Health Budgetary Review and Recommendations Report

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18 October 2017
Chairperson: Ms M Dunjwa (ANC)
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Meeting Summary

The Portfolio Committee on Health met to adopt its Draft Budgetary Review and Recommendations Report (BRRR) which covered the Department of Health and its entities. Members raised a number of grammatical amendments and changes to be effected to editing of the Report. There was discussion on sources of information in some areas of the Report, clarity on what some of the information related to and the importance of relating the BRRR to the Annual Reports of the Department of Health and its entities. Members felt it was important to categories the Report according to the Department, provinces and entities, sought clarity on certain points and stressed the importance of points reflecting the sentiments of the Committee and engagement had with the Department/entities. The Committee cautioned against practical consequences for some of the recommendations proposed and added timelines for the recommendations concerning the Office of the Health Standards Compliance.

The Committee adopted its Draft Budgetary Review and Recommendations Report, for the 2016/17 Financial Year on the Department of Health and its entities, with amendments. 

Meeting report

Consideration and Adoption of the Draft Budgetary Review and Recommendations Report of the Portfolio Committee on Health

The Chairperson, after accepting apologies tendered by absent Members, noted the Committee would consider the Report page by page and Members could then point out their observations and make amendments.

Mr A Mahlalela (ANC) outlined grammatical amendments to be made.

Ms C Ndaba (ANC) also highlighted grammatical amendments required.

Mr Mahlalela asked for the source of the information contained in one section of the Report as he could not find it in the Annual Report of the Department of Health. He asked if the Committee officials summarised the information in their own words of if the information was lifted from the Annual Report – clarity was required.

Ms Lindokuhle Ngamane, Committee Content Advisor, responded that the indicators were drawn from the Annual Performance Plan (APP) of the department and the Committee officials looked at what the Department planned to do and how far it went in achieving it.

Mr A Mahlalela said the BRRR was meant to report on performance and not what future plans were. He observed that the achievement was not indicated and the information provided was not related to the BRRR. He asked if the information was taken directly from a certain document.

Ms Ngamane said when the Committee officials were preparing the Report, they looked at and considered various documents, the Department’s strategies and APP. It was a combination of various documents. It was not the formulation of the Committee officials.

The Chairperson asked if Members were satisfied with the response from the Ms Ngamane.  

Mr Mahlalela was uncomfortable with the information because he was not able to relate the BRRR to the Annual Report. However if the information was extracted from any of the documents then it would be good. He only wanted to confirm that information contained in the BRRR came from document.  

Ms L James (DA) agreed with Mr A Mahlalela that it would be good to know the source of the information.

Mr Mahlalela said the abbreviation ‘NHLS’ should be added after ‘National Health Laboratory Services’ where it was mentioned for the first time so that it became correct to refer to the entity as NHLS in other parts of the Report. He noted the discussion on the sector incurring R6.4 million as irregular expenditure was followed by NHLS and this gave the impression that the amount of irregular expenditure reported was incurred by NHLS. Irregular expenditure in the sector comprised of irregular expenditure of the entities and the provinces which ran into billions of Rand. Therefore the statement cannot be correct. Secondly, the mention of NHLS made it seem as if it was the worst culprit for irregular expenditure in the sector. Contrary to that, three provinces, Kwazulu-Natal, Gauteng and Mpumalanga, had the highest irregular expenditure in the health sectors. NHLS was the highest culprit among the entities. The amount in the Auditor-General of SA’S (AGSA) report was also confusing. He requested clarification on the amount of irregular expenditure incurred by the Department. It would be better if the Report was divided between discussion on the Department, the provinces and then the entities to avoid a mix up.

Ms Vuyokazi Majalamba, Committee Secretary, said Committee officials would look into points noted by Mr Mahlalela and rectify it by categorizing the information as suggested.

The Chairperson raised a grammatical amendment required.

Mr W Maphanga (ANC) also suggested a minor amendment.  

Mr Mahlalela observed that the AGSA used ‘information technology’ while the same term was referred to as Information Communication Technology or Information and Technology in some other documents. He suggested the Committee adopt one of the three phrases for the sake of consistency.

Ms Ngamane said the matter of ICT or IT would be corrected according to the AGSA’s document which used ‘Information Technology’.

Ms Ndaba suggested some sentences required reconstruction as it appeared as if they were disjointed.  

Dr P Maesela (ANC) assumed the sentences were in order.

The Chairperson agreed with Ms Ndaba that the sentences needed to be reconstructed but they must be constructed without losing their meaning. She asked the Committee staff to reconstruct the sentence while Members were still considering the Report.

Dr Maesela observed that the sentence ‘healthcare system with financing distributional and geographical inequities’ was incorrect

Ms Ndaba said the phrase was correct.

Mr Mahlalela found that one of the points in the Report gave the impression that the Western Cape, Eastern Cape, Free State, and Gauteng were all achieving unqualified result for the first time, which was not true. He recommended that it should be reconstructed such that the sentence reflected the true information intended.

Ms C Ndaba said sentence ‘The post of Interim Registrar of the Council for Traditional Practitioners Council has been filled’ should be reconstructed.

Dr Maesela added the word ‘interim’ should be removed from the sentence because there was no post called interim.

Mr A Mahlalela said the post referred to was called the interim Registrar of the Council for Traditional Practitioners.

The Chairperson said the word ‘post’ would be removed from the sentence.

Mr Mahlalela asked for clarity on a certain paragraph of information.

Ms Majalamba responded that there were 29 hospitals, one in the district, 14 regional and 14 tertiary.

Mr Mahlalela said explanation on the 29 hospitals was clear but he requested the Report state targets and achievement of the indicators mentioned.

Ms Majalamba said the information was contained in the Annual Report of the Department. What was missing was the target set for the indicator mentioned.

The Chairperson said the sentence should be reconstructed. She asked if the SA Medical Research Council (SAMRC) had submitted a written report on its recommendations as requested by the Committee.

Ms Ndaba was not sure how the Committee would deal with the SAMRC because if the Council did not submit its report it might be too late because the Committee was already ready to adopt its BRRR.

The Chairperson said the SAMRC had two weeks to submit its report - the Committee cannot wait for it because it had to submit its own BRRR.  

Mr Mahlalela said non-submission of the report by the SAMRC showed its understanding of the BRRR.  Issues raised during budgets of financial constraints should be addressed during the BRRR and the Committee would remind the entities when they come to present their APPs. All the entities had been told but none of them had submitted their reports.

Ms Majalamba said it would be better if the Committee informed the entities of the requirements of the BRRR and what they should report to the Committee.

The Chairperson would be surprised if entities of the Department were not versed on expectations of government on the BRRR. The Department must also assist with ensuring that entities understand the BRRR process.

Mr Mahlalela observed that the challenge of entities and the Department not citing challenges and recommendations was not limited to the health sector - he had picked this up in other Committee’s BRRRs. Departments and entities did not report on their financial challenges but only reported during the APP. The Committee was partly responsible because it did not relay responds of Treasury back to the entities and Department. The problem was not the problem of the Committee alone but a parliamentary one - the system had to be reworked.

The Chairperson said the matter would be considered because it was of great importance.

Mr Ndaba said the way targets and performance were reported was good and it would be preferred if a page earlier in the Report was constructed in the same manner.  

Turning to observations and recommendations, Mr Mahlalela noted a number of grammatical amendments. He said the recommendation that the Minister should investigate fruitless and wasteful expenditures at national and provincial departments and apply consequences was impractical for the Minister because he did not have direct control over the provinces and the major portion of irregular expenditure lied with the provinces. It might be that the Committee was making recommendations that cannot be implemented. He proposed that the Department engage National Treasury on the new funding model for the NHLS. 

The Committee agreed with the proposal.

Mr Mahlalela said the Committee was too generous on the recommendation concerning the Office of Health Standards Compliance (OHSC) – the office flouted the law and a timeline should be added in the recommendation.

The Chairperson asked Members to specify the timeframe which should be included to the recommendation regarding the Office so that the Committee would be able to follow up.

Mr Mahlalela, unsure of when the Report would be adopted and appear in the ATC, said it should not be more than a month after adoption. There was no need to get additional funding for the Compensation Commissioner for Occupational Diseases (CCOD) because it can source funds from the industry.

The Chairperson asked if Members accepted the proposal.

The Committee agreed

Ms Ngamane said the Committee officials would need more time to search for some of the references contained in the report.  

Ms Ndaba said the Committee officials would amend the matters requiring attention and where documents could be checked thoroughly.

Mr Mahlalela moved for adoption of the Draft Budgetary Review and Recommendations Report of the Portfolio Committee on Health with amendments.

Ms James seconded the motion.  

The Chairperson informed Members of a joint meeting with the Department of Basic Education on 31 October and 14 November.

The meeting was adjourned. 

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