The Committee considered and adopted the Electoral Amendment Bill [B22B-2013]. The DA rejected clause 7 (4) of the Bill.
The Department of Health presented highlights of its Annual Report for 2012/13 and reflected on strategies to address the constraints. Only two provinces, North West and Western Province, had received unqualified audits. Interns, who were unemployed financial, information communication technology (ICT) and human resources graduates had been appointed to address some of the shortcomings revealed in the audits. Additionally, 945 ward-based public healthcare outreach teams were constituted, each consisting of community health and environmental health officers; 34 district clinical specialist teams (with a minimum of 3 members) were appointed; and Health Facility Improvement Teams were established at district and national level to assist provinces.
Norms and Standards had been developed in Information Technology, Human Resources and Infrastructure and the National Health Act was amended and proclaimed in order to establish an independent Office of Health Standards Compliance. Furthermore, the National eHealth Strategy had been approved by the National Health Council and was published during July 2012.
A Draft White Paper on National Health Insurance (NHI) was prepared and in line with cabinet guidelines and NHI management structures at the Deputy Director General (DDG) level had been established in Mpumalanga, Limpopo, KwaZulu Natal, North West, Northern Cape.
Prevention was the mainstay of the Department’s efforts to combat HIV and AIDS. A total of 612 118 new patients were put on Antiretroviral Treatment, and 360 168 HIV positive patients received Isoniazid Preventive Therapy. 85.3% of tuberculosis (TB) patients were tested for HIV and 74.1% of eligible TB/HIV co-infected patients received Cotrimaxozole Prophylaxis Therapy to prevent opportunistic infections.
A total of 945 ward-based primary health care (PHC) outreach teams were established and a total of 34 districts had District Clinical Specialist Teams. While there had been some backlogs with regard to registration of medicines by the Medicines Control Council, there had been noticeable improvements.
The Department presented the budget and expenditure per economical classification, the audit outcomes and conditional grant expenditure per province. The Department had spent 99.4% of its entire budget, with a small variance of R158 million. In terms of economic classification, the DoH had spent 99% on compensation; 85% on goods & services and most funds had been transferred out of provinces.
The Department received an unqualified audit and all audit findings had been addressed in terms of performance information and financial regularity. Key interventions to strengthening internal controls for performance information were: implementation of an electronic tool of the District Health Information System across provinces to all facilities over a three year period; Uniform Facility Level implementation of the District Health Information Management System Policy; and revision of the National Indicator Data Set 2013/14 to 2014/15. In most cases the Department was reporting on deliverables at provincial level which put the Department at some degree of risk in terms of performance indicators.
Most of the Department’s expenditure was conditional grant expenditure. By the end of the year, 97.2% of conditional grants were spent by all provinces. There was a slight overspend on the Health Infrastructure Grant. The NHI conditional grant had been approved late in the previous financial year, resulting in only 52% of it being spent. However, at the end of the second quarter in the current financial year, 61% of the entire budget had already been spent.
The Minister added that Limpopo’s disclaimer was based on R500 million worth of invoices not being submitted to the Auditor General. However, this was due to the audit being completed before the outcome of a court case which had directly caused the delay in submission of the invoices. There was no unauthorised expenditure in Limpopo. The Minister asked the Members to support the HIV Counselling and Testing Campaign and to be aware that the improvement in health infrastructure was owed to the hiring of engineers.
Members asked if parkhomes would be rolled out to all areas that required additional consulting rooms; in which provinces the additional 30 mobiles would be operational; why supervision of PHC facilities was lacking; and why there were so few ward-based PHC outreach teams in the Northern Cape and Mpumalanga.
Members also asked how the Department would ensure sustainability of Limpopo’s improvement in its audit; why, out of 52 District Health Plans, the Western Cape health plan was the only one that did not receive feedback; how the Department was addressing the shortage in human resources while the population escalated in rural areas; and how the Department assisted religious institutions which had good infrastructure but had shortages in medicines and funding.
Members then asked what happened to the 9896 community health workers after they had completed their phase 1 training and whether this training was accredited; what was being done to encourage students to study engineering and to employ them; how the Department ensured that specialists were retained and attracted to the NHI contract; and what the Competition Commission’s view was on the private sector pricing.
Members further asked what the Department strategy was with the Department of Basic Education with regard to prevention of HIV and interventions at schools; why there was a reduction in the Programme 4 budget from R760 million to R113 million; and why there was under-spending on TB.
[PMG missed the first part of the meeting. Our report starts with the discussion on the Electoral Amendment Bill].
Finalisation of the Electoral Amendment Bill [B22B-2013]
The Select Committee on Social Services considered and finalised deliberations on the Electoral Amendment Bill, [B22B-2013] s75. Members from the Electoral Commission of South Africa were present as well as the Director of Drafting and the Senior Legal Administration Officers of the Department of Home Affairs. The State Law Advisor and Parliamentary Legal Advisors were also present.
Mr M De Villiers (DA, Western Cape) questioned how the Independent Electoral Commission would monitor South Africans who were, for example, registered to vote according to their residential address but were staying in Zimbabwe while someone rented their house in South Africa.
Mr W Faber (DA, Western Cape) suggested that it would be simple to send votes to one central place in Pretoria to allow an individual to vote for a party in the province that they were registered while living in another province at the time of voting.
Ms M Makgate (ANC, North West) commented that people with dual citizenship voted nationally by applying for a special vote.
Ms B Mncube (ANC, Gauteng) added that a South African who became a resident or citizen of Australia, but retained citizenship of SA, could vote nationally but not provincially.
Mr T Makunyane (ANC, Free State) commented that even some people working in Parliament had dual citizenship. These people could vote nationally but it would be fraudulent for them to vote provincially.
Ms Fatima Chohan, Deputy Minister of Home Affairs, said that the 2009 court case regarding distinguishing reasons for being abroad such as sport, work, government service, etc influenced the ability to vote was declared unconstitutional. The current scheme envisaged was to treat all South Africans equally, irrespective of where they were. If they were outside the province on voting day, they forfeited their provincial vote - otherwise ballot papers criss-crossed the country. The same applied for South Africans abroad. They would be allowed to register and would be placed on the international segment of the voters roll. If they were already registered, they would not need to re-register. They would all forfeit their provincial vote and would only receive their national ballot. Their vote would not go to one place in the country but be couriered to the province where they came from. This is where the IEC talked about credibility and integrity of the election.
Some Members voiced their concern that the Parliamentary Legal Advisor had not advised the Committee on its opinion.
The Chairperson acknowledged the Members’ concerns.
Committee Report on the Electoral Amendment Bill [B22B-2013]
Members had deliberated clause by clause on the amendments and had agreed to adopt them, except for the two DA Members- Mr Faber and Mr De Villiers who were not in agreement with clause 7 (4) of the working amendments.
The Chairperson read the report of the Committee. “The Select Committee on Social Services, having considered the subject of the Electoral Amendment Bill [B22B-2013] – NA - s75, referred to it, reports that it has agreed to the Bill with proposed amendments”. Mr Faber and Mr De Villiers did not agree to the report.
Briefing by the Department of Health on its 2012/13 Annual Report
Ms Malebona Matsoso, Director-General, Department of Health (DoH), presented the highlights of the Annual Report for 2012/13 and reflected on strategies to address constraints experienced – which were also outlined in the DoH’s Annual Performance Plan for 2013/14. The Negotiated Service Delivery Agreement (NSDA) 2010 to 2014, informed the development, implementation and monitoring of the Annual Performance Plan (APP) for 2012/13.
Programme 1: Administration and Corporate Services
Interns, who were unemployed financial, ICT and human resources (HR) graduates, had been appointed to address some of the shortcomings relating to the audit, as only two provinces, North West and Western Province, had received unqualified audits. The interns had been instrumental in implementing a project to improve revenue management at Charlotte Maxeke Hospital in Gauteng. The objectives of the Project were to reduce Medicom backlog in the hospital due to system down time, and to improve data quality by correcting errors in patient contact details. The entire backlog of patient admissions dating back to April 2012 had been cleared. 400 patients were registered daily, and 400 patient files were checked daily to improve data accuracy.
The Road Accident Fund and Medical Scheme receipt allocations were earmarked for correction. Through the project, a total of R36.5 million receipts (R14 million - RAF and R21.5 million - Medical Schemes) were reconciled to their invoices. The billing backlog to April 2012 for support services had also been cleared. This model was currently being rolled out in Free State, Limpopo, Eastern Cape, Limpopo, Gauteng and Northern Cape.
Programme 2: NHI, Health Planning and Systems Enablement
Norms and Standards had been developed in four key areas: (1) Information Technology (IT) – the Council for Scientific and Industrial Research developed Normative Standards Framework which had subsequently been adopted by the National Health Council. (2) Human Resources – the Workload Indicators for Staffing Need (WISN) model of WHO has been adopted and rolled out at Primary Health Care (PHC) facilities in health districts. (3) Quality – The National Health Act was amended and proclaimed in order to establish an independent Office of Health Standards Compliance (OHSC). This office had been established to improve quality of care. (4) Infrastructure – 80% of Norms and Standards for health infrastructure had been developed.
The National eHealth Strategy had been approved by the National Health Council and was published during July 2012 (strategic priority areas are listed in the attached document).
Innovation leading to the roll out of the NHI included Ministerial road-shows in each of the 10 NHI pilot districts involving a wide range of stakeholders; NHI management structures at DDG level had been established in Mpumalanga, Limpopo, KwaZulu Natal, North West, Northern Cape; 945 ward-based PHC outreach teams were constituted; each consisting of community health and environmental health officers; 34 district clinical specialist teams (with a minimum of 3 members) were appointed; a Draft White Paper on NHI was prepared and in line with cabinet guidelines; Health Facility Improvement Teams were established at district and national level to assist provinces. Approximately 1000 facilities were directly or indirectly supported through this initiative.
Over 84% of the population utilised the public health system and the Mindset public broadcast channel set up for the NHI districts covered health education and promotion on HIV and AIDS, TB, child health, chronic conditions and underlying factors such as gender violence in multiple languages.
Programme 3: HIV and AIDS, TB and Maternal, Child and Women’s Health
Prevention was the mainstay of the DoH’s efforts to combat HIV and AIDS. During 2012/13 a total of 422 262 medical male circumcisions were conducted, which was 70.4% of the 600 000 target set for 2012/13; and a total of 612 118 new patients were put on Antiretroviral Treatment, which exceeded the 2012/13 target of 500 000 patients. 85.3% of TB patients were tested for HIV. Though this was an improvement from the 82.9% achieved in 2011/12, 74.1% of eligible TB/HIV co-infected patients received Cotrimaxozole Prophylaxis Therapy (CTP) to prevent opportunistic infections. A total of 360 168 HIV positive patients received Isoniazid Preventive Therapy (IPT).
The DoH had exceeded the 2012/13 target of 35 % for couple protection rate - a performance of 37% was achieved. All public health facilities provided contraceptive services. 55.4% of women were screened for cervical cancer, which was 1.4% above the 2012/13 target of 54%. This improvement was linked to improved training of healthcare providers to take cervical swabs, but more needed to be done and the Minister would be announcing the additional interventions options to be introduced. 98.2% of pregnant women were tested for HIV, which was consistent with the 2012/13 target of 98%. 81.6% antenatal clients were initiated on highly active anti-retroviral therapy (HAART).
For child health, national immunisation coverage of 94% was achieved, which exceeded the 2012/13 target of 90%. A total of 10354 Quintile 1 and 2 schools were visited by school health teams to provide Integrated School Health Programme (ISHP). A total of 84 281 Grade 8 learners assessed using the ISHP learner assessment, compared to the target of 65 100 learners. The DoH worked together in a joint task team with the Department of Education (DBE) on the ISHP.
An EU supported project was purchase of 30 Mobiles and in the second phase, the DoH would be buying 30 more mobiles for delivery in January 2014. The vans were not appropriate for all provinces and therefore 4x4 vehicles had been purchased for the more rural mountainous areas.
Programme 4: Primary Health Care (PHC) Services
A total of 945 ward-based PHC outreach teams were established as part of the PHC re-engineering strategy, exceeding the target of 500. However, supervision of the teams had to be up-scaled. Training of 9896 Community Health Workers had been trained and Module 2 would begin in November 2013. This would include Phase 1 training on Health Promotion, Nutrition, Maternal and Child health, HIV, and TB was complete. Phase 2 training would be on non-communicable diseases, mental health, youth, older persons, substance abuse and violence. The Northern Cape had not performed well in establishing their outreach teams.
A total of 34 districts had at least 3 members of the District Clinical Specialist Teams appointed compared to the target of 10 districts. The family physician was the most available group and anaesthetists and paediatricians were the most difficult to attract.
Vitamin A supplementation coverage rate among children aged 12-59 months was 42.8%, which was marginally above the target of 42%, mostly due to the poor performance in the Northern Cape and North-West Province.
Other PHC targets achieved were development of norms and standards for Environmental Health Services; draft legislation on alcohol advertising was prepared and consultation processes were conducted; and regulations on salt content in processed food were promulgated.
Malaria continued to be a problem mostly due to cross-border movement.
Programme 5: Hospital, Tertiary Services and Workforce Development
The Nursing College and Schools Grant funded upgrade of 32 Health Infrastructure Programme projects and the infrastructure Project Maintenance Information System was reconfigured, maintained and implemented so that every project in every province could be tracked.
Programme 6: Health Regulation and Compliance Management
The public health entities had previously presented to the Portfolio Committee. They submitted biannual governance and management framework reports and quarterly compliance reports. There had been improvement in compliance.
While there had been some backlogs with regard to registration of medicines by the Medicines Control Council (MCC), there had been noticeable improvements.
The National Health Amendment Act for establishment of the Office of Health Standards Compliance had been proclaimed and the Board would be established soon. So far, 600 facilities had been inspected for compliance.
A HR plan for health oversight and control mechanisms in terms of recruitment processes and causes of staff turnover had been developed. The vacancy rate had been reduced in response to the prior year's audit findings. The new organisational structure had been implemented in April 2012 and a dedicated Performance Management and Development System (PMDS) had been implemented to ensure linkages between individual and organisational performance and to minimise the administrative burden of the process. So far it had worked well up to level 12, but implementation needed to improve.
Dr Ian Van Der Merwe, Chief Financial Officer (CFO), presented the budget and expenditure per economical classification and explained the material variances, the audit outcomes and the conditional grant expenditure. The DoH had spent 99.4% of its entire budget, with a small variance of R158 million. In terms of economic classification, DoH had spent 99% on compensation; 85% on goods & services and most funds had been transferred out of provinces.
In programme 1, 96% of the budget was spent, with some under-spending attributed to hardware for ICT solution which could not be ordered before financial year-end. Earmarked allocation for hospital tariffs could not be spent on the hospital tariffs project before year-end.
In programme 2, 97% of the budget was spent. Under-spending was attributed to earmarked funds for the hospital re-imbursement tool not being spent and to the travelling budget for the NHI & Health Financing sub-programme.
In programme 3, 99% of the budget was transferred. The transfer of R10 million to the South African National Aids Council (SANAC) was approved by National Treasury during the latter part of March 2013, leaving the Department with insufficient time to verify the banking details before transferring the funds. Outstanding invoices by Government Communication and Information System (GCIS) for the media campaign as well as outstanding condom invoices contributed to the under-spending.
In Programme 4, 93% of the budget was spent. There was under-spending on the goods and services budget of non-communicable diseases and the non-finalizing of the Round About Project.
In Programme 5, 100% of the budget was spent in terms of transfers.
In Programme 6, 93% of the budget was spent, with most of the under-spending due to the delay in the Office of Standards of Compliance approval of the Bill and the Act.
The DoH received an unqualified audit and some issues were raised by the AG. Quarterly performance reports on conditional grants were not submitted within 45 days after the end of each quarter to the Treasury. This had been addressed and programme managers were working closely with provinces to ensure timely submission of reports to Treasury. Business plans for utilisation of the HIV and AIDS grant allocation made to all provincial departments of health were not approved prior to the start of the financial year and this had also been addressed. All business plans have been signed prior to the financial year starting and in terms of the framework.
There was also an issue of employees of the Department performing remunerative work outside their employment without written permission. Action had been taken against employees by HR and Treasury would be assisting Departments to make available all the databases necessary to properly control this situation. Annual leave taken by employees were not recorded in a timely manner thereby ensuring that all leave is accounted for accurately and in full. All leave was now captured in line with prescripts from Department of Public Service and Administration (DPSA).
All audit findings had been addressed in terms of performance information and financial regularity. Key interventions to strengthening internal controls for performance information were: implementation of an electronic tool of the District Health Information System across provinces to all facilities over a three year period; Uniform Facility Level implementation of the District Health Information Management System Policy; Revision of the National Indicator Data Set 2013/14 to 2014/15 was completed and the final revised set was approved. In most cases the DoH was reporting on deliverables at provincial level which put the DoH at some degree of risk in terms of performance indicators. There was a meeting of the National Health Information Systems Committee of South Africa to formally address the finding of the 2012/13 audit of performance information by the AG. While much progress had been made to address performance indicators, more progress was needed.
Most of DoH’s expenditure was conditional grant expenditure. By the end of the year, 97.2% of conditional grants were spent by all provinces. There was a slight overspend on the Health Infrastructure Grant.
The NHI conditional grant had been approved late in the previous financial year, resulting in only 52% of the budget being spent. At the end of the second quarter in the current financial year, 61% of the entire budget had already been spent.
Provincial teams from the provinces with unqualified audits were reassigned to support provinces experiencing challenges.
Dr Aaron Matsoaledi, Minister of Health, DoH said that he had only three points to add. As the DG had mentioned, there were two provinces which had received disclaimers - Northern Cape and Limpopo. However Limpopo had made progress which was not reflective of its financial situation. The disclaimer was based on R500 million worth of invoices not been submitted to the AG. However, this was due to the audit being completed before the outcome of a court case which forced a company to hand over documents to the DoH. There was no unauthorised expenditure in Limpopo.
The Minister asked the Members to support the HIV Counselling and Testing Campaign and to be aware that the improvement in health infrastructure was owed to hiring of engineers.
The Chairperson asked the DoH how it would ensure sustainability of Limpopo’s improvement in its audit.
Ms Matsoso replied that the unemployed graduates started as interns and were deployed to provinces for training on two year contracts. The intent was for the provinces to absorb them. Some provinces such as Mpumalanga and KwaZulu Natal (KZN) refused to pay the higher salaries. However, a certain level of performance was expected from those trained on the job and the DoH was persisting with this strategy in the Northern Cape and Limpopo.
Ms Mncube commented that there were clinics which benefited from increased space for consulting rooms through the parkhomes. She asked if they would be rolled out to all areas that required additional consulting rooms.
Ms Matsoso replied that with the assistance of the DPSA, a total of 200 parkhomes would be installed around the country where clinics had insufficient consulting rooms and also where there was additional land available.
Ms Mncube asked what was being done to encourage students to study engineering and to employ them.
Ms Matsoso replied that the DoH had started a programme with FET colleges whereby DPSA was assigning 1000 engineers to the different facilities to fix the basic problems. The DoH also had a MOU with technology colleges and an agreement with the Japanese Development Agency whereby 45 South African engineers were trained in clinical engineering in KZN.
Mr De Villiers asked in which provinces the additional 30 mobiles would be operational.
Ms Matsoso replied that all provinces would receive mobiles.
Mr De Villiers asked why supervision of PHC facilities was affected by a lack of dedicated supervisors caused by shortages of staff.
Ms Matsoso replied that the DoH worked with Health Systems Charts. The competency assessment had identified specific areas where training was required for people managing clinics and those managing at district level. Competency of provincial managers and the issue of delegation was also being addressed.
Ms JR Hunter, Deputy Director-General: Public Healthcare, DoH added that there were staff shortages and that the 80% target to address the problem was realistic. It was not only about numbers but about the managers being adequately skilled.
Mr De Villiers asked why, out of 52 District Health Plans, the Western Cape health plan was the only one that did not receive feedback.
Ms Matsoso replied that only one district, the City of Cape Town, out of 52 districts, refused to respond despite repeated requests. The other districts in the Western Cape did respond.
Mr De Villiers asked what happened to the 9896 community health workers (CHWs) after they had completed their Phase 1 training and whether this training was accredited.
Ms Hunter replied that prior to PHC re-engineering, there were already CHWs in the area but referred to by other titles. They were admitted into outreach teams after receiving skills training but sometimes they chose to find work elsewhere.
Mr De Villiers asked why there were so few ward-based PHC outreach teams in the Northern Cape and Mpumalanga compared to the Eastern Cape and if these provinces could not have more of outreach teams. The Northern Cape had only one team.
Ms Hunter replied that the Northern Cape had been slow on the uptake of teams. The report was up to the end of March 2013 but currently it had 75 teams.
Mr De Villiers asked why there appeared to be under-spending on PHC service payment for tangible or software assets, and computer and furniture equipment.
Mr Van Der Merwe replied that there was not much spent on computer and furniture equipment mainly because the DG was only appointed at the end of the year. It was relatively small compared to the allocated amount and the amount had been deferred. There was no expenditure on tangible or software assets as the classification for renewal of licences against the allocation had been changed and corrected in the financial statement, annual report and asset register.
Mr De Villiers asked why, when TB was a high priority, there was under-spending on it.
Mr Yogan Pillay, Deputy Director-General of Strategic Health Programmes, DoH replied that the money had been set aside for the national TB survey programme. A decision on the tender was made but an unsuccessful candidate then took the DoH to court. The money was thus rolled over for the same programme in the current financial year.
Ms M Boroto (ANC, Mpumalanga) said that on oversight, it was apparent that there was a backlog in infrastructure in the deep rural areas. While the structures had not changed the population grew each day. She asked how the DoH planned to accommodate the growing population. There was also a shortage in HR to accommodate the escalating population. She suggested rethinking the categorisation of the hospitals and to plan based on the area, population and threshold accessibility to a healthcare centre.
Ms Matsoso replied that the DoH talked to facility planning rather than delivery of infrastructure. DoH’s planning approach looked at the catchment population, utilisation of services and transport. This exercise had been completed and was the basis for what informed the infrastructure delivery planning for the next facility to be built. The health estate was about R300 billion and if not maintained, replacement costs were 20-30% of the cost of the estate. Investment in existing infrastructure was on repair, preventative maintenance and routine maintenance.
Access to specialists and facilities in Mpumalanga resulted in movement to Gauteng. The DoH had a list of provincial facility requirements for each province.
The Minister said that the DoH had to be systematic with infrastructure. The audit for infrastructure in the country had been completed and engineers would visit each NHI facility at the 11 pilot districts. Although there were 52 districts, the work of the DoH did not stop at the 11 pilot districts. It was just not as intense as in the pilot districts. The status of all the facilities would be assessed and a decision made on each facility. They would finish evaluating and costing of clinics in OR Tambo in December 2013 and then would continue to the other provinces the following year. Eight clinics in OR Tambo would be demolished and contractors were scheduled. At least 30 clinics in OR Tambo were short of space. This is where parkhomes became important. The original parkhomes were donated by the Industrial Development Corporation and they could accommodate up to 6 GP consulting rooms. The DoH was aware that without GPs the rest of the chain would collapse. The parkhomes offered complete service delivery. OR Tambo would be followed by Vhembe.
Ms Boroto commented that there was a backlog in registration of generic medicines which affected the service delivery at hospitals where there was already a shortage in medical professionals.
Ms Matsoso replied that the South African Regulatory Forum model was problematic as it was mostly composed of professors in academic institutions. There was no way to have them full time at the MCC. The FDA in the US had 10000 experts performing evaluations. The 150 full time staff at MCC were pharmacists inability to provide support to professors’ part-time evaluations caused the backlog. The DoH’s proposal was for well-established researched regulatory agencies to make available their reports on evaluated products marketed in South Africa. The four agencies were the Swissmedic in Switzerland, the Food and Drug Administration (FDA) in the US, the European Medicines Agency (EMA) in the EU, and the Medicines and Healthcare Regulatory Agency (MHRA) in the UK. This would need to be accommodated in law. The DoH planned to expose 26 Masters and PhD South African students to training by these four agencies.
Ms Boroto asked how the DoH ensured that specialists were retained and attracted to the NHI job.
Ms Matsoso replied that the DoH’s first approach was to work with the universities to see whether the specialists could be rotated and attracted. Secondly, there was the option to sign contracts with the private sector and the third option was to recruit specialists from Cuba. Anaesthetists were very rare.
Ms Boroto asked what the DoH strategy was with the Department of Basic Education (DBE) with regard to prevention of HIV and interventions at schools.
The Minister replied that an issue had been raised in one newspaper and caused confusion. The ISHP had nurses who screened learners confidentially one by one. When the learners themselves asked for condoms, the nurse dispensed them.
Dr Pillay added that the DoH had been engaged in discussions with the DBE and the school governing bodies to develop a Tool Kit and each governing body would decide how the kit would be used at their school - with respect to condoms and other contraceptives. The ISCP did teach about age-appropriate sexual reproduction health issues. For grade 4’s, it was called “Know Your Body” and for grade 8’s and above, teaching was more advanced. KZN had moved very fast with their ISHP, owing to the former MEC for education now being the premier driving that programme, particularly where students were sexually active. The DoH would use their example to fast-track access to commodities in the other provinces.
Ms Boroto asked why there was a reduction in the Programme 4 budget from R760 million to R113 million.
Ms Matsoso replied that there was consensus that there was under-spending on PHC. Programme 3 (maternal and child health) and programme 4 (PHC) both provided PHC and the budget was spread between the two programmes. Programme 3 services were decentralised and included the district health teams, ward-based teams and school health which all included PHC.
Ms Boroto asked how DoH assisted religious institutions which had good infrastructure but had shortages in medicines and shortage of funding.
Dr Anban Pillay, Deputy Director-General: Health Regulatory and Compliance Management, DoH replied that there was certainly opportunity for the facility to access state stock. Depending on where the facility was situated, the clinic would have a relationship with the provincial department. KZN had a model which won an award for access to chronic medicine. They decongested hospitals by taking medicines to the facilities and dispensed medications in an orderly and regular fashion.
Ms Matsoso added that the DoH would like to get the name of the particular facility so that it could ensure follow up.
Ms Boroto asked what the Competition Commission’s view was on the private sector pricing.
The Minister replied that the Commission was appointing commissioners and there would be a public enquiry wherein people would be subpoenaed. It would be like a Truth and Reconciliation Commission (TRC) process.
The Chairperson said that the Committee would be interested in more information on the KZN model.
The meeting was adjourned.
- PC SocDev: Consideration of Annual Report of South African Social Security Agency for 2012/2013 financial year
- PC SocDev: Consideration of Annual Report of South African Social Security Agency for 2012/2013 financial year
- SC Socials: Consideration and Finalization of the Electoral Amendment Bill, [B22B-2013] s75
- Committee Report on the Electoral Amendment Bill [B22B-2013]
- Ubuntu Centre Presentation
- IEC Presentation
- Red Haines submission
- South African Catholic Bishops Conference –Parliamentary Liaison Office submission
- Briefing Analysis of the Department of Health
- AfriForum Comments on the Electoral Amendment Bill
- Telkom SA submission
- Audit outcome of the Department of Health
- Electoral Amendment Bill (22 Of 2013)
- Presentation Department of Health Annual Report
- Submissions [CGE] on Electoral Amendment Bill
- Apology on behalf of the Minister of Home Affairs
- Ubuntu Centre South Africa submission
- We don't have attendance info for this committee meeting
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