WC Departments of Health and Wellness & Social Development on oversight visit commitments; NDoH 2023/24 Annual Report and Audit Outcomes (with Deputy Minister); Older Persons A/B: Final Mandates

NCOP Social Services

04 December 2024
Chairperson: Ms D Fienies (ANC, Northern Cape)
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Meeting Summary

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The Select Committee on Social Services convened virtually for briefings by the Western Cape Departments of Health and Wellness (DHW) and Social Development (DSD) following commitments made on an oversight visit to the Western Cape Province. Additionally, the Committee was briefed by the Auditor-General of South Africa (AGSA) on the audit outcomes of the National Department of Health (NDoH) for the 2023/24 financial year and by the NDoH on the 2023/24 Annual Report. 

There was broad agreement amongst participants that the shortage of social workers in the healthcare system was not receiving the required attention. The impact thereof was that older persons who had been subjected to abuse have not been receiving the necessary psychological and social support. Furthermore, the number of programmes to support the well-being of older persons was negatively impacted due to budget cuts of almost R70 million. It was suggested that the National Treasury was not considering social work as an essential frontline service. Hence, the limited resources are being allocated for this important function. Conversations for a bigger share of the budget to supplement the Department of Social Development work were ongoing. The Committee was implored to support the pleas for more funding from the national fiscus to benefit all social workers nationwide.

The limited number of environmental healthcare practitioners in the system was another cause for concern, especially given the escalating number of deaths as a result of food poisoning. It was reported that food labelling regulations had not been completed. The NDoH acknowledged the need for more environmental healthcare practitioners to cover health hazards affecting the supply and distribution of food. The Committee was advised that the lack of resources presented a challenge in speeding up the food labelling process. The classification of the role of environmental healthcare workers within municipal health services is being considered. However, the review was put on hold due to the many challenges that municipalities are facing at present. Meanwhile, the Department is making provisions for the deployment of health inspectors to supplement the capacity of municipalities.

Per the 2019-2024 Medium-Term Strategic Framework (MTSF), 100% of the primary healthcare facilities nationwide must have attained or maintained Ideal Clinic status by 31 March 2024. The ideal clinic monitoring system revealed that the MTSF target was not achieved. Reasons for not meeting the target included the lack of prevention and detection control measures, poor stock control and supplies of medicines, limited equipment and medical supplies, limited human resources, and infrastructure and maintenance challenges. Additionally, the NDoH did not progress with the National Digital Health Strategy rollout. Provinces do not have a clear plan to roll out technologies to support and enable service delivery. The Committee was assured that interventions had been introduced to assist struggling provinces. The move towards digitisation was an ongoing process, and capacity building continued.

Finally, the Committee considered the Final Mandates and the Committee Report on the Older Persons Amendment Bill [B11B – 2022].
 
Having considered the Bill, which was referred to the Committee on 4 May 2024 and classified by the Joint Tagging Mechanism as a section 76 Bill, the Committee recommended that the Council pass it with proposed amendments.

Meeting report

The Chairperson welcomed the delegation from the National Department of Health, the Provincial Members of the Executive Council (MEC) and officials from the various departments. Because of the time constraints, she requested that participants be succinct in their presentations. 

Western Cape Department of Health and Wellness (WC DHW)
The MEC, Ms Mireille Wenger, remarked that the Department would present information following an oversight visit by the Committee to address matters relating to older persons in the Western Cape Province.  The Superintendent-General of the Department, Dr Cloete, would be setting the policy context for addressing matters related to older persons and how it is being incorporated into the provincial strategic plan as well as the five-year plan of the Department, which would be completed by the start of the new financial year in April 2025. The presentation will feature the broader global phenomenon of ageing societies and how the department has prepared to address the situation. Furthermore, information on the recommendations of the Committee will be provided. Love, care, and attention for the elderly are measures of humanity, which the Department would be sharing information on in the context of the Western Cape.

The HOD, Dr Keith Cloete, reported on the oversight visit conducted by the Committee on 24 and 25 October 2024 at the McCrone Clinic and Helderberg Hospital in the Western Cape. He highlighted several interventions by the Department to address matters affecting older persons, e.g., the DHW having regular meetings with the DSD, establishing alternative medication distribution to old age homes, and introducing outreach programmes by medical officers. He provided the following responses to the specific issues of concern that the Committee had identified on the oversight visit.

Address Human Resources for Health Challenges
A report on the Human Resource for Health (HRH) Challenges will be submitted to the Committee by April 2025. Indicators show that the 2025 MTEF budget allocation will not increase.

Strengthen intergovernmental relations
The Department will submit a report by June 2025. Various departments have convened in two sessions with civil society organisations and committed to multi-sectoral collaboration.

Use of integrated E-Systems
The DHW had developed a strong patient record system and planned to implement a patient portal system. A report on the integrated E-Systems will be submitted by April 2025.

Provide home-based healthcare
The DHW has an established community healthcare system, which is part of community-oriented primary care (COPC) in partnership with NPOs across the province.

Awareness campaigns
The DHW and DSD undertook to raise community awareness about programmes for older people as part of the new five-year provincial strategic plan.

(See Presentation)

Discussion
Mr M Feni (ANC, Eastern Cape) advised that he was tasked to take over as acting Chairperson because the Chairperson was experiencing connectivity problems. After establishing that Members had no questions, he proceeded to raise some of the issues he had encountered as part of the delegation on the oversight visit. At some facilities, the amount charged for accommodation was found to be in excess of the older persons' social grant income. As a result, they cannot pay the drivers to transport them. He suggested intervention was needed to overcome the accommodation challenge and assist the drivers in providing a service to older people. The issue of abuse was highlighted as a major concern. Older people who suffer abuse at home are often afraid to raise the matter with authorities for fear of further abuse.

Dr Cloete noted the concerns and said the DHW would raise issues of accommodation with the DSD, which is responsible for the accommodation of older persons. He advised that people needed to be made aware of the stigmatisation of elder abuse and educated on the protection of the rights of older persons. The matter would be dealt with collaboratively with the DSD.

Mr Feni thanked the MEC and her team for the presentation and the responses. He invited the DSD team to proceed with their presentation and reminded them of the time constraints.

Western Cape Department of Social Development (WC DSD)
The MEC, Mr Johan Londt, said MEC Wenger had indicated in her introduction the approach of working together as different departments of government. He called on the responsible Chief Director to proceed with the presentation. 

The Chief Director, Children, Families and Vulnerable Groups, Mr Charles Jordan, said the rollout of funded home-based care needed to be prioritised because old age homes were becoming extremely expensive and unaffordable to provide care for frail older persons in their homes. He agreed with Mr Feni that the placement of abused older persons needed to be strengthened. A number of social workers have been employed to deal with court cases when abuse takes place, and the SAPS are involved in the arrest of perpetrators. The psychological and social support is important when it becomes necessary to move the older person to an old-age home. It was found that 99% of perpetrators were family members. A dedicated assessment centre is needed for the placement of abused older persons. He provided the following responses to the issues of concern identified by the Committee on the oversight visit.

Status of service centres
The report on the status of the 144 service centres for older persons will be provided to the Committee by April 2025.

Strengthen intergovernmental relations
An updated report on strengthening intergovernmental relations will be provided to the Committee by June 2025.

Awareness campaigns
The DSD and the DHW raise community awareness about programmes for older persons. The Golden Games event is limited to certain areas in the province and is hosted with the support of the Department of Sport.

Support for outdoor activities
Budget cuts impacted support for active ageing programmes in the province. Financial contributions from members of the Older Persons Forum should be supplemented by external funding due to budget cuts.

Accommodation for service centres
The Western Cape Department of Infrastructure and Municipalities made rental space available, which some community service centres have started using. The MEC is leading the campaign to lobby for more funding from private donors for financial support for old-age homes and community-based centres that support older persons. 

The MEC, Mr Londt, stated that 40% of the DSD budget is being used to fund more than a thousand NGOs. Payments were made on time, as evident in the 13 consecutive clean audits. He thanked the officials for caring for the money and partnering with the NGOs. He found it problematic that National Treasury was not viewing social workers as essential frontline services. Given that all departments were under pressure, he pleaded with the Committee for support to secure more funds for social workers. It would benefit all provinces and social workers across the country. 

(See Presentation)

Discussion
Mr Feni noted that the DSD had responded to some of the issues raised during the oversight visit, specifically regarding the problems of social workers and the accommodation of older persons. He noted the request for funding support from the Committee and agreed that the Department needed support to ensure the required funds were available. He enquired about progress relating to the requirements for registration in terms of the Amendment Bill. Some of the delays were found to be a result of the registration process of residences because some people did not want to be registered not to be held legally accountable. He wanted to know how the R18 million budget cut was impacting the work of the Department.

MEC Londt replied that the Department does not fund any organisation that is not properly registered. The wage negotiations and the budget increase not matching the salary increase placed pressure on the NGO sector. The DSD had come out-of-the-box programmes to augment the budget in the pipeline, which the Department would happily share with the Committee in the new year after it had been launched.  With the limited resources, the Department is stretching the rand while still keeping a high standard of services. The Western Cape is the third most populist province, getting the fifth-highest budget share. Conversations were ongoing to get a bigger share of the budget to supplement the work of the Department. It would help if the Committee could strengthen the hand of the Department to support more social workers.

The HOD, Dr Robert Macdonald, said a significant demand for registration was noted, making it difficult to keep up with all the registration requirements. Old age homes which are not cooperating are closed down. Some of the new requirements of the Bill have financial implications. The province gave input stating that it did not have the capacity or resources to implement the Bill in its current form. Should the current Bill be implemented, National Treasury must fund the shortfall. The new requirements need more assessments to be done, which come with cost implications. The budget cuts of around R70 million on the older persons’ programmes would impact all the NGOs due to the dual effect of the budget cut and the above-inflation wage increases that were not fully funded by the National Treasury. This was squeezing out money from the NGOs. Some additional money was allocated during the Adjustment Budget for service centres that were disproportionately affected, such as the Older Persons and Disability Programmes. Concerns about these programmes were brought to the attention of Provincial Treasury. He hoped the trend could be reversed because many old-age homes had to close down due to insufficient funds. The Department is considering partnering with private donors to help where money runs out.

MEC Londt thanked the Committee and said he looked forward to future engagements.

Mr Feni invited the AGSA and reminded officials to deliver the presentation within the allocated 15 minutes as instructed by the Chairperson.

AGSA Audit Outcomes of the Health Sector
The Business Unit Leader for Health, AGSA, Ms Thabelo Musisinyani, replied that it would be difficult and requested in advance to be pardoned if the Chairperson’s request was not met. She drew attention to a briefing note on the presentation that was submitted to assist the Committee. She trusted that the presentation would empower the committee.

Portfolio Performance 
The Deputy Business Unit Leader for Health, AGSA, Ms Nelisiwe Mohlongo, reflected on the performance of the health sector in terms of the indicators. The monitoring of key targets would become critical within the new five-year plan. The following observations were made:

All provinces recorded improvement in the findings, and no province had material limitations on performance information. However, material misstatements remained due to insufficient supporting documents to verify performance information.

The Free State and Western Cape provinces remained clean with no findings on the reported information as a result of strengthened day-to-day controls at facilities and on quarterly reporting.

Only the Gauteng and Limpopo provinces had pervasive findings in one of their programmes. All other provinces reported some improvements in information planning and reporting. Despite the improvements, credible performance data remained a challenge for the standard indicators in terms of measuring primary healthcare in the provinces.

As of 31 March 2024, three of the MTSF targets were still in progress, while 16 had not been achieved.

Service Delivery
The Public Health Medicine Specialist, AGSA, Dr Molapane Chueu, reported on the MTSF initiatives relating to universal healthcare coverage (UHC) for all South Africans by 2030. 

Ideal Clinic Initiative
Per the 2019-2024 MTSF, 100% of the primary healthcare facilities nationwide must have attained or maintained Ideal Clinic status by 31 March 2024. According to the ideal clinic monitoring system, the MTSF target was not attained. Reasons for not meeting the target included the lack of prevention and detection control measures, poor stock control and supplies of medicines, equipment and medical supplies, limited human resources, and infrastructure and maintenance challenges. 

Ideal Hospital Initiative
The Ideal Hospital Initiative was not included in the 2019-2024 MTSF but was developed in 2018 to improve hospital healthcare services. According to the ideal hospital monitoring system, only 11% of district hospitals attained or maintained Ideal Hospital status during the 2023/24 financial period. Only two of the nine provincial departments, i.e. Free State and Gauteng, included the Ideal Hospital as an indicator in their Annual Performance Plans.

National Digital Health Strategy
The strategic plan involved implementing robust and effective health information systems to automate business processes and improve evidence-based decision-making. The NDoH did not make progress with implementing the strategy, and provinces do not have a clear plan for rolling out technologies to support and enable service delivery.

Infrastructure
The acting Business Leader, AGSA, Ms Mmule Thipe, reflected on the outcomes of the infrastructure audit. The following observations were made based on the 25 audited projects:

Delays in the majority of the infrastructure projects audited, i.e. 92% (23) projects were delayed;

Cost overruns, variation order, and extension of time resulted in increased costs, i.e. 44% (11) projects had cost findings; and

Poor quality issues, i.e. 32% (8) projects, were found to be deteriorating due to poor maintenance.

Financial Reporting and Compliance
The acting Business Leader, Ms Thipe, remarked that some improvements in audit outcomes of the Limpopo, KwaZulu-Natal and Nort-West provinces have resulted in six departments receiving unqualified audit opinions in the current financial year. Concerns remained over the control of financial records by the Eastern Cape, Northern Cape, and Free State provinces, which received qualified opinions. The Western Cape was commended for maintaining clean audit outcomes over the MTSF period. Concerns remained over the inability of the sector to comply with key legislative requirements, particularly as they relate to consequence management, procurement, and contract management. The biggest concern is with the Northern Cape province.

2022/23 Minister’s Commitments 
The Deputy Business Unit Leader for Health, Ms Mohlongo, reported that some of the commitments were implemented, and some pockets of improvements were noted. An area of particular concern was the non-implementation of the ICT steering committee. Although the department had established the committee, it was not operational due to other commitments by the chairperson. The lack of cyber security governance controls identified in the previous financial year remained unresolved, and minimal progress was made to address the reported control weaknesses.

(See Presentation)

Discussion
The Chairperson appreciated the gender balance in the department and applauded the progressive women-led team of the AGSA. He invited Members to interact with the AGSA team during the presentation.

Ms N Du Plessis (DA, Gauteng) sought clarity about the difference between monitoring the NHI and UHC indicators.

Mr M Sibande (ANC, Mpumalanga) commended the office of the AGSA for a job well done, but he had concerns about monitoring material irregularities (MIs). He wanted to know how often the AGSA does follow-ups on the reported irregularities and how often communication occurs with the NDoH to rectify the issues. He found the financial mismanagement of infrastructure projects concerning. He asked if the problems were related to provinces not having the relevant structures, such as the internal audit function, to follow up on issues of supporting documents. He wanted to know what had happened with the allocated money if it was not used for the intended projects. He found the lack of consequence management disturbing. Recommendations would not make sense without the structures to enforce the actions. He asked what led to the Northern Cape not including key indicators in their Annual Performance Plan. He requested the AGSA to indicate the officials who were lagging.

The Chairperson, Ms Fienies, requested that the AGSA make the audit action plans available to assist the committee in its monitoring process.

Ms Musisinyani requested Ms Du Plessis to repeat her questions as her audio was unclear. She replied to the Chairperson that audit action plans would be made available. She, however, recommended that the Committee request the audit action plans directly from the departments to enable the Committee to track the plans. She explained the MIs procedure to Mr Sibande. Accounting officers must ensure internal controls are in place to monitor compliance with procurement regulations. The relevant laws and regulations are the starting point of the audit. An irregularity is raised when a transaction does not meet the requirements. Several follow-ups are done throughout the process. Some issues, such as filling vacancies, take longer to resolve. She advised that each department should have an internal audit function. In some provinces, the function is shared with the Provincial Treasury and needs to be capacitated to execute the job.

An AGSA official involved in the infrastructure audit in the Free State explained that the project was completed in 2019, but it had not been commissioned three years later. The Mantsopa TB facility was found to be exposed to vandalism and theft and could not be commissioned without rehabilitation work. The R29 million was spent on the project, but the Department did not derive any benefit, and the return on investment was not realised. The reason for the vandalism was the lack of coordination in the planning phase. The end-users complained about the facility not making provision for a mortuary.

Ms Musisinyani noted Ms Du Plessis’ post in the Group Chat. She replied that the AGSA was not monitoring universal healthcare. The mandates of the different departments are reviewed to assess the long-term goals and the indicators linked to achieving the targets. If the sector sets a goal to achieve universal healthcare, the AGSA would monitor the indicators to achieve the specific goal. The sector included the realisation of Ideal Clinics as an indicator in the MTSF. A framework was developed to measure themselves against the target. The AGSA took the same framework and checked certain elements within several facilities to monitor the progress towards achieving the targets. It was found that some of the facilities audited were struggling to achieve the targets. The role of the AGSA is to elevate the message and for the Department to respond by implementing action plans to achieve the targets. Reviewing the Ideal Hospital framework found that much work was still required. The AGSA recommended that action plans be implemented to achieve this target. The role of the AGSA is to support the sector in ensuring processes are in place to achieve the set targets. She asked that the Chairperson remind her of any questions that might have been missed.

The Chairperson thanked Mr Feni for steering the ship while she was experiencing troubled waters. She also thanked the AGSA office for the responses. The Committee would communicate via the Committee Secretary for written responses to outstanding questions. She invited the Deputy Minister to introduce the presentation on the 2023/24 Annual Report of the National Department of Health.

National Department of Health 2023/24 Annual Report
The Deputy Minister, Dr Joe Phaahla, reminded the meeting that this was the first full financial year of ramping up the recovery from the COVID-19 pandemic and focusing on the key programmes, unlike in the three previous financial years. Many resources have been directed towards fighting the COVID-19 pandemic, including the vaccination programme.

The Director-General, Dr Sandile Buthelezi, was accompanied by department officials. He called on Ms Zondi to lead the presentation on the Annual Report and the CFO to report on the figures.

Performance Information
The Chief Director, Research, Monitoring and Evaluation, Ms Thulile Zondi, said the Department remained grounded for the Seventh Administration and the 2030 vision of the National Development Plan. She presented the achievements per programme based on the Annual Performance Plan targets.


                                                                                                              Annual Target Achieved        
Programme 1: Administration                                                               30% (3 of 10)
Programme 2: National Health Insurance                                             50% (1 of 2)
Programme 3: Communicable and Non-communicable diseases        70% (12 of 17)
Programme 4: Primary Healthcare                                                       57% (4 of 7)
Programme 5: Hospital Systems                                                          50% (2 of 4)
Programme 6: Governance and Human Resources                            75% (6 of 8)

Strategies to overcome areas of underperformance were in place. Of the 1 122 approved posts, 817 were filled, resulting in a vacancy rate of 24%.

Financial Management
The Chief Financial Officer (CFO), Mr Phaswa Mamogale, reported that 99% of the R58 billion budget was spent. As of 31 March 2024, R52 billion (98.5%) of the total adjusted budget of R53 billion Conditional Grant allocations were spent. Approval was obtained for R604 million of the R812 million underspending. The National Department and six provinces achieved unqualified audit outcomes for the 2023/24 financial year. Only the Eastern Cape, Free State, and Northern Cape had qualified audit outcomes.

Performance Overview
Deputy Minister Phaahla said there might be questions about the performance summary, i.e. achieving 58% of targets. Some of the results were not a true reflection of the core business. For example, in Programme 1, one of the areas which negatively impacted on performance indicators was staff equity. The Department set a 7% target for disability staff employment. When the matter was interrogated during the year, the target was far above the 2% performance target set for all government departments. The 7% target was an earlier proposition by stakeholders, but the government did not adopt it. The team was unable to change the target during the financial year. Similarly, the 30% youth employment target could not be met because all vacancies were frozen due to the cost containment measures of National Treasury. The Department could only submit requests for approved positions, and the process became lengthy. He acknowledged the achievements in several key areas of public health, such as the 90% TB treatment coverage. This was a difficult target to achieve due to the difficulty in tracing and placing people on treatment after they had been tested. The World Health Organisation reported that South Africa would likely achieve the 2030 target. He stated that the Department is affected by cost containment, e.g. the HIV grant was reduced by R1 billion in the last financial year to contribute towards cost saving in the national fiscus. The team underwent a vigorous process to obtain low-cost anti-retroviral treatment, enabling the Department to continue rolling out anti-retroviral treatment. Almost 93% of the R58 billion budget allocated to the National Department was transferred to provinces. The Department had a huge task of following the money to ensure that Conditional Grants were utilised correctly. This was not always possible, as the CFO’s report indicated that not all provinces had spent all of the allocated funds.

Discussion
The Chairperson thanked the Deputy Minister and his team for the detailed presentation. She invited Members to pose any questions for clarity.

Mr Sibande expressed his disappointment that only 5% of the 30% target was achieved for youth employment, given the high unemployment rate amongst the youth population. He requested a breakdown of the 5% about gender balance. He found it worrying that only 0.11% of the 7% target for employing people with disabilities was achieved. He was concerned that the food labelling regulations had not been completed. Given the current food poisoning situation in townships, he called for a fast-tracked process. He inquired about the number of health inspectors employed by the Department. He asked whether disciplinary or criminal procedures were performed concerning unauthorised expenditure. He asked for an indication of the subsequent management steps to remedy irregular, fruitless, and wasteful expenditures.

The Chairperson wanted to know why the clean audit targets for provincial departments were removed. She inquired about the support given to provincial departments to resolve audit issues raised by the AGSA. She wanted to know how the Department addressed the data reliability audit issue. She asked how the success of health promotion messages was measured. She inquired about the costs of the medico-legal system, which company had been contracted, and why the CSIR was not commissioned to run the system. The Department is forced to make out-of-court settlements due to improper record-keeping and poor administration. She asked about the remedial actions to address the matter.

The Legal Advisor, Adv Lufuno Makhoshi, replied that more than R1. 4 million had been paid to date for the medico-legal case management system. A transversal tender was issued, but Abacus Consulting was appointed an interim service provider because the Council for Scientific and Industrial Research (CSIR) system dealt with more comprehensive issues. The Department was working with the Special Investigating Unit (SIU) on investigations involving implicated officials. He acknowledged that poor record administration was challenging and serious intervention was needed. Without proof, the court would award costs to the plaintiff. The Department assisted provinces with proper record keeping to ensure a proper defence of claims against hospitals.

Ms Zondi said the main problem in terms of the reliability of data was linked to the indicators for service delivery in Programme 3. Efforts were ongoing to strengthen record-keeping for communicable and non-communicable diseases. Some of the interventions include built-in rules for managers to capture the data. Managers are provided with feedback on the quality reviews of programmes. Data quality audits are conducted at facilities to enable managers to interrogate the data. Part of the challenge is moving from a system of paperwork to a digital system. Capacity building in terms of using the existing system was continuing. Standard operating procedures had been implemented to ensure that all officials were informed about data collection requirements. Moving towards digitisation was an ongoing process. Meanwhile, the reliability of data is taken seriously, hence the interventions.

The DDG for Primary Healthcare, Ms Jeanette Hunter, said the lack of resources posed a challenge in speeding up the food labelling process. More environmental health practitioners or health inspectors were needed to cover health hazards affecting food supplies. It is the responsibility of municipalities to appoint health inspectors. The ratio of health inspectors against the set norm was too low. The Department does regular inspections and submits recommendations to municipalities. She replied to the Chairperson that health promotion messages have increased in the past two years through training community health workers and traditional health practitioners and involvement in school health programmes. Political leaders' appearances at gatherings contributed to the promotion of health messages. A demographic health survey is conducted every five years to measure the impact of health promotion messages. The Department recently launched a digital health platform to send pop-up messages. The platform enables citizens to ask follow-up questions and allows the Department to refer people to the appropriate channels for assistance.

Mr Mamogale said the National Department had no fruitless and wasteful expenditure. The fruitless and wasteful expenditure were concerning the provinces. He explained that the clean audit target was removed from the Annual Performance Plan because the National Department was not directly involved in achieving provincial targets but was supporting provinces to improve their audit outcomes. The Department and the nine provinces meet regularly with the AGSA to reflect on the audit outcomes of the sector, including irregular, fruitless and wasteful expenditure and consequence management. The next meeting was scheduled for 9 December 2024. The Labour Relations Department was dealing with disciplinary processes. Support is provided to the three provinces with qualified audit outcomes. The CFO Forum would visit the Eastern Cape to assess the identified issues. Service providers had been appointed to assist the Free State. The team in the Northern Cape started verifying the interim financial statements against supporting documents. The support would continue until the audit outcomes improve.

Dr Buthelezi said the constrained environment resulted in the 30% youth employment target not being met. The target would be adjusted in the medium-term budget because it was not feasible given the cost constraints. The target should be incrementally adjusted over the next five years.

Closing remarks
Deputy Minister Phaahla said the employment equity target was out of sync with the target set for all government departments. He acknowledged that achieving not even 1% of the disability employment target was a dismal performance. However, it indicated the difficulties in disclosure when people apply for positions. Everyone was committed to reducing youth unemployment. He hoped the fiscal environment would improve to create opportunities in the administration areas and not only in professional careers. The Department continued to work with the SIU on the medico-legal claims to ensure that legal firms facing criminal charges for fraudulent claims were held to account. Capacity is being created nationally to assist provinces by providing a bird’s eye view in monitoring medico-legal claims. The Minister of Health is often cited as a respondent in many of the claims, which helped bring the cases to the attention of the Department. A medium- to long-term review of the current position of environmental health workers is being considered to classify the role within municipal health services. However, the review was put on hold because of the many pressures municipalities face. The Department is making provision for the employment of health inspectors to supplement the capacity of municipalities.

The Chairperson thanked the Deputy Minister for his presence and the team for the comprehensive responses. She requested that the Department use the audit action plans for monitoring purposes and brief the Committee on their progress in the new year. Any outstanding responses to the questions should be submitted to the Committee in writing. She permitted the Minister and his team to leave the platform.

Final Mandates on Older Persons Amendment Bill [B11D-2022]
The Chairperson called on Members to read the final mandates on behalf of their provinces.

Mr M Feni (DA, Eastern Cape) said the Bill was deliberated on 2 December 2024. The Eastern Cape Legislature mandated the permanent delegate to the NCOP to vote in favour of the Bill

Ms T Breedt (FF+, Free State) said the Free State Legislature deliberated the Bill on 26 November 2024 and voted in favour of it.

A delegate read the final mandate on behalf of the Gauteng delegate. The Gauteng Legislature supports the principle and detail of the Bill and therefore voted in favour of it on 28 November 2024.

Ms S Ngcobo (MK, KwaZulu-Natal) said the KwaZulu-Natal Legislature met on 26 November 2024 and mandated the permanent delegate to the NCOP to vote in favour of the Bill. 

Mr M Mokwele (ANC, Limpopo) said the Limpopo Legislature considered the final version of the Bill on 26 November 2024 and mandated the permanent delegate to the NCOP to vote in favour of the Bill.

Mr M Sibande (ANC, Mpumalanga) said the permanent delegate of the Mpumalanga Legislature was mandated on 3 December 2024 to vote in favour of the Bill.

Ms D Fienies (ANC, Northern Cape) said the Northern Cape Legislature voted in support of the Bill on 21 November 2024.

Ms J Adriaanse (DA, North-West) said the North-West Legislature agreed on 26 November 2024 that the final mandate should constitute the voting mandate in favour of the Bill.

Ms M Bains (ANC, Western Cape) said that on 2 December 2024, the Western Cape Legislature conferred on the permanent delegate to the NCOP the authority to support the bill.

Committee Report on the Older Persons Amendment Bill
The Chairperson read the entire report and put it into the record. Members then voted to adopt it.

Read: 

ATC241204: Report of the Select Committee on Social Services on the Older Persons Amendment Bill [B11b-2022] (Section 76), Dated 04 December 2024

Announcement
The Chairperson announced that this had been the last meeting of the term. She wished everyone a peaceful and festive holiday and thanked the support staff for their help and guidance.

The meeting was adjourned. 
 

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