Midterm Review of Government Priorities: State Performance & Challenges: Department of Performance Monitoring & Evaluation

Public Service and Administration, Performance Monitoring and Evaluation

12 September 2012
Chairperson: Ms J Moloi-Moropa (ANC)

Meeting Summary

The Department of Performance Monitoring and Evaluation presented a Midterm Review of the Priorities of Government. It commenced with a summary on the focus areas of the department and the targets set by government, progress made and recommendations on the following priority areas: Education and Skills, Health, Fighting Crime and Corruption, Jobs, Economic Infrastructure, Rural Development, Human Settlements, Local Government and Basic Services, Environmental Assets and Natural Resources, Creating a better South Africa and Contributing to a Better and Safer Africa in a Better World and an Effective and Efficient Public Service. The Department also examined the institutional performance of the government in general through the annual assessment of management performance of national and provincial departments using the Management Performance Assessment Tool (MPAT) and Frontline Service Delivery Monitoring (FSDM) programme, which was a joint Department of Performance Monitoring and Evaluation and Offices of the Premier programme. In conclusion, the Mid-Term Review showed that implementation of policies was still a key challenge. Many of the implementation challenges related to weaknesses with generic management functions which in turn led to poor service delivery.

Members commended DPME for an insightful, detailed and thoroughly researched presentation. They asked how issues raised in the Report were addressed with other departments; questioned whether there was an oversight committee to which the department reported; asked what measures were being put in place to address the acute skills shortage of health professionals in the country; noted with dismay that Home Affairs had the highest percentage of complaints about undignified treatment of applicants. Members decried the statistics on the number of departments that had not carried out the self-assessment function using MPAT, particularly departments located in provinces where the requisite skill was available and stated that this was an issue that needed to be addressed urgently. Members remarked that there was a need for politicians to boost confidence in the public health system by using public hospitals. The Chairperson noted that the mid-term assessment failed to examine South Africa’s position in relation to the Millennium Development Goals and the African Peer Review Mechanism.

Meeting report

The Chairperson remarked that the interaction with the DPME was necessary to give guidance to the Committee during oversight visits.

Mr Sean Phillips, Director General: Department of Performance Monitoring and Evaluation, anchored the presentation. He commenced with a summary of the focus areas of the department and the government’s mid-term review. He discussed in detail the targets set by government as outlined in its Mid-Term Review, the progress made and recommendations for each of its priorities.

Education and Skills Development
Progress made on set targets included: increased number of children benefitted from Early Childhood Development (ECD); Grade R enrolment doubled between 2003 and 2010 and there was a likelihood to meet 2014 target of all Grade 1 learners having attended formal Grade R; Workbooks had been developed; measures to address teacher quality were being implemented; 70% of learners were enrolled in no-fee schools; Grade 12 percentage passes increased in 2011; but fewer learners were passing at bachelors level; and fewer learners passing maths; average 2011 ANA Grade 3 literacy (35%) and numeracy (28%) and Grade 6 literacy (28%) and numeracy (30%) scores were very low, pointing to general lack of effective teaching and school management; including general weak district oversight of schools. Targets for curriculum coverage were not being met; there were budget pressures due to compensation and lack of implementation of national guidelines limits spending on other essential education services; there was lack of implementation of policy dealing with excess teachers which was a major contributing factor to budgetary pressures. There was increased enrolment of adult learners for Adult Based Education and Training (ABET); increased enrolment at Further Education and Training (FET) colleges; National Senior Certificate for Adults to meet university entry requirements had been registered; but the curriculum development was delayed. The number of unemployed learners and workers entering learnerships had exceeded targets;11 335 artisan learners entered training; exceeding target of 10 000 however economic slowdown had reduced opportunities for workplace experience component of learnership and artisan qualifications; projections indicated targets for new teachers; honours; masters; doctoral graduates will be met by 2014. Recommendations to meet up challenge areas on a broad spectrum included improving the quality of basic education, addressing problems of unemployed and unskilled youth and addressing the skill requirement of the economy.

Progress made on set targets was as follows: Life expectancy had improved largely because of comprehensive response to HIV & AIDS however; life expectancy still compared poorly with other countries with similar or lower levels of investment in health. Number of people living with HIV had stabilised; there was reduction in mother to child transmission from 8% in 2008 to 3.5% in 2011; protecting more than 30 000 babies (per annum) from infection; 19.9 million people tested for HIV from April 2010 to date; 1.7 million people had received antiretroviral therapy; costs of ARV drugs had halved; 8 million people were tested for TB and cure rate improved; reached 70% mark in 2010; but high TB incidence and HIV-TB co-infection remained a challenge. There had been 70% immunization coverage for diarrhoea and pneumonia; there was improved percentage of mothers and babies presenting for care within 6 days of birth; cervical cancer screening rate increased from less than 40% in 2009 to 57% in 2011; latest data indicated improvements in infant and under-5 mortality rates; linked to
Prevention of Mother To Child Transmission (PMTCT) and antiretroviral therapy (ART) progress. There was progress in Primary Health Care re-engineering and deployment of health teams to communities but significant challenges remained.

Measures to address these challenges included: strengthening management of the health system; implementing comprehensive information management system to track people on antiretroviral treatment; intensifying prevention of HIV and AIDS and TB and integration of services between them; addressing increasing non-communicable diseases and socio-economic determinants of health such as poverty; intensifying focus on child nutrition and meeting the 90% target of deliveries in facilities; implementing service quality improvement plans following quality audits; joint planning between Health, Higher Education and academic institutions to train doctors, pharmacists and nurses; consider moving funding and management of the 10 central hospitals to national level; improving performance of the National Health Laboratory Services; addressing under-expenditure on health infrastructure grants and maintenance; addressing financial and supply chain management challenges in health departments; maintaining turnaround momentum - despite significant improvements. SA performance on health indicators still poor by international standards relative to expenditure levels.

Crime and Corruption
Progress made so far was: serious crime had decreased from 3 872 to 3 680 per 100 000 of the population; Murder, attempted murder, car-jackings and house robberies had decreased however there was marginal increase in business robberies; perceptions of the management of crime among citizens had improved; detection rates for contact and trio crime had increased; case backlog had decreased; 1 529 allegedly corrupt people in the criminal justice system had been investigated; progress had been made in establishing Thuthuzela Care Centres and Victim Support Rooms at police stations. Recommendations made to address pending challenges on a broad scope included: Improving effectiveness of criminal justice system, Monitoring parolee re-offending and rehabilitation in general,
Improving victim support and Combating corruption.

Job Creation
GDP growth was slow largely due to slowdown in global growth since 2008; sluggish export growth; and lower consumer demand largely due to over-extension of credit in SA in the boom period. Gini co-efficient and share of the poorest was stagnant due to the impact of global crisis on low skilled workers and informal sector in SA and slow progress in implementation of policies to reduce inequality.

Advances had been made in coordination around growth strategies (NGP; stakeholder agreements); there was progress with promotion of labour absorbing growth; public employment programmes grew in volume and impact. Recommendations for remainder of the term included: implementation of New Growth Path and related strategies; taking decisions on youth employment programmes and urgent implementation of these; addressing stagnating research and development; increasing impact of SME support programmes; more systematic monitoring of implementation of microeconomic reforms; reviewing impact of government regulations, charges and administered prices on employment creation; implementation of business case for expansion of Community Work Programme and improvement of capacity in government to oversee the programme; preparations for risk of slow global growth and to reduce potential impact of immediate risk of higher food prices; reviewing policies which allow sharp food price fluctuations; improving coordination of jobs initiatives across departments.

Economic Infrastructure
Progress made included: Creation of Independent System and Market Operator (ISMO) was underway to allow participation by Independent Power Producers (IPPs). There were marked improvements with regard to road, rail and ports; there had been progress with Water Augmentation Schemes and rehabilitation of 9 out of 25 dams completed; there had been progress on water licences backlog but little progress on equitable water pricing and funding models. Wholesale broadband prices dropped by 73%; local loop unbundling with different providers on the same telephone lines was billed to commence November 2012; 60% Digital Television broadcasting coverage had been achieved. There was improved coordination of the infrastructure build programme through the Presidential Infrastructure Coordinating Commission – project plans clustered, sequenced and prioritised into a project pipeline.

Recommendations to address challenges included: Complete establishment of Independent System and Market Operator; establish single transport regulator; increase private sector participation in rail and ports; monitor Medupi build programme; promote co-generation options; accelerate integration of renewable energy and accelerate demand-side savings; further improvement of port productivity; address the affordability of road tolls; ensure progress on equitable water pricing strategy, funding models and institutional structures for water infrastructure delivery and maintenance; Complete ICT connections of 125 Dinaledi and 1 525 district schools; finalise and implement national broadband plan; local loop unbundling; oversee Digital TV implementation; create new institutional mechanisms at administrative level to sequence and coordinate the delivery of strategic integrated projects across the spheres of government and the private sector; fast-tracking approvals and ensuring value for money.

Rural Development
Progress made so far included: Some appropriate service delivery models for remote rural areas had been developed (such as solar power; mobile clinics) but still needed be introduced more widely. Comprehensive Rural Development Programme (CRDP) reached 80 wards but at high cost per household. Under Land Acquisition and Redistribution programme 823 300 hectares had been distributed to 20 290 beneficiaries between 2009 and 2011;
712 claims settled between 2009 and 2011 under the Restitution Programme. Overall, 6.7 million hectares were transferred to blacks between 1994 and 2011 (representing 27% of 2014 target of 24.5 million hectares). Remaining claims for settlement are on high value commercial farmlands in the northern and eastern regions and difficult to resolve. There was under-utilization of the newly acquired land post-settlement; there had been insufficient involvement of the commercial sector in developing smallholders and inadequate/ineffective agricultural support (via extension workers). Questions regarding effectiveness of financial support to small farmers remained. Broad unemployment in ‘tribal areas’ was rising rapidly from 44% in 2009 to 52% in 2012.

To address the myriad of challenges facing rural development, recommendations were made on a broad spectrum to include: addressing rural needs in a comprehensive fashion, there was need for agrarian reform and improving access to food, establishing focus on rural job creation.

Human Settlements
Progress made so far included: a total of 83 000 serviced sites were delivered by provinces by September 2011. However concerns remained about meeting target of reaching 400 000 households by 2014. 15 469 social/public/private units were built (19% of target) with good project pipeline. Eight municipalities had been accredited to level 2, awaiting provincial gazetting; 16 municipalities had been assessed for compliance. 1 329 hectares of State Owned Entities land was being transferred to Housing Development Agency & 1 066 hectares transferred to municipalities; 122 000 loans had been granted by Housing Development Finance Institutions as at September 2011.

Recommendations for the remainder of term: acceleration of integrated housing delivery; identification and release of well-located state land to support higher densities; facilitation of improvements in affordable gap housing market.

Local Government and the provision of Basic Services
Progress made so far included:
Overall access to water stood at 94.5%; although this figure was only a measure of the infrastructure in place and not of the actual service or quality of service accessed by citizens. Due to lack of operation and maintenance, 21% of the households with access to a tap did not always get water from the tap and 26% were affected by sanitation services and/or facilities that were not fully functional. Rate of delivery of the water infrastructure was slowing due to lack of bulk infrastructure; lack of engineering expertise for maintenance and operation. Basic level of refuse removal had risen to 72% by 2010/11; on target for 2014 although unpermitted land-fill sites remained a constraint. Insufficient progress has been made in improving the financial and administrative capabilities of municipalities. Operation Clean Audit has had little impact and oversight and support to municipalities was fragmented and ad-hoc. Majority of ward committees had been established but there was need for more focus on providing guidance to ward committees to prepare ward-level service delivery improvement plans. In 2012 the department worked with the Department of Cooperative Governance and National Treasury to develop a tool for monitoring and identifying management and service delivery problems in local government; would be piloting municipal assessments in 2012 and then roll out to municipalities with poorest audit outcomes in 2013.

Recommended focus for the remainder of term broadly included: provision of basic services and strengthening of municipal capacity.

Environmental Assets and Natural Resources
Progress had also been recorded:
Water use efficiency targets had been set for agriculture sector; Water use licensing backlog was significantly reduced; 66 water supply systems were awarded Blue Drop certification for 2010/11 indicating an increase of 74% against 2010; the number of waste-water treatment works that scored more than 50% in Green Drop assessment increased from 216 in 2009 to 460 in 2011. Accelerated Community Infrastructure Programme achieved 63 cubic metres of water savings.Plans for addressing Acid Mine Drainage were in place and emergency scheme started by March 2012 in the Western Basin. National Air Quality Indicator showed marginal improvement. 42% of renewable energy in Integrated Resource Plan was undertaken. 28 preferred independent power producers were announced. 200 000 solar heaters were installed with 70% in rural areas. New biosphere reserve (Gouritz Cluster) was added to conservation estate; 13% of the coast had partial protection (target of 14% by 2014); 307 731 work opportunities and 74 114 full-time jobs were created through Environment and Culture Sector of the Expanded Public Works Programme.

Specific recommendations for this sector included: Expanding Blue Drop and Green Drop certification programmes and raising quality of water; Implementing Acid Mine Drainage plans; monitor mines’ compliance with water licences. Reduce solid fuel burning in homes and manage vehicle emissions. Implement White Paper on Climate Change and meet ambient air quality standards. Implement the projects approved and take forward the SA Renewables Initiative (SARI) launched at COP 17. Ensure amendments to building regulations to promote energy efficiency are implemented. Implement simplified Environmental Impact Assessment (EIA) process for Small Medium Enterprises (SMEs) and centralised electronic system for tracking environmental authorization. Strengthen the National Wildlife Crime Reaction Unit (NWCRU) to address poaching, including rhinos. Consolidate the conservation estate.

etter South Africa and a better and safer Africa
Progress made included: successful integration of NEPAD into the structures of the AU;there had been progress with the planning of key NEPAD infrastructure projects including the North-South road and rail corridor; South Africa was elected onto the AU Peace and Security Council for a two year term, and the AU endorsement of SA’s candidature for the non-permanent UN Security Council seat; aiming to improve linkages between these two,Minister Dlamini-Zuma was recently appointed as head of AU Commission.SADC Free Trade Agreement had been consolidated. 92% of product lines now 0% rated, compared to 85% in 2009.World Bank Executive Director position was created for SA; Nigeria and Angola. With regard to the UN Security Council, there had been some progress in agreement to move reform from a discussion forum to a formal negotiation process.Inward foreign direct investment had improved and there was improvement in high value added exports and number of tourists.South Africa successfully hosted COP 17 and obtained agreement.

Broad spectrum recommendations included: Consolidation of the African Agenda; Regional integration; Reform of global governance institutions and leveraging additional investment from targeted economies.

Creating an Effective and Efficient Public Service
Progress was recorded against the set objectives: There had been significant examples of improvements in service delivery although not yet widespread (Home Affairs average turnaround time on processing of IDs and permits had improved from 127 to 45 days; SASSA had improved with processing of social grants; SAPS reaction times had improved). On average less than 3% of funded posts vacant; but there remained particular shortages of professional and technical skills. Time taken to fill vacant posts had improved from 9 months to 6 months (target is 4 months). Standardised financial and human resource management delegations were developed to enable quicker decision-making in departments. New regulations for monitoring of supply chain management were developed and payment to suppliers in 30 days ensured. 74% of national departments received unqualified audits in 2010/11 – an improvement from 66% in 2009/10. National Treasury, Department of Public Service and Administration (DPSA) and Offices of the Premier were assessing quality of management practices in departments and improvement plans were being put in place and monitored.

Specific recommendations for remainder of term included: Resolving issue of single public service. Improve service delivery quality and access. Focus on recruitment of professional and technical staff. Ensure 100% of senior managers disclose their private interests; verify disclosures; and eliminate any potential risks of conflict of interest. Pay suppliers within 30 days. Address deteriorating provincial audit results. Deal with cases reported on Anti-Corruption Hotline (currently national departments have finalised only 70% of cases and provincial departments 78%).

Institutional performance of national and provincial government
In June 2011, Cabinet approved annual assessments of management performance of national and provincial departments using the Management Performance Assessment Tool (MPAT). It focused on quality of management practices in departments and aimed to provide a holistic picture of state of management by drawing on existing secondary data.Assessments were based on 31 management standards in 17 management areas and standards were based on legislation and regulations. Standards were developed collaboratively with National Treasury, DPSA, Office of the Public Service Commission, Office of the Auditor General and Offices of the Premier. Assessments were a joint initiative with Offices of the Premier – the department facilitated assessment of national departments; Office of the Premier facilitated assessment of provincial departments. The presentation highlighted illustratively, the assessment procedure, management performance areas, assessment descriptors and sample results from the assessment (see document).

Conclusions drawn from the MPAT assessment were as follows: The June 2012 results of 2011/12 self-assessments for 103 national and provincial departments (65% of 158 departments) was presented to Cabinet
. Departments were expected to implement improvement plans. All departments were to participate in 2012/13 and look for improvements against 2011/12 results. Futuristically, there would be increased focus on moderated scores, linking results of MPAT to assessments of HoDs and stronger role for Presidency and Office of Premiers in HoD assessments. The department was finalising case studies of good practice (level 4) for dissemination. The full report and results for national departments were available on the DPME website.

The DPME developed a programme of unannounced monitoring visits to frontline service delivery sites – to demonstrate the value of on-site monitoring and to demonstrate to departments how daily collection of information at site level can be used to institute corrective actions to improve service delivery. The Frontline Service Delivery Monitoring (FSDM) programme was a joint Department of Performance Monitoring and Evaluation-Presidency and Offices of the Premier programme. Unannounced site visits were conducted to monitor quality of service delivery at selected service sites and information collected was used to work with sector departments to catalyse improvements. Interviews were conducted with citizens and staff and the findings produced in the form of a score card for each facility monitored. Findings were presented to relevant sector departments and Cabinet at least once a year. The department worked with the relevant departments to ensure that corrective actions were taken where the results were found to be poor. The department further developed case studies of good practice e.g. Home Affairs. Monitoring indicators examined included: Location & accessibility, Opening and closing times, Visibility & signage, Queue management & waiting times, Dignified treatment, Cleanliness and comfort, Safety, Complaints & compliments management. A graphical illustration of Home Affair’s score card based on these indicators was reviewed (see document).

In conclusion, the
Mid-Term Review showed that implementation of policies was still a key challenge. Many of the implementation challenges related to weaknesses with generic management functions (e.g. financial management, supply chain management and procurement, human resource management, planning, monitoring, facilities management) which in turn led to poor service delivery.National departments responsible for concurrent functions needed to: Put in place more comprehensive appropriate minimum norms and standards for the quality of provincial or local delivery of services; Monitor these regularly, and provide support or take corrective action in terms of relevant constitutional and legislative provisions where necessary; the Monitoring, Support and Intervention Bill needed to be finalised urgently.

Mr N Du Toit (DA) remarked that the department’s presentation had been both insightful and shocking and questioned on what basis targets were determined. He questioned what the average results were for those who had been tested for HIV and Tuberculosis. He asked if the controversial youth wage subsidy was one of the decisions that had been earmarked for urgent implementation under recommendations of focus for the remainder of term as it related to job creation.

Mr Phillips replied that there had not been sufficient progress on youth unemployment against the commitments that had been made and decisions needed to be made on programmes which had more impact on youth unemployment. It was not a call either way to what these decisions should be, but more a call to focus on putting effective youth employment programmes in place for the remainder of the term.

Mr Du Toit remarked that the challenges faced in addressing rural development could not be tackled solely by the Department of Agriculture. There was need for a more concerted effort.

He remarked that the statistical/graphical illustrations in the presentation depicting average figures did not reflect the real situation. One needed to resort to the density distribution mechanism found in the bell curve for better illustration.

Mr Phillips agreed with this observation and committed to addressing this in future presentations.

Mr Du Toit remarked on filling positions at the municipalities with the right capacity, that the real challenge lay in training municipal officers and one needed to reflect this against the background of the public service.

Mr Du Toit said there was a need to resolve the issue of a single public service. Would central control and deployment solve the problem of skill shortage? Perhaps the answer was in the employment of more hands by management and oversight by locally elected politicians and audit committees and that these politicians took responsibility and be held accountable.
Mr Du Toit decried the statistics on the number of departments that had not carried out the self-assessment function, particularly departments located in provinces where the requisite skill was available. This was an issue that needed to be addressed urgently.

Mr Du Toit noted with dismay that the statistics on Home Affairs showed it had the highest percentage of complaints about undignified treatment of applicants and a complaint management system. There was obviously an attitudinal and management problem and this signalled a shortcoming on the systematic approach to management.

Mr Du Toit asked what the target was for turnaround times at the various service delivery departments.

Mr Du Toit noted that there was a problem with the supervision of management and an evident disconnect between the Minister and managerial positions. This was an issue that needed to be addressed both by the department and by Parliament through legislative interventions.

Mr C Msimang (IFP) remarked that the department’s presentation was well received and showed marked improvements on the part of the government.

Mr Msimang asked whether there was an oversight committee to which the department reported.

Mr Phillips responded that reports were presented to Cabinet, the Forum of South African Management Committee, the Provincial Executive Council and the Forum of South African Directors General.

Mr Msimang asked how issues raised in the DPME’s report were addressed with other departments. How could the Committee support the department?

Mr Phillips replied that the department consulted widely with other departments and brought issues to their notice that had to be addressed. The mid-term review was a result of intensive collaboration with other departments. The DPME had been engaged with the Appropriations Committee, to whom it reported, with a common interest to see overall improvement in the performance of the government. The department provided this committee with information and the committee in turn took up issues with departments on oversight and monitoring visits. It was important that this collaboration still respected the independence of the Parliament.

Ms J Maluleke (ANC) noted that although there seemed to be improvement in the educational sector, the real challenge particularly in the rural areas related to the poor quality of teaching. Most of the teachers in the rural areas had only Matric qualifications.

Ms Maluleke remarked that although the no fee schools were a welcome idea, the distribution of funds to schools at the right timing needed to be addressed.

Ms Maluleke noted with discontent that it was unfair that the government discouraged youths who tried to create job opportunities for themselves, with oppressive regulations. It was more ideal to integrate these youths into the system.

Ms Maluleke questioned how the department ensured the provincial governments carried out their duties.

Ms M Mohale (ANC) asked whether the plans to train teachers included training for teachers who taught at special schools and for teachers that had physical challenges.

Ms Mohale asked what was being done by the Department of Health to close the gap on the shortage of healthcare professionals.

Ms Nolwazi Gasa, DPME Deputy Director General:
Outcomes Monitoring and Evaluation, replied that for the first time in August 2011, the Department of Health put forward a human resource strategy that clearly mapped out its strategy on acquiring healthcare professionals. Firstly, in the short term, the strategy translated to targeted agreements with Departmental heads and educational institutions on training of healthcare professionals. In this regard, an agreement had been entered into with Wits University for the specific training of medical doctors. Other universities had been targeted. Secondly, the Department of Health planned to enter into bilateral agreements for the training of medical personnel. In this regard, it had entered an agreement with Cuba to train in excess of 1 000 doctors yearly. Thirdly, the Department of Health planned to reengineer the primary health care system and shift focus from hospital based care to preventive health care. Outreach teams had been formed at school level to target issues such as oral healthcare, sex education and vaccinations. There had been deployment of healthcare teams at ward levels in municipalities and district based clinical approach – targeting districts with high infant and maternal mortality rates had commenced.

Ms Mohale remarked that beyond restitution of farm lands, there was an urgent need to train rural farmers on management of farmlands to ensure sustainability.

Ms Mohale asked whether there was sufficient capacity at the municipal level for the municipalities accredited to provide housing functions.

Mr Phillips responded that the municipalities had undergone a verification process to ensure they had the requisite capacity before they were accredited. This was why the process was slow and incremental.

Ms Mohale asked which official verified the disclosure forms which Managers were required to submit.

Mr Kenny Govender, DPSA Deputy Director General:
Human Resources Management and Development, replied that disclosure forms were lodged with the Public Service Commission, which in turn analysed the information provided and linked with relevant authorities such as the Police, to verify the information provided. The Department planned to introduce upfront disclosures before appointment of Managers. Extensive work was underway with regard to developing an integrity management framework, the appointment of ethic managers etc. There were plans to migrate to a E-filing system for disclosures.

Ms Mohale questioned whether the unannounced visits carried out by department officials were indeed an efficient tool in painting the true picture and if surveys carried out in the process were confidential.

Ms D Boshigo (ANC) suggested that the department ensure proper monitoring in municipalities where under qualified staff had been employed. Proper monitoring of cleanliness and drug availability in hospitals, particularly in rural areas, needed to be addressed.

The Chairperson remarked that from the department’s presentation, it was clear that learners were dropping out of school before the conclusion of Matric. What did these learners do and which institutions engaged them? What did this translate to in economic terms?

The Chairperson remarked that most learners despaired at the lack of jobs upon conclusion of their studies. It was time the country as a whole addressed its Human Resource policies and a link be created with the public sector.

The Chairperson questioned the type of development the health sector needed to consider to address its organisational restructure challenges: increased managerial capacity or increased ‘on the ground’ implementers.

The Chairperson remarked that usage of public health system needed to be on a majority basis to help identify and address loopholes in the system. There was a need for politicians to boost confidence in the public health system by using public hospitals.

The Chairperson noted that the challenges highlighted with regard to local government in the department’s presentation was akin to the issues that had been raised at a joint committee meeting with the Committee on Cooperative Governance and Traditional Affairs. A collaborative effort between Parliamentary Committees was necessary to help address these issues.

The Chairperson questioned the idea of a single public service and how this was to be integrated.

The Chairperson referred to rural development, saying the decline in job creation and problems with district municipalities were worrisome. It was increasingly difficult for the rural environment to attract skilled personnel.

The Chairperson noted that although the department’s presentation had been very thorough and detailed, it had excluded an examination of South Africa’s position in relation to the Millennium Development Goals and African Peer Review Mechanism.

In her closing remarks, the Chairperson stated that there was a need for collaborative efforts between the Committee and the Standing Committee on Appropriation to decide on coordinating findings based on reports and ensure monitoring of issues raised during oversight visits. There had been the process of the
Budgetary Review and Recommendation Report (BBBR) which required recommendations on budgetary review from all committees of Parliament. The Committee would seek to use this to signify areas of weaknesses that had been noted in this regard.

The meeting was adjourned.