treatment facilities had severe maintenance issues which required immediate attention and cooperation from the Department of Public Works.


Minutes

Briefing by Department of Social Development (DSD)
Mr Coceko Pakade, Chief Financial Officer, DSD began his presentation by speaking about progress in the development of regulations under the Substance Abuse Act. In this regard, the Central Drug Authority, provincial departments of Social Development and the national and provincial departments of Basic Education, Health, Higher Education and Training, Correctional Services, Cogta, Women, Children and People with Disabilities, Arts and Culture, Sports and Recreation, Medicines Control Council, National Youth Commission, and various civil society organisations had been consulted on the Act’s regulations. Comments had been received, scrutinised and incorporated in the regulations where necessary and published for public comment on March 9 2012 in the Extraordinary Regulation Gazette.

The regulations had been promulgated to facilitate the implementation of the Act, which had been passed by Parliament on June 24 2008 and assented to by the President on April 21 2009.  Section 65 of the Act would be implemented only once the regulations had been finalised by the Minister of Social Development.  Proclamation of the Act was planned for October 1 2012.

The presentation then followed, with a non-exhaustive description of the main chapters (slides 7-20) within the Act.  Chapter II gave the minimum norms and standards and programmes that gave effect to prevention services from which regulation 3 noted prevention programmes must: be accessible at all times; be available to families and individuals; link up families and individuals with resources; aim to create development opportunities; discourage experimental use; educate and raise awareness about substance abuse; and promote healthy lifestyles and abstinence.

Regulation 4 stated that early intervention services must focus on: preventing harm; screening affected individuals; motivating individuals and families to be involved in intensive treatment; and facilitate admission to intervention programmes.

Regulation 5(a) noted that treatment centres and halfway houses must protect children and service users against: all forms of ill treatment; discomfort and inclement weather conditions; unhygienic premises; risk of fire; malnutrition; illness and disease; hazardous activities; and abuse of corrective measures.

Chapter III dealt with the manner for entering into contracts with service providers, conditions for receiving financial assistance by service providers, and the remedies for non-compliance with conditions, accounting and compliance measures.
Chapter IV provided the norms and standards for community-based services, while Chapter V regarded the conditions and requirements for registration.  Chapter VII dealt with the guidelines for the functioning of community-based services and Chapters VIII and IX listed the requirements and conditions for registration of treatment centres and halfway houses. Chapter X provided for the appeals against certain decisions of the DG while Chapter XII dealt with integrated aftercare and reintegration services. The final Chapter dealt with in the presentation, Chapter XV, referred to the transfer and retransfer of service users from prison, health establishment youth centres and alternative care.

Recommendations from the Department to the committee included taking note of the development of the regulations, commenting on them and supporting the minister on their finalisation.

Discussion
The Chairperson asked for a definition of professional staff and then asked what remedies there were for the closure of institutions, especially in the case of the death of patients or malfeasance. The chairperson did not feel this was dealt with clearly enough in the Act and was at the centre of the public debate on the issue.

Mr M Waters (DA) asked how large the inspectorate would be for investigating institutions, the frequency of inspections, and asked for some indication of the cost implications for this Act. What budget provisions were in place for the Act and what additional funding would be provided to ensure proper implementation?  He mentioned there were no treatment centres in Limpopo, and wondered what funding mechanism had been created to ensure more centres were built around the country. What was the planned program in terms of the roll out of reintegration facilities around the country?

Ms P Xaba (ANC) asked what the time frame was to consider an appeal to the Minister.

Ms M Mafolo (ANC) said in regard to teachers visiting treatment centres, were there any particular schools that had been identified that would be helping children in these centres?

Mr R Bhoola (MF) noted that the media in KwaZulu-Natal (KZN) had reported on the sudden death of a 23-year-old activist over the weekend, raising the issue of the easy circulation of cocaine in clubs. He believed the legislation was long overdue to tighten up certain aspects of substance abuse and wished for greater clarity on professional staff requirements at treatment centres. How could enrolment in a centre be fast tracked?  And how did the courts get involved with institutional committals?

The Chairperson said that on a visit to a substance abuse centre at Chatsworth in KZN, the facility had been very dilapidated, with one huge ward for both adults and children, although in terms of staff commitment there were no problems. How did the legislation ensure different age groups would be kept separate? She also mentioned that there had been broken windows in the facility and it was during winter -- a situation which impacted on the issues of discomfort and unfavourable weather conditions and the need for secure environment.

Responses
Ms Conny Nxumalo, Chief Director, DSD said the Act and regulations were clear in terms of the professionals required to work at an institution.  These were a full time social worker, a nurse, and a sectional doctor. Treatment centres would not be registered without the correct staff in place.

Currently there was no inspectorate. Instead, the DSD had used their own social workers to do monitoring and inspection when there was a need to do patient registration.

DSD was also training auxiliary social workers so that they were available in communities, although presently they were not in use as they were not yet experienced enough, but training was ongoing.

The possibility of an inspectorate was currently being explored, as this would allow for different programme components to be dealt with separately for greater monitoring.

The programme had been costed in 2007, with funds allocated to all provinces and national departments. The cost report had not been brought to the committee meeting today but would be made available as soon as possible. In 2007 the costing was specific for building treatment facilities, and the Limpopo facility was almost finished, although in the case of the Northern Cape the money had been reallocated. DSD was currently requesting more funds, as the problem of substance abuse was growing.

Provinces were still under-spending their budgets despite an implementation plan for each and every province. This would be monitored further from 1 October, when the Act was scheduled to be proclaimed.

Provisions were necessary for the aftercare and reintegration component of treatment and a model on how to guide service providers and social workers on programme administration had been established in communities.

The admission process for state facilities remained very tedious, so many families were opting to use private facilities.  It was therefore necessary to streamline the admission requirements so that within 24 hours, one could be admitted to a treatment facility.

Legislation was in place to separate age groups -- children from adults -- and provide separate treatment programmes and separate areas within the same facility which was in line with the developmental needs of children.

DSD agreed that maintenance was poor at state facilities and there was great room for improvement. An audit had been done which agreed and acknowledged that state facilities were not in a good state, and the DSD faced challenges in working with the Department of Public Works (DPW) on this matter.

Mr Puseletso Loselo, Chief Director of Legal Services, DSD, referred to the issue of legal remedies for the closure of institutions where a patient had died.  He said that outcomes and recommendations of the Act clearly dealt with this matter, saying that one could either close a centre or proceed with a criminal procedure with charges laid by the police.  An investigation could be conducted, and some of the remedies were available to relatives of affected patients, as centres could be sued for negligence for any injury sustained or loss of life incurred within their boundaries.

The time frame to consider an appeal against the decision of the minister was 90 days. Sections 35 and 36 of the Act dealt with the committal of a person to a treatment centre.

Mr Pakade said there was a need for children not to miss their classes while they were in a treatment centre.  Section 5 of the Act dealt with the need to develop strategies in this regard, to indicate how that should be exercised, but there was still a need to set a number of teachers to be present in a centre.

Mr Bhoola, referring to the Newlands treatment centre in KZN during an oversight visit there, said that a number of young ladies were enthusiastic to get involved with skills development but no programmes were in place. What was being done on the provision of skills development and addressing the issue of job creation post reintegration?

Mr Pakade said that the matter of skills development was different from what was envisioned by DSD, giving the example of a student who was going to write matric exams at the end of the year.  The DSD’s job would be to ensure that that student was not left behind, rather than developing that student’s skill set. This was a separate process from the issue of skills development.

The Chairperson said that the issue of guidelines for regulations depended more on the value chain, as there was a need to strengthen this from committal to admissions, through treatment, aftercare, and monitoring, but monitoring by the DSD was still very weak. As a follow up, DSD would have to visit both Newlands and Chatsworth treatment centres in KZN so that one could see how to deal with the challenges in those centres, as more and more problems kept emerging. Presently there was a focus on facilities for older persons and children and since officials knew this, everyone was “up to scratch” because they were aware of oversight visits. The Chairperson concluded by noting that DSD had been severely affected by budget cuts, saying that provinces had reallocated social development monies to hire young social workers.

The meeting was adjourned.