NHI Bill submissions: Update on procurement of external service provider to process comments; Provincial NHI Public Hearings Report

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04 November 2020
Chairperson: Dr S Dhlomo (ANC)
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Meeting Summary

Video: Portfolio Committee on Health (National Assembly) 04 Nov 2020

13 Oct 2020 National Health Insurance (NHI) public participation: way forward

In a virtual meeting, the Committee was briefed on how the procurement of an external service provider for the processing of the National Health Insurance (NHI) submissions was going. There had only been one quotation and it was suggested the Committee cannot move forward with this, as it is against procurement regulations to proceed with only one quotation.

This led Members to question whether the decision to employ an external service provider should be rescinded and that the Committee should rather use the internal capacity of Parliament instead.

A discussion ensued where the Committee decided on whether it should vote on rescinding the decision to outsource or not. The Chairperson finally asked the Committee to vote and it was decided that the procurement would not be re-advertised while the Project Management Unit examined whether it could handle it in-house instead.

The Committee further went on to discuss the report that the Chairperson had mistakenly sent out to Members before it was ready. The Committee decided that the Chairperson and his staff would edit the report further and that if Members had feedback, they would send it to the Secretary. A suggestion to hyperlink the raw data into the report was made, as some Members highlighted that they would like the transcripts to be made available to help them in ensuring there were no gaps in the report.

Meeting report

The Chairperson welcomed Members to the meeting and extended a special welcome back to Mr M Sokatsha (ANC) who had been ill. He then went on to wish Minister Mkhize well, who is recovering from COVID19.

The Chairperson pointed out how the meeting was meant to take place the previous week. After consultation with staff members, the Chairperson noticed things in the report that the Committee was meant to review in the meeting that he was not happy with, so requested extra time and postponed the meeting then. He noticed how there are considerable gaps in the report and that it should not have been released to the Committee as yet.

Update on the procurement of an external service provider for the processing of the National Health Insurance (NHI) submissions

The Chairperson brought it to the attention of the Committee that he had been briefed by Mr Dennis Bandi, Unit Manager: Committee Support Services, Parliament, in the previous week and decided that Mr Bandi should brief Committee with this information.

Mr Bandi took to the platform and began by reminding the Committee of the procurement process for an external service provider. On Friday 16 October, the Committee issued a request for a quotation for the processing of submissions through Parliament’s Supply Chain Management (SCM). He reminded Members that this was in line with the timeframe that the Committee had agreed to on 13 October. Mr Bandi’s team directly invited research institutions, namely, the Human Sciences Research Council (HRSC), Council for Scientific and Industrial Research (CSIR) and three universities: The University of the Witwatersrand (Wits), University of Cape Town (UCT), and the University of the Western Cape (UWC).

The closing date for service providers to apply was on Wednesday, 28 October 2020. By the due date, only one service provider had responded. Its application was comprehensive; however as there was only one response, Parliament’s SCM advised that the request for quotation be re-issued.

Mr Bandi noted that if the Committee agrees to follow through with the advice from Parliament’s SCM, his team will need to follow up with the institutions telephonically and ask them to concede in this regard.

The Chairperson asked Members to comment on Mr Bandi’s briefing. He confirmed that he had also heard in his Chair of Chairs meeting that these were the rules when only one quotation is received.


Dr P Dyanti (ANC) pointed out that it was not the Committee that wanted the outsourcing in the first place. It had decided to outsource because of the information that it was fed. Listening to Mr Bandi, Dr Dyanti proposed that the Committee do not go down the outsourcing route at all as Parliament has dealt with Bills before. She said that the Committee must ask Parliament to put human resources together and get the job done, like it would normally do with other Bills.

Dr K Jacobs (ANC) welcomed the partnerships between the pharmaceutical and health product companies that will manufacture the vaccine against Covid-19. He agreed with Dr Dyanti that a single response means the office cannot proceed. Dr Jacobs also asked that the Committee rescind the decision to decide outcomes of public hearings and find alternative means in consultation with the administration.

Ms S Gwarube (DA) suggested that the discussion around the rescinding of the decision to outsource needs to be a separate matter for discussion as it was a significant decision. Due to the advice received, the Committee decided to outsource although this was not its initial decision. Often it happens that entities are meant to be bidding and they do not. The Committee would be throwing the baby out with the bathwater because it did not get the results it wanted with the first attempt.

Ms Gwarube recommended that Parliament restart the process. The Committee would gain by working with an institution that can give substantive services to the processing of submissions. She said that she is worried that Parliament must find the resources. To leave the process to parliamentary services, who have already indicated that they are thinly spread, is not satisfactory. To rescind a decision taken months ago is a separate decision and she thinks it is worth doing the procurement process again. Whatever the rules are, they must be followed.

Ms A Gela (ANC) supported Dr Dyanti and proposed that the Committee rescind its previous decision and resolve to use internal capacity. She believes capacity exists beyond Parliament and proposed that the Project Management Office in Parliament may be able to assist. The Project Management Office has managed big projects in the past. It has graduates working for it and qualified staff, with over eight years experience. Outsourcing will be too costly in the current climate and the Committee cannot waste money especially when there is internal capacity. It is also difficult to hold private companies accountable. The Committee must rescind its previous decision to outsource and instead use internal capacity. Ms Gela confirmed that Parliament has dealt with complex Bills in the past.

The Chairperson asked that Mr Bandi respond to the Committee’s suggestions once Members have finished with their questions.

Mr T Munyai (ANC) pointed out that Members who are not full-term Members have raised their hands to participate and this is not supposed to happen.

Ms E Wilson (DA) noted that this is standard and Members who are not full term are always in meetings.

The Chairperson confirmed Ms Wilson’s point that Alternate Members do participate and can speak in meetings.

Ms Wilson asked the Committee to remember the reasons for outsourcing.  Firstly that parliamentary staff had made it clear that they were going to be under pressure and unable to do it. Secondly, the Committee asked for it to be done so that there would be 100% transparency, as the outsourcing institution would have no interest in the results of the hearing. This would ensure complete transparency, that it was legal and above board.

Ms Wilson said that she would not support the decision to rescind on these grounds. The Committee cannot make a decision based on a whim. This was discussed a long time ago and this has disturbed her. The Committee cannot afford a lack of transparency. It needs an unbiased and neutral facilitator for this process. Staff made it clear that they were not in a position to do this. If the Committee are happy for parliamentary staff to take a year to complete this process, then so be it, but she would not support that choice.

Ms N Chirwa (EFF) highlighted how happy she was that the Committee is having this conversation, as she had raised this issue in a previous meeting. It is vital that the state exercise its capacity in processing Bills and public responses. Outsourcing should not be a necessary thing. She confirmed that she would be very happy to rescind the Committee’s previous decision. But, just to clarify, what process is it now revoking? Public hearings, analysing the contributions or the online submissions? She would support all of this. Outsourcing is not something the Committee should be proud of. Capacity must be increased. State capacity needs to be able to process.

The Chairperson clarified that while the Committee were travelling country wide for the hearings, which will be discussed as a second item on the meeting’s agenda, there was correspondence coming into Cape Town which was presented to the Committee a few weeks ago. There was a lot that was hand delivered and a lot that was emailed. He confirmed that this was the part that the Committee was talking about and whether it should be outsourced.

Ms H Ismail (DA) urged the Committee to deal with this matter appropriately. The Committee cannot change its minds on a whim because things did not go as planned. It needs to ensure that this process is done transparently and ethically. All submissions need to be dealt with appropriately, so there is no issue of bias. Everyone has the right to make decisions, but now that there is a turnaround that could lead to legal issues. She said that she does not want legal issues coming back to the Portfolio Committee.

Mr M Sokatsha (ANC) supported Dr Dyanti, Dr Jacobs and Ms Chirwa in the decision to rescind. His choice was based on two issues. The Committee only had one service provider and secondly, because time is against the Committee to go back, re-advertise and consult with universities. He said it would be better to make use of Parliament’s internal capacity.

Mr Munyai noted how this is not the first Bill that Parliament’s internal capacity has dealt with. He supports the decision to rescind emphasising that decisions are not static, not permanent and when there are prevailing conditions, the Committee must be able to review a decision. He agreed with the content as put forward by Ms Gela concerning Parliament’s Project Management Unit. It would be incorrect to say that previous decisions cannot be reviewed. He agreed with Ms Chirwa that the Committee must build internal capacity. It must augment its own internal staff. It is a solid proposition that the Committee does not outsource, otherwise it is costly and cannot hold accountable those outside of Parliament.

Turning his attention to Mr Bandi, Mr Munyai asked him to share the name of the organisation that applied for the outsourcing, for completeness of the record.

The Chairperson asked Mr Bandi to talk about these institutions that the Committee had not been made aware of.


Mr Bandi said that this was an exercise to test the waters and his team has not engaged with institutions as yet. It is a territory they are not familiar with so they want to check whether they can beef up what they have already received.

Regarding the Project Management Unit, the project office assisted them during public hearings. It might be worth considering requesting their assistance. He noted that the head of this office is present in the meeting. It will be a less busy period in December and January so it might be worth working with them.

Mr Bandi mentioned how he does not have the full name of the organisation that applied to the external provider procurement. All he knows is that part of the name is Thompson, but is not sure of the full name.

The Chairperson asked Mr Bandi to clarify what he meant when he said that the Project Office is present.

Mr Bandi clarified that he meant someone from the Project Office was present on the online platform in which the meeting was taking place. He asked if the Committee would like to hear from her and the Chairperson confirmed it would.

Ms Nomkhosi Dube, Head of Enterprise: Project Management Office, Parliament, stated that she was invited to the meeting just before it commenced. She confirmed that she believed the Project Management Office would be able to assist in this matter. However, she requested that the Chairperson and Members give her an opportunity to engage with Mr Bandi to go over the details. It does not have to be the entire Committee, it could just be the Chairperson. She will then provide a report and a plan going forward.

Ms Dube confirmed that she is confident that her team are very comfortable with this kind of work. They have been working on critical projects for eight to 15 years, including the State of the Nation Address (SONA). She is confident that her team could handle this during the quiet period at the end of November into December, but she also says this with caution because she needs to engage with Mr Bandi first.

Mr P Van Staden (FF+) was concerned that the Committee is rescinding a decision without all the facts. The Committee needs to get all of the facts first, so that it knows what it is getting into. He said in a previous meeting that this is a very serious matter. As a Committee, it must do its job and do it carefully. It will face serious consequences from various stakeholders which will not be in favour of what it is doing if it is not careful. Mr Van Staden therefore pleaded with the Committee to not rescind on that very day, but to get the facts first.

The Chairperson highlighted how the suggestion to outsource had been brought in by Mr Bandi because the Committee had not explored what was available in Parliament. The information coming from Ms Dube is new.  He further went on to say that one of the reasons for outsourcing had not been due to credibility issues. The integrity of Parliament was never in question. It was not that the Committee did not trust them and the Committee did not want to leave that impression.

Ms Gwarube pointed out that none of the Members raising concerns about rescinding, doubted the ability of Parliament to do its job. She does not doubt parliamentary staff and it would be improper to insinuate they are not trustworthy. She heard Ms Dube and credibility is not in question.

She further went on to express how this new information comes as a shock. The Committee was told there was no capacity. Then one of the Members within the Committee did not know that Parliament suddenly had capacity. Ms Gwarube said that she would assume that no Committee Members are interacting with parliamentary staff outside of the meeting. So, the decision was made to rescind, which is a big step. She asked that the Committee forgive Members for wanting to explore why it made the decision to outsource in the first place. She reiterated that this was a big decision and it is a decision that must be taken by the Committee. The Committee is being blindsided and needs time to process what this means. Agreeing with Mr Van Staden, she said that if the Committee wants to rescind the outsourcing decision, it must be rescinded with unanimous agreement. The Committee needs information on the scope of work this would entail, more information on the unit Ms Gela mentioned and the timelines. She said that she does not want the Committee to be hoodwinked.

Mr Munyai pointed out how this decision cannot be postponed. The private sector is unknown, whereas the Committee knows that Parliament has credible capacity to do this work. He affirmed that he thought the Committee should rescind as it is not managed by external stakeholders. Regarding the legal issues raised by other Members which were of concern, he does not feel that the Committee should feel threatened when it is making a democratic decision. With the current information available, it is important not to waste time. He said that he stands by the view that the Committee does not outsource so that there will be no risk of integrity. The only risk would be the outside, because they do not account to the Committee. His question was why waste money, knowing how the economy has been devastated by Covid. There have been unprecedented consequences, therefore, the Committee cannot waste money and should use internal capacity instead.

Ms Ismail wanted to put on the record that her colleagues are not questioning parliamentary staff, as they appreciate all the work. The Committee is making a decision without the facts and does not know how long it will take. The Committee cannot be expected to make a decision without all the facts. It needs to make logical decisions.

She pointed out that the Chairperson himself had said that the request for the quotation needed to be re-issued. If that is the normal procedure of Parliament, then why is the Committee not doing this first? She thought the Committee should do this first, with timeframes in place. It needs a plan and the facts on who is doing what. The Committee must make logical decisions. She said that she is prepared to listen and to discuss everything, but in order to make a decision, they must have the facts.

Ms Gela also supported Mr Munyai and she appreciated Ms Dube’s points. In her view, she does not believe the Committee should outsource because there is internal capacity. It will be good to look into this and if there is capacity, the Committee should take advantage of this.

The Chairperson noted that there is nothing legally binding that states that the Committee must re-advertise especially because of the chronology of events in which the decision to outsource was based on capacity concerns and now, at the current moment, the capacity problem is being questioned. Even if the Committee agrees that it does not ask Mr Bandi to re-advertise because he has to have a discussion with Ms Dube first, that is a good enough reason to rescind. Give the benefit of the doubt to those Members who are doubtful until they get a report from Ms Dube.

The Chairperson said that the Committee should not agree to a re-issuing of procurement for outsourcing while the Committee decides what it wants to do. Perhaps it was a blessing in disguise that there was only one application, so it can now have these discussions.

The Chairperson confirmed that he will not stop having bilateral meetings with the Chair of Chairs. He also noted that the Committee is not technically rescinding the decision to outsource, it is just practically not moving forward with outsourcing right now and so will delay re-advertising.

Ms Gela agreed with the Chairperson.

Ms Gwarube accepted that the Committee will be leaving the decision like that, but she noted how the Committee would need to vote on the matter, so objections can be noted. This must be done formally. Each Member needs to be able to say afterwards what their role was in this decision and voting will create a record of where each Member stood.

Ms Chirwa said that she had one small grievance. It is an injustice to each other when Members do not listen to each other. This suggestion was raised before, during the public hearings and was rejected by the Committee without research. Now that the Committee has heard from Ms Dube and it is considered a viable option, even though the idea of internal capacity had been brought forward months ago and it was ignored. This could have been resolved when she initially raised it. Instead, the Committee had to wait for someone external to say it. She also agrees that the Committee should vote, so it knows who is against rescinding. She re-emphasised that she had recommended months ago that the Committee should not outsource.

The Chairperson noted Ms Chirwa’s point saying that he will not stop Members if they want to sort this out.

Dr Dyanti did not believe that there is a need for the Committee to wait for the next meeting if a proposal can be put forward. It could vote so it can continue with the work.

Mr Munyai agreed to vote on that day.

Ms Gela also agreed.

The Chairperson said that he would not stand in the way if that is what the Committee wants.

Ms Wilson expressed how it is not appropriate to change direction all over again like this.

The Chairperson responded by saying that he must listen to Members as they speak and respond to their wishes accordingly. Thereafter he asked Members to prepare to vote.

Ms Gwarube raised the suggestion that the Committee make this decision once Ms Dube has provided more information. The Project Management Unit may have organised SONA but that requires very different responsibilities. It is important to see what this unit can do, what resources they can free up, so the Committee can satisfy that this task is not given to people who are resource constrained. She asked that the Committee vote once it has this information. She said that she is struggling to understand what the Committee would be voting for as it cannot rescind without data. This is not political jostling so it needs a coherent strategy first.

Ms Wilson agreed with Ms Gwarube.

The Chairperson clarified that the Committee is not giving Mr Bandi further mandate to further advertise. On the point of whether the Committee is technically suspending, it is instead voting on whether Mr Bandi should re-advertise right now.

Dr Jacobs gave an analogy of how this situation was like the chicken or egg situation. There is a decision to be taken here that the process will be stopped. It is the same thing. The Committee is rescinding its decision on that day. Ms Dube and Mr Bandi will then bring a report to Members based on facts which some Members want to have before they make a decision. But the process has to be stopped first and it must be done through rescinding this decision. Pleading that the task be taken forward he said that if the Committee must vote, let it vote. The majority agrees that the process has to stop now. In order to stop the process, the Committee must rescind.

Mr Van Staden stood by what he had said before. He pleaded with the Chairperson to get the facts first and then vote because the Committee does not want to regrets its decision when it is busy with this Bill. It is a very serious matter and it must get all the facts first.

The Chairperson requested the Committee to vote on whether it would rescind the decision to outsource.

Mr Sokatsha, Dr Jacobs, Dr Dyanti, Mr Munyai, Ms Gela, Ms Chirwa, Ms M Hlengwa (IFP) and the Chairperson voted to rescind.

Ms Gwarube, Ms Wilson, and Mr Van Staden voted against rescinding.

The Secretary of the Committee pointed out that Ms Chirwa is no longer a full Member of the Committee and therefore cannot vote.

The Chairperson confirmed that he did not know this, but respected what the Secretary claimed.

Consideration of the Provincial NHI Public Hearings

The Chairperson moved to the second item on the agenda. He explained how he had taken the draft report of the NHI public hearings and forwarded it to the Committee before he had gone through it. He then called on the staff, which raised some issues with it and decided he should ask the Committee for their preliminary notes on the report before going back to the staff to work on it.

Dr Dyanti noted that it is a huge piece of work but, as the Chairperson mentioned, there are normally a few drafts first. Maybe the Chairperson should have considered going through the report first. She thought that the Committee was going to be given transcripts. She pleaded that the Committee still be given those transcripts.

She also noted that there are some areas that have been left out, such as gaps from what the Committee has heard from the public hearings. Not sure whether her expectation was too much from the report, she said that she at least expected that the executive summary would cover almost all the important things that the people were talking about in the hearings. Therefore she would like to see the transcripts to satisfy that everything has been covered.

Dr Jacobs noted that the Committee was at the hearings so it is keenly aware of what was raised. Having read the draft report, he said that he does not believe that it captures all the views of individuals and organisations who spoke. He reminded the Committee that the reason for using public participation processes is to provide interested parties with an opportunity to expand on written submissions. He also agreed with the suggestion that transcripts should be made available. As Members of Parliament, there is a need for true reflection of what was stated. He requested that the Committee be afforded more time to look at the draft report and after receiving those transcripts, then it would be able to come back again and provide its feedback.

Ms Gela raised the point that the report should be sent back as other Members have already noted gaps in the report. She agreed she needed time to check the report as it systematically missed out information from the people who supported the NHI in the first public hearing. Approximately 85% of the population support the NHI and the statements from the various individuals, unions, Non-Governmental Organisations (NGOs) etc, who supported the NHI implementation, were excluded from the report. There were some issues regarding the different treatment between public and private healthcare that also were not included. There were also some equity issues about medical aid schemes. Therefore, the report needs to correct this. The NHI is a healthcare financing system which will ensure that every member of the population will be able to access health. Ms Gela pointed out some other benefits that the NHI will provide.

Ms Wilson raised a point of order saying that all Members of the Committee know what the NHI is, and what it is aiming to do therefore it did not need Ms Gela to update it on this again.

The Chairperson said that he appreciated Ms Gela’s suggestions on where the gaps lie and how her feedback highlighted what he had mentioned, namely, that the report was not ready to be commented on by the Committee however Ms Gela’s feedback would be considered in due course.

Ms Gela responded to Ms Wilson’s point of order stating that she knew that Members understood the Bill, she was just raising gaps. The summary report is important and the staff was not prepared which left a gap. The Committee must revert the report to be corrected and re-submitted so it can close all the gaps. People have shown they support NHI.

The Chairperson requested that if Members would like to make similar comments to Ms Gela, namely, highlighting the gaps in the report, they should do so through other means and not through asking any more questions as he did not want to spend more time on these points in this meeting.

Ms Gwarube pointed out that those Members that attended the hearings knew there was a lot of information to capture. The Committee must accept that this is a consolidated report of all the hearings. She suggested that parliamentary staff create hyperlinks to the raw data, i.e. the transcripts, in the report so as to provide access for those who want to look over this data without clogging up the report as the report cannot be 5 000 pages long.

She further clarified that to include the raw data would not be a report, but just minutes. She said that the Committee has had the report for two weeks and she has had time to go through it. They all took notes at the meetings and she believes that the report is an accurate collation of the meetings. She agreed that many people did come out in support of the Bill, however there were those who did not support it in the public hearings and she believed this had been delineated in the report.

Ms Wilson supported Ms Gwarube’s points. It was a long process where thousands of people were seen. To transcript every word is a huge ask. The Committee must instead satisfy itself that the main points are in the draft. She confirmed that even she had made considerable notes at the hearings. To expect a transcript of every meeting would be putting staff under enormous pressure. However, she asked to see copies of all the forms that were distributed on the chairs before the hearings as she suspected that some of these were unconstitutional. She did not believe it was necessary to ask for transcripts, as Committee Members should just look at their own notes that they made during the hearings.

Mr Munyai asked that the Committee deal with the report and not deal with the internal affairs of the ANC. The current issue at hand is that there were many gaps in the report, which he expected to be covered. He did not expect this in the summary but in the report itself. He pointed out that looking at the summary, there is some bias. He did not agree with colleagues that it has been consolidated. Instead, he said that they must listen to the transcripts and watch the videos to prove the misrepresentation and mis-summarisation of the content. Transparency will therefore be clarified. The ANC came up with documents and these were not included. He agreed that there are gaps and that he did not want to engage with those yet.

He also pointed out that the Chairperson should have looked at the report himself. He should have cross-checked if it represented the outcome of the session before handing it over to the Committee.

The Chairperson accepted the feedback from Mr Munyai and responded by saying that only after he had forwarded it to the Committee did he realise he should have looked at it with the staff first. The Chairperson accepted this criticism. The fact that Ms Gela had already started to provide feedback is evidence that he should have done this differently. He will not dismiss the issue that the report should be better consolidated and the suggestion that hyperlinks be added. In future, he will work with staff members to refine this work with their inputs. On the positive side, Members already have a draft so it will be quicker for them to get around the next draft.

Dr Dyanti highlighted how she was born before technology and that the Committee is here to empower each other. She agreed that the Committee must assess its concerns and look at its notes. But also that it should look into the hyperlink idea. Even though she has notes, she still would like to look at the transcripts. She was not saying that the report should take everything, but there are areas that should have come up in the executive summary.

Mr Sokatsha noted that other Members had already covered his points. Indeed, there are many gaps but he wanted to thank the staff for their efforts. He said that he would like to send the report back for now so that the gaps are covered. He proposed that the Committee ask organisations to come to do oral presentations to the Committee.

Ms Gwarube suggested that even if the Committee amends the report itself, there should be a facility to look at the data. A hyperlink that leads to the raw collated data could assist Members who did not attend hearings. But in terms of the content of the report, she liked the way it was laid out. If Members believe there are gaps, which many do, the Committee must welcome that. The Committee could get Members to identify the gaps and send them in, so they will be incorporated in the report.

The Chairperson pointed out that Ms Gwarube had summarised what he was going to say. He directed the Committee to give constructive comments to the Secretary, so that those comments need not be debated during the meeting. He will then find time to sit with the Secretary to work on this. They will need some time. He thought this process would take about two weeks. While the staff are refining the report, there is also other work that would need to be done. They could start with the organisations.

Mr Munyai pointed out that they must be careful not to put hyperlinks in a report that goes directly to the public, as the Committee does not want the public to have access to the transcripts before the Committee have dealt with it. The other key issue is that the organisation that makes an input should also be listed and explain why it does or does not support the NHI.

The Chairperson reminded the Committee to not get into specific feedback on the report right now but the hyperlink suggestion from Mr Munyai is important. When to put the hyperlinks in must be carefully considered.

The meeting was adjourned.

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