Health & Welfare priorities for next 5 years; Pharmacy Amendment Bill: briefing

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Meeting Summary

A summary of this committee meeting is not yet available.

Meeting report


20 October 1999

Documents handed out:
Pharmacy Amendment Bill
Briefing on the Pharmacy Amendment Bill (contained in the minutes)
Briefing by Minister for Welfare & Population Development (contained in the minutes)

Dr A Ntsaluba, spoke on behalf of Health Department. In his address Dr Ntsaluba (Director-General: Department of Health) stated that as much as there are insufficient funds, resulting in a deterioration of services, managers are also to blame for bad management. He called for decisive action in tackling the problems faced by the Department before the health system collapses. Dr Ntsaluba expressed concern that tuberculosis and HIV/AIDS are major problems. He advised that AIDS must be fought by targeting children between the ages of 9 and 14. "If we target them later, we are already late," he warned.

Ms L Abrahams (Director General: Department of Welfare) read out an address from the Minister of Welfare. Dr Zokufa briefed the committee on the Pharmacy Amendment Bill.

Review of Department of Health

Dr Ntsaluba stated that the strategy document which addresses the current challenges and discusses the experiences of the past five years has been completed. Dr Ntsaluba said that "we have managed to get national approval of some of our priorities especially in primary health care infrastructure." He however warned that the Department has still much to do in improving the quality of care in all dimensions and he made an example of the quality of nursing which he said is beginning to be eroded. He quoted in particular the problem of nurses leaving the country for greener pastures in the Middle East, the United Kingdom and other parts of the world. For the above reasons Dr Ntsaluba said the Minister and the MECs have prioritised issues relating to human resources. "Every time we try to ascertain from our managers why there is a deterioration in services, we are told there is not enough money. Much as there is no money, we have problems with managers managing badly," claimed the Director-General. He nonetheless assured the committee that the problem would be addressed. The Director-General suggested that there should be a revamping of the management structures within institutions when dealing with the issue of quality improvement.

Dr Ntsaluba continued, "Also, in review, it came out that we should engage in budget issues. We have concluded that although we have improved in equity we have a problem with provinces prioritising differently. We realise that if we do not tackle decisively the current problems we have… the health system is going to collapse."
In addition, Dr Ntsaluba promised that this time around the issue of the different arms of government working together will be critical.

National Health Bill
The Director-General stated that they needed to accelerate the tabling of the National Health Bill. He said this Bill will set the legal framework for relations between the public and private providers amongst other matters.

Mental Health Bill
Dr Ntsaluba said a commission had been set up which had produced a damning report on the current Act. He said the situation has to be rectified.

Nursing Act amendments
Dr Ntsaluba said the Nursing Act must be amended to ensure that nurses are empowered to do what they are expected to do especially with primary health care. He said the Act should also address the problem of losing skilled nurses to other countries.

On the question of maternal and child health, Dr Ntsaluba asserted that they have progressed in the areas of polio and measles. He said the country is about to be certified polio free. He said the one worry with vaccinations is that only 63% of children have reached the required vaccination standards on their first birthday. "We are targeting 90% by next year… we need to encourage mothers to take their children for vaccinations," he emphasised.

"AIDS has risen to be the second highest cause of death amongst pregnant mothers. No.1 is still hypertension…and third is excessive bleeding…The positive aspect from the report on deaths of pregnant mothers is that we no longer have a high rate of deaths due to abortions."

Dr Ntsaluba said tuberculosis and HIV/AIDS are still a major problem. "The worrying thing about HIV/AIDS is the high rate amongst teenagers. We must target children between nine and fourteen and educate them about AIDS, if we target them later, we are already too late.

International Relations
Dr Ntsaluba announced that the President has signed a protocol on health. "Sometime early next year we will need to ratify that protocol," he said. Finally, he mentioned that South Africa is increasingly called upon to participate in world health programmes and they were gearing up to that challenge.

Questions and comments
Ms S Ntlabati (ANC, Free State): Thank you for the superb presentation. Whilst I am pleased that we will be polio-free, I am concerned about the now easy movement of people between countries, so, we might in that way have incursions of polio and other diseases. Secondly, has the report of maternal deaths looked at the situation in the rural areas where traditional birth attendants operate? Further, could copies of the SADC Protocol be made available to the Committee?

Response: I think the member is correct about the concern of the spreading of some diseases through the movement of people between countries and, that is why we have prioritised contaminating diseases. The report has not looked at traditional birth attendants. We have been asked to look more closely at community health workers and that will include traditional birth attendants. We will make the SADC document available as soon as possible.

Ms L Jacobus (Chairperson, ANC, Gauteng) stated that she hoped that more of the budget is being allocated to deserving priorities such as HIV/AIDS.

Ms J Vilakazi (IFP, KwaZulu Natal): About the escalation of tuberculosis and defaulters in immunisation, what programmes are you planning to address the problem, especially for the community health workers?
Response: I must say that we were surprised to see that the Northern Cape and Northern Province did much better in immunisation statistics than some urban areas. They did much better than Gauteng and the Western Cape.

Ms E Gouws (DP, Eastern Cape): Concerning TB vaccination for infants, am I correct to say that there are no longer any problems?
Response: For all the kids that are born now, the vaccine is there. We may have a slight problem beginning next year when we move from the present vaccine to the injection type but as I said the problem is solved.

Dr P Nel (NNP, Free State): The fact that the budget is coming down every year has negative effects. As you said the quality of service has not improved and as a result of lack of funds, in the Free State, we have cut the theatre list.
Response: Indeed we do not have the tools. We need to have a constructive dialogue around this. We are worried about the life of the equipment because the provinces cannot even do routine maintenance of their equipment.

Pharmacy Amendment Bill
Dr Zokufa from the Department made the following presentation on the Pharmacy Amendment Bill:

1. Introduction
1.1 To amend the Pharmacy Act, 1974 so as to provide for the performance of Community Service by persons registering for the first time as Pharmacists; and to provide for matters connected therewith.

1.2 To insert Section 14A in Act 53 of 1974 which will then provide for:
· Performance of remunerated pharmaceutical community service for a period of one year in terms of the regulations contemplated.

· Entitlement to register to practice as a pharmacist on the completion of such service.

· The Minister may after consultation with the council make regulations regarding the performance of the pharmaceutical community service, including but not limited to the place at which it is to be performed and the conditions of employment.

The Constitution guarantees everyone the right of access to Health Care Services. There is however an acute shortage of Pharmacists working for the State. With the introduction of Community Service for Medical Practitioners in 1998, this shortage has since been reduced. This Bill seeks to introduce a similar system in respect of Pharmacists.

1.3 The following statistics sketch the scenario:-
Number of Pharmacists in South Africa in 1999: 10 206

Kwa-Zulu/Natal KZN 1490
Eastern Cape ECP 826
Gauteng GAU 4118
North West NW 433
Northern Province NP 271
Northern Cape NC 112
Mpumalanga MP 398
Free State FS 450
Western Cape WC 1664
OUTSIDE South Africa 444

Number of Pharmacists in Retail ( Community) Pharmacy 4753
Number of Pharmacists in State (Public) Hospitals 1611
Number of Pharmacists in Private Hospitals 227

By far the largest percentage, 51.4% , of Pharmacists are in Community Pharmacy and only 15.8% in Hospital Pharmacy, (66% of this in State Hospitals).

About 83% of Pharmacists are practising full time. There is one pharmacist for every
3 752 people in South Africa, (1 : 3 752). According to the World Health Organisation, WHO, the average for Industrialised Countries is 1: 2 300. This ratio is problematic particularly in the Northern Province with one Pharmacist for every 16 446 people, (1 : 16 446). The gender distribution is 51: 49 male to female ratio in 1998.

In 1998 there were 1 726 pharmacy students registered at the seven Schools of Pharmacy in South Africa. Of these 531 were in their 4th and final year of study before the 12 months Internship period.

In 1999 we have 479 Pharmacy Interns in the following training sites
· Community (Retail) Pharmacy 252
· State Hospital Pharmacy 163
· Pharmaceutical Manufacturing Industry 25
· Academic Centers 50

It is expected that by the end of this year, 1999, about 500 pharmacy students will qualify in South Africa to do their Internship at the beginning of the year 2000. This is the number of Interns that is targeted for Community Pharmaceutical Service in the year 2001

2. Consultation Process
Consultation with the nine Provinces and the South African Pharmacy Council was done

2.1 During the month of August and September 1999, the following Schools of Pharmacy were visited by representatives from the Chief Directorate : Human Resources, Chief Directorate : Pharmaceutical Services and South African Pharmacy Council:
University of Port Elizabeth
Rhodes University
University of Western Cape
University of the North
University of Durban-Westville
Potchefstroom University

The University of Witwatersrand and MEDUNSA could not be visited in this round. The idea of the visit was to address mainly the 4th year students to explain the Community Pharmaceutical Service to be introduced in 2001. They would be the first group to do this Service after their internship period in 2000

2.2 Concerns raised by the students were around the following issues:
· Can they do locums whilst doing community service?
· Can they do community services in a private clinic/hospital that serves under-serviced areas?
· Will there be concessions made by banks to repay student loans?
· What happens if they fall pregnant and need to take maternity leave during community service?
· What professional support will be provided?
· Where are they to be placed?
· What happens to foreign students who studied in SA and need to go back to their countries?
· If one leaves the country after internship without doing community service and comes back later, will they need to do community service?
· If internship is done in Industry, how will they then do community service?
· Will they work in public sector clinics or only public sector hospitals?
· Will marital status of individuals be considered favourably for placement?
· Will there be assured accommodation, DSTV and Internet provided for community services Pharmacists?
· Are they going to be paid? What is the remuneration package?
· How will Government afford the approximately 450 students?
· Why give another year of their life to this country when they have already done National service?
· Why are they only being told now, August 1999, during their last year of study?
· What is the registration status as Pharmacists before and after community service?
· If they start internship on December 1999, will they do community service in 2001?
· Why should they support this Government Initiative when Govt. does not support them financially with bursaries?
· What happens to contracts made with private sector that gave them financial support on condition they come and work for them on completion of their training?
· What happens to contracts made with public sector to work in a rural hospital after completing their internship in an urban hospital?
· Will they be orientated after doing their internship in the private sector?
· Can they negotiate for a lower salary (less than R55,000) so that they do not have to pay income tax?

2.3 Proposals put forward by the students were:
Continue to do community service where internship was done.
· Need to know by June 2000 their placement in identified facilities, salaries, availability of posts, supervisors and accommodation.
· Need a job description to be included together with the application form for placement.
Need to consider other career options in the public sector and not only hospital.

2.4 The Chief Directorate : Human Resources, which is championing the consultation process with the Chief Directorate : Pharmaceutical Services, has planned a consultation meeting on 15 November 1999 with the following stakeholders on this issue:-
South African Pharmacy Council
Pharmaceutical Society of South Africa
Heads of Provincial Pharmaceutical Services in Public Sector
Pharmaceutical Manufacturing Association
National Association of Pharmaceutical Manufacturers
Pharmaceutical Wholesalers and Distributors
Community Pharmacists Representation
Schools of Pharmacy and their Deans
Pharmacy Students Representation

Unfortunately the 15 November 1999 date does not suit the students because of the examinations that are in progress this time. They will however table their concerns to this meeting via their chosen representation. Some of the students who are not writing examinations during that time will make an attempt to attend.

A special session however, mainly for the students, is planned for 6 December 1999 when the examinations are over. According to the latest communication with the students' representation, this arrangement is acceptable.

3. Remarks
It is crucial for us to continue with the consultations with all the major stakeholders on this sensitive issue. By far the pharmacy students are the major stakeholders.

To adequately address the rendering of Pharmaceutical Services to the people of this country who utilise State facilities we have to influence the current trend of the distribution of pharmaceutical services. This will not happen on its own, therefore there is merit in having this kind of legislation.

To do this successfully the following issues must be carefully addressed:-
Persons who will be performing Community Pharmaceutical Services will be employees of the Provincial Departments responsible for Health. They will therefore be remunerated for their services by such Departments. All the arrangements to employ these persons in the year 2001 should be well on the way.

· Of the total number of Interns only 25% do their internship training in the Public Sector facilities. An Orientation Program that will focus on all aspects of the National Drug Policy, Stock Management processes and general logistics within the public sector environment will therefore be advisable for the 75% of interns who would have done their training outside the public sector.

All the issues around professional mentoring, support and development will have to be carefully arranged.

Questions and comments
Ms L Jacobus (Chairperson, ANC, Gauteng): What was the general feeling of the pharmacy students at the various institutions when they were consulted?
Response: Their responses indicated that more than 60% did not like the idea of community service. On further break-down we found that the students at the historically Black institutions were mostly in favour of community service as compared to those in White institutions. That was in 1998. More recently communication with the students has been fruitful.

Ms L Jacobus (Chairperson, ANC, Gauteng): Have preparations been made in the provinces for students when they start their service.
Response: The concerns that the students have will be addressed soon. All monies that are involved are accommodated in the provinces' budget.

Dr P Nel (NNP, Free State): Is there a restructuring of the salaries of pharmacists? Response (Dr Ntsaluba): We have started discussing the review of the salaries. There are pharmacists who have worked at retail pharmacies for many years and now when they join the Department they are paid at an entry level. They do not accept that but we are discussing the matter.

Review of Department of Welfare
As Minister of Welfare, Population and Development, Mr Z Skweyiya, was not available, Ms L Abrahams, the Director General in the Department of Welfare, presented his briefing document:


Members of the Select Committee on Social Services,
Thank you for the opportunity to discuss with you my vision for welfare and how we can achieve it.

Since taking up office a few months ago, I have made a number of visits to various provinces.

These include the North West Province, Kwa-Zulu Natal, Northern Province and the Eastern Cape Province.

The visits have emphasised a number of important issues that we need to confront if welfare is to contribute to achieving the developmental objectives of this government.

How does welfare contribute to these developmental objectives? Why do we have departments of welfare?

In essence they exist to promote social development. The White Paper defines social welfare as "an integrated and comprehensive system of social services, facilities, programmes and social security to promote social development, social justice and the social functioning of people".

The White Paper represents a radical departure from previous policy approaches. It advocates a developmental approach that should address the root causes of problems as well as the systemic crises that beset our nation.

In line with this developmental approach we have identified four strategic focus areas:
Poverty eradication
We will finalise a poverty eradication strategy to target particular groups (such as women-headed households) and link up with other initiatives of government, such as the spatial development corridors and the integrated rural development strategy.

A comprehensive social security system
Social security means a set of public and private schemes that provide support to citizens for social risks such as old age or retirement, disability, injury at work, unemployment and others. However our system inadequately covers these risks and therefore we are working on proposals to improve our social security system.

The transformation of welfare services
Vulnerable individuals, families and communities require services that will enable them to function effectively as productive members of society. These services include counseling, rehabilitation, prevention, early intervention services and care and support services. However, these services need to be transformed into holistic services that are more responsive to local communities and target areas of greatest need.

Special development areas
This strategic focus area seeks to integrate a number of national priority issues throughout the work of the department in a cross-cutting way. This includes HIV / AIDS, support to victims of crime and violence, substance abuse and our focus on poverty and women.

These are the four focus areas in which a number of concrete programmes and initiatives are being carried out to ensure that we do achieve our goal of promoting social development. The details are contained in Annexure A, called "Departmental Programmes and Initiatives".

However, I would like to bring us back to the issues which struck me as being critical from my provincial visits.
1. Infrastructure development
The most striking feature of these visits has been the almost total lack of appropriate infrastructure for welfare, particularly in the payment of social grants.

We pay beneficiaries of social grants or take in applications under trees, in goods containers, in offices with no electricity, no computers or photo-copiers.

This is a recipe for fraud, inefficiency, robberies, low morale and bad behaviour by officials.

Our beneficiaries are the poorest of the poor. They are old age pensioners or persons with disabilities. Every month they have to endure the humiliation of long queues, unscrupulous loan sharks and arrogant officials.

This we cannot tolerate. Part of the solution is a completely new Welfare
Payment and Information Service (WPIS). The national Department of
Welfare will find a business partner from the private sector to establish such a
new service.

Cabinet has approved this initiative and a tender will be published early in the new year.

But we also need to ensure that provincial departments link with the one-stop centers or multi-purpose community centers that are being established by government (inter alia Department of Communications and Department of Labour). Such infrastructure will meet some of the requirements for appropriate physical accommodation.

2. Improving national - provincial relations
In terms of our Constitution, the delivery of welfare services and programmes is a concurrent competency between the national and provincial spheres of government.

While this arrangement may have advantages, it certainly poses a number of challenges that we constantly need to address. This is particularly true now that we have a new national Minister and seven new MECs for welfare.

Firstly, we need to improve the information flow between the national department and the provincial departments.

Secondly, we need to ensure that the provincial departments get the support they require to implement policies and programmes.

In this regard we need to ensure that structures such as MINMEC (the forum for the national and provincial ministers) are functioning effectively and address the concerns of provinces.

3. Human resource development
Many provinces still do not have the human resources they require to function effectively and efficiently.

This manifests itself in terms of having people who are not qualified to do the work and an inability to find and employ those people who do have the skills required.

In some cases such as the Eastern Cape province, the ratio of payment officials to beneficiaries is very low compared to higher ratios in other provinces. Also staff need to travel great distances to effect payments.

To implement our developmental approach we need a new set of skills. We need development economists, development planners, financial analysts and persons with development facilitation skills among others.

The welfare function manages a global budget of R18-billion, the third highest expenditure of government. Yet in some cases we have junior officials managing these vast sums of money.

I am determined to correct this situation. Government has identified training and capacity building as a priority and has set aside money for such programmes. We will access these funds and call on the donor community to provide assistance where necessary.

4. Programme review
What has also emerged from the provincial visits are a number of problems with critical programmes such as the poverty relief programme.

The initial experience indicates that this programme could be more effectively targeted at groups who are in greatest need. Small-scale projects are not having the desired outcomes.

Persons with disabilities, unemployed youth and single mothers should be more centrally involved.

Thirdly, there is a need to ensure closer collaboration and integration with other departments, especially on issues such as violence against women and children and HIV / AIDS in particular.

The Poverty Relief Programme of Welfare will be integrated into the projects of the Integrated Rural Development Strategy. Initial projects are already unfolding in KwaZulu-Natal (Mbazwana Pilot Project), Northern Province and Eastern Cape.

5. Budgetary issues
We are witnessing a trend where social grants are continuing to consume virtually the entire welfare budget.

In the past financial year, payments in social grants totaled about R16,65-billion. This represents about 90 percent of the welfare budget.

Clearly this impacts negatively on our ability to deliver other welfare services which are vital to ensure the social functioning of vulnerable individuals and families.

There is another issue which we need to raise. Funds for social grants are paid into provincial treasuries and become part of the provincial budgets.

In this way the national department has no control over the actual spending at provincial level. It is possible that funds meant for social grants actually end up being spent on other programmes.

6. Y2K

I am pleased to report that the national Y2K compliance project has been completed and contingency plans for the national and provincial departments have been finalised. The contingency plans deal in particular with the boundary period 31 December to 21 January when all service providers will be on alert.

In our view, there should be no significant problems in relation to grant payments in January or February 2000. The generation of payment information for January will be finalised by 6 December 1999 and we will have advance notice of any difficulties.

Similarly, payment information for February is generated in the first week of January, so there is sufficient time to address, any problems that may arise.

The national department and all agencies that are involved in the payment services have confirmed that their business is Y2K compliant.

After highlighting these critical challenges, what is my vision for welfare? It can be put in the following way:

"A public welfare system which meets the basic needs of our people in a way which promotes social development, which is based on adequately resourced departments delivering services effectively and efficiently and which contributes to creating a caring society"

In conclusion I would like to address the role of civil society. Welfare and development organisations need to consolidate their critical involvement with the government and forge constructive partnerships to address our many challenges.

I am giving these stakeholders an opportunity to engage with me through the National Consultative Process which began 12 October. This will hopefully be the first step in necessary dialogue.

Members of the Select Committee are also invited to make submissions on the issues affecting welfare and development.

We need to mobilise all citizens to come together as a collective force as we attempt to build a better life for all our people.

Annexure 1
Departmental Programmes and Initiatives
The following represent the four priority programmes of the Department of Welfare for 1999/2000 and for the medium term to 2001/2:

Social assistance
Social assistance in the form of grants remains one of the most extensive forms of redistribution in South Africa. The welfare department has ended legal disparities by race, changed access to grants and established a unified administrative system at the provincial level. Fraud in the pension system has been reduced and a major revamp of the payment system is currently underway to ensure high levels of operational efficiency and quality service to citizens.

The introduction of the Child Support Grant in April 1998 has seen a slow uptake in the first year. Current applications stand at around 150 000.

The immediate objective is to reach 500 000 children in payment by December 2000.

In the FY 1999/2000, the Department of Welfare will pay around Rl7bn to 2,9 million beneficiaries, of whom 1,8 million are older persons.

Welfare Payments and Information Service
The objective of the WPIS is to design a service that will offer citizens who qualify at least the following:
· Access to a range of payment options including physical and electronic cash services and partial withdrawal of benefits
Access to a high quality service with quick turn around times between application and first payments
Value added services such as interest-bearing savings mechanisms and other micro-finance services
Access to information regarding the full range of welfare services offered in South Africa

The objective is also to offer government at least the following:

· The most cost-effective way to administer public funds
· Significant and incremental fraud reduction
· Accuracy of beneficiary information to ensure that the service is targeted in line with government policy of reaching the poorest of the poor
· A high level of productivity of staff responsible for the payment and information functions
The ability to reconcile payments on a daily basis

These stated objectives will also improve medium to long term budgetary planning. The current cost of disbursing social grants is estimated at around R500m per annum.

Poverty Relief Fund and anti-poverty strategy
The design of an anti-poverty strategy for the Department of Welfare is in its first phase. The model includes the following features:

1. Allocation of funds to local projects (both large- and small-scale) on the recommendation of provincial welfare departments
2. Allocation of funds to national projects in collaboration with other national departments (Department of Water Affairs and Forestry, Department of Environment Affairs and Tourism) and non-governmental organisations (Federal Council for the Disabled, National Trauma Network)
3. A developmental facilitation role played by the national and provincial department of welfare to promote sustainability of the recommended projects and the programme as a whole
4. A capacity-building role played by a large number of non-governmental and community-based organisations to support local projects with skills development and knowledge transfer, also in support of project sustainability. The Independent Development Trust (IDT) is a major partner in the disbursement and administration of the funds, while the Departments, NGOs and CBOs are responsible for promoting long term project sustainability.
5. The national Department is also responsible, in collaboration with provincial departments, for designing appropriate poverty reduction strategies which link the investment of the funds to preventative services and early intervention services. For example, projects will be encouraged where HIV/AIDS counseling services for young people in rural villages and towns, that typically do not have access to welfare services or other counseling services, are supported. To this end, the national Department will also be seeking co-operation with a growing number of government departments including health, agriculture and education.
6. Funds specifically designated for capacity building will be set aside in each successive year of the poverty relief programme. The Department (and in some instances projects themselves) has also secured support from ".international donor agencies. The Micro-Save programme is supported by the UNDP. Funding for the National Trauma Network is being considered by the European Union, on the basis of an allocation and commitment to fund from the Department of Welfare.
7. Training for national and provincial staff has been embarked on to introduce and/or revitalise project and programme management skills.

Implementation of the Financing Policy for Welfare Services
Past and current arrangements for financing welfare services are based on a subsidy related to the number of staff working at the institution. The new financing policy proposes a number of shifts in financing to promote services which focus on prevention and early intervention measures; "one-stop shop" type services/facilities; services which link remedial services to social development initiatives.

The policy is concerned with whether the particular service meets the needs of the local community and whether the quality of the service is appropriate to the needs expressed. Citizens and clients of welfare services will have greater say in reviewing the nature and quality of services.

The current welfare services budget is around R1,45bn per annum. These funds must be used more cost effectively and distributed more equitably between rural and urban areas. This is a key objective. The "basket of services" will be costed using a funding model to test and plan the effective distribution of services and resources, both human and financial.

The financing policy is a key element of the programme to transform welfare services and will be introduced over the period 1999 - 2004. Quality assurance mechanisms and measurements will form a crucial part of the programme.

Other programmes and initiatives include:
A range of initiatives under the transformation of welfare services including:

Transformation of the child and youth care system to ensure that, wherever possible, children are diverted from the criminal justice system and are provided with legal representation when required. The transformation process incorporates a wide array of measures including diversion programmes, family and group counseling, secure care facilities separate from facilities for adult offenders. A number of pilot programmes have been implemented in various provinces and will be replicated. Reports are available from the Department.
Survivor support and development (previously known as victim empowerment) which will design services to inter alia, survivors of rape, domestic violence, criminal violence, child abuse and neglect

Departmental restructuring
To ensure that the Department of Welfare is able to meet these very important objectives, a major restructuring project is underway. Following a number of initiatives in the first five years of government, the National Department is continuing its own internal transformation initiatives through, inter alia:

· Identification of strategic focus areas (SFA's);
Restructuring of the department to ensure attention to these SFA's;
Creation and filling of posts with specific public and business management (not merely policy) competencies;
The introduction of appropriate management tools and methodologies such as project management, information management and technology management disciplines;
· Continuous business and strategic planning to ensure business continuity;
· The delegation of financial management to programme managers, though the accounting officer retains overall accountability
· A human resource development programme aimed at introducing and consolidating management skills and new knowledge.

The employment of an appropriate pool of persons bringing together a multidisciplinary package of knowledge and skills is the major objective of the human resource management approach of the Department. In excess of 15 posts have been advertised in the past 10 months, aimed at recruiting new knowledge and skills in fields such as local economic development, development planning, information strategy design and management, strategic business development, internal audit. An adequate pool of human resources has, thus far, not been achieved.

Annexure 2:
Legislative programme
This aspect of the departments work involves a review of all welfare legislation including social assistance legislation, as well as legislation pertaining to children and older persons. The following legislation will be presented to Parliament before March 2000:
1. The Developmental Welfare Governance Bill aims to establish appropriate arrangements for a relationship between the Minister of Welfare and the non-governmental welfare sector to ensure that the objectives of the White Paper for transformation and equity in welfare services are achieved equally within government and within the broader welfare sector.
2 The Status of Older Persons Bill aims to enshrine the rights of older persons to care and protection from harm in law, whether they are cared for in the home or in residential care facilities. The Bill seeks to provide redress for any persons who may require it, more importantly the Bill seeks to prevent the abuse of older persons by providing appropriate mechanisms for public complaint and oversight. The Bill will be a further step in the deracialisalion of services and institutions for older persons.
3 The Disaster Relief Fund Bill seeks to rationalise a number of pieces of legislation dealing with disasters and emergencies to create a coherent framework for the administration of funds.
4. A minor amendment is proposed to the Not for-Profit Organisations
D. The S A Law Commission has established a Project Committee responsible for drafting a comprehensive child care statute. A number of departments including the Departments of Justice and Welfare participate in this legislative drafting exercise. Welfare is the lead department. It is envisaged that a draft Bill will be presented to Parliament in the latter half of the parliamentary year.

The meeting was adjourned.


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