South African Social Security Agency; Children’s Bill: Department of Health Response

Meeting report

SOCIAL DEVELOPMENT PORTFOLIO COMMITTEE
8 February 2005
SOUTH AFRICAN SOCIAL SECURITY AGENCY; CHILDREN’S BILL: DEPARTMENT OF HEALTH RESPONSE

Chairperson: Mrs T.J Tshivhase (ANC)

Relevant documents:
South African Social Security Agency (SASSA) presentation
Children's Bill: Implications for state Departments and other institutions (Department of Health)
Committee Programme

SUMMARY
The Department of Health responded to issues raised during an intersectoral workshop on the Children’s Bill held in Johannesburg in December 2004. The Department said that it had the necessary legislation and polices to address children's rights as provided in the Constitution and the Children's Bill. There was a need for discussion on the application and interpretation of Chapter 3 of the Bill with which the Committee had problems particularly with regard to initiation schools and circumcision. The Department said that the issue of harmful social and cultural practices such as initiation schools presented a major challenge and needed to be approached in a strategic manner. It said that it was important to engage traditional leaders and healers on this issue. The Bill should provide a legal framework on all issues relating to HIV testing and consent by children, as these were not covered by any document in the Department. Clarity was also required as to which Department was responsible for the funding of HIV tests for foster care and adoption purposes.

The Committee were given a progress report on the South African Social Security Agency which would be operational from April 2005. Provinces would continue to be responsible for the delivery of social grants until March 2006. A process of identifying positions of staff that should be transferred to the Agency had been undertaken and management in five provinces had already signed off some social security staff. A process of financial ring-fencing whereby provinces would identify assets and liabilities to be transferred to the Agency would be completed by April 2005. In response to Committee concerns, it was noted that an amount of money had been set aside to help provinces improve grant pay points. The Department was discussing with banks the possibility of paying grants directly into a bank account similar to the Mzantsi account. Members were also concerned with the amount of corruption and fraud in the administration of the grant system. The Department in response said it was doing its best to fight this. A number of people involved in corrupt and fraudulent activities had been reported to the Department and they would be dealt with accordingly.

MINUTES
The following people attended the meeting: Ms R van Zyl (South African Law Reform Commission: Researcher), Dr M Mabetoa (Department of social Development: Chief Director), Ms S Ngake (Department of Health - Director: Child Health), Mr P du Preez (Department of Social Development: Legal Advisor), Ms L Stuurman (South African Law Reform Commission: Researcher), Ms D Mohlabi (Department of Health: Deputy Director), Mr S Jehoma (Department of Social Development: Deputy Director) and Ms U Mguye (Department of Social Development: Deputy Director).

Ms E de Klerk presented the Department of Health's response to issues that had come up during an intersectoral workshop in Johannesburg in December 2004 (see document attached).

Discussion
Mr M Waters (DA) was concerned by the manner in which the Bill dealt with "harmful" social and cultural practices. It gave people an option to refuse virginity testing. However, it would be difficult for some people to refuse testing. He wondered why the Bill did not expressly outlaw virginity testing. He noted that some provinces had legislation on the monitoring of circumcision, initiation schools and virginity testing. He asked if the Department had the manpower to enforce the legislation.

Ms Mohlabi replied that the issue of social practices was very challenging and not easy to deal with. The Department intended to put policies to deal with the issue in place and legislation would possibly follow later. Health practitioners might believe that certain social practices were dangerous but every community had its norms and beliefs. Parents or legal guardians might insist that certain practices be observed despite the warning from health practitioners. One could not come up with legislation on this issue overnight and a lot of research was needed before introducing any legislation. It was not easy to tell a community that it may not send its children to initiation schools. Some aspects of culture were difficult to deal with whilst others could be nurtured and improved. She believed that, with time, the Department would be able to come up with something acceptable to all concerned.

Ms de Klerk replied that policing was difficult given resource constraints. The Department was trying to ensure that initiation schools addressed health issues.

Mr Waters said that it was pointless to have a provision in the Bill providing that children had the option to refuse virginity testing if they could not do so in practice. He suggested that the provision should specifically outlaw the practice or be deleted.

Mr M Masutha (ANC) said that there were many things that were regulated in policies as opposed to legislation. The Bill only provided rights. The purpose of legislation should be to give guidance on how to exercise rights and when action would constitute violation of the rights. It should also guide on how to deal with violation of rights. He asked if the Department was saying that the details on how far and under what circumstances circumcision and similar practices be lawful, would be dealt with in policies or it would develop legislation. He felt that Chapter 3 of the Bill was vague and lacked detail. Policies had no effect of law and guidelines could not be used to enforce or prevent particular conduct.

Ms de Klerk replied that the Department of Health looked at whether a procedure was done in a safe manner. There was a need to look at the Bill and see if the issue of procedure was adequately covered. The Department's policies covered the health aspect of social practices and the training of traditional surgeons.

Ms H Weber (DA) asked if sufficient information was given to mothers on antenatal care and when to take their children for immunisation. More and more mothers were not treated as expected and this was causing a lot of disabled children to be born.

Ms de Klerk replied that one was tempted to ask if there was ever a time where one could safely say that everybody had sufficient knowledge. The Department had social mobilisation programmes to ensure that everybody knew the importance of immunisation. The Department also conducted periodic campaigns in the media and also stressed the importance of immunisation in its life skills programme in schools. Antenatal services also focused on immunisations. One could not say that enough was done. However, the Department did what was possible, given the resources at its disposal. There was always room for improvement. The Department tried to ensure that everybody had enough information about all child health issues through its Integrated Childhood Illness programme. The Department was also discussing ways of ensuring that communities got involved in health services and took responsibility for their heath.

Mr Masutha felt that the Bill was trying to recreate the Bill of Rights. He felt that clause 15 of the Bill would not assist in the enforcement of the rights. The Bill of Rights was part of the Constitution and was interpreted within the context of the Constitution. The Children's Bill was not part of the Constitution and the rights in the Bill were not an extension of parts of the Bill of Rights. Consequently, the rules around interpretation of the Constitution did not apply to the Bill. It was difficult to imagine how the courts would interpret the Bill. There was a need for discussion on the application and interpretation of Chapter 3 of the Bill. He wondered if it would be clear whether a particular practice was in contravention of the Bill. A question would arise as to who would decide if a conduct contravened the Bill. He asked if one was not putting the community in a dilemma. It was also unclear whether violation of certain rights in the Bill would constitute a crime or whether one would be entitled to civil remedies.

Mr W Morwamoche (ANC) reminded people to distinguish between circumcision and initiation. There might be some confusion because the Bill referred to "circumcision" whilst provincial legislation referred to "initiation".

Ms Mohlabi replied that a solution to the problem posed by cultural practices would not be found overnight. There was a need to engage traditional leaders and healers on this matter. The Department realised the magnitude of the problem and the need to protect children's rights. It was important to come to a solution in a strategic manner and without burning doing away with cultural practices that might benefit children. Section 43 of the National Health Act allowed the Minister to set different standards, conditions and penalties relating to traditional practices. It also defined initiation school and ceremonies. She disagreed with the suggestion that the provision of virginity testing should simply be left out of the Bill.

Mr Masutha said that the National Health Act was more on the right track. Courts gave content to the rights in the Constitution and in line with its provisions. Another way of giving content to rights was to elaborate the specifics of rights in legislation. He cited the Schools Act as an example. The Chapter in the Bill gave broad rights but not the content of the rights. He wondered what legal implications this would have and how the courts would apply Chapter 3. The Bill should have clearly regulated circumcision if it wanted to do so. For instance it clearly outlawed female genital mutilation.

Ms de Klerk said that the Health Act addressed issues of procedure and not cultural aspects. It was important to have discussion on cultural issues.

South African Social Security Agency (SASSA)
Mr Selwyn Jehoma briefed the Committee on the establishment of SASSA (see document attached). The number of people accessing social grants had increased since 1994 from 2.5 million to 9.3 million. With the further extension of grants to children up to 12 years, the number was set to increase. The budget had also increased and it was expected that the Department would spend R51 billion in the next financial year on social grants. Social grants provided real benefits in terms of alleviating poverty and destitution. Contrary to popular beliefs, people were more able to look for work and participate in the labour market if there was someone in the household who was getting a grant.

Discussion
Mr Morwamoche asked if there was any mechanism to check if there were any children who received grants in more than one province. He also asked how the Minister of Social Development was able to roll over huge amounts of money whilst provinces had exhausted their budgets.

Ms F Batyi (ID) said that there was a child who was receiving a grant in two different places in the Western Province. She asked why it was not possible for the provincial government to pick up this issue.

Mr Jehoma replied that the Department knew how many people were getting the grant and how many were supposed to get the grant in Mpumalanga province. It was clear that there were people crossing from northern borders into the province with the intention of getting grants. The Scorpions were investigating this issue. The Department had sent is officials to school districts to ask for names of pupils so that it could compare the information with the number of children in its system. In Mpumalanga parents were asked to bring their children along when collecting grants. A number of parents did not show up or arrive to inform officials that the child had since died. Home visits were conducted in Gauteng and it was established that some parents were still getting grants for children who had died some time ago. Serious initiatives were underway to root out fraud. It was important to note that social security systems across the world were open to corruption and exploitation. When the Department had visited Sweden it was told that the Swedes were honest people. However, an investigation conducted last year revealed that many of them were cheating the system because they were employed but still collecting social grants.

He added that the North West province might have over spent but the Gauteng province had doubled its target from 46 000 to over 100 000 children due to migration from one province to another. Although it might look like under-expenditure in one province, the target was exceeded nationally. The Minister of Finance, during the budget speech, would present conditions for grants that provinces would have to adhere to in the next financial year.

Ms I Mars (IFP) asked what criteria the Department would use in determining who got transferred to the Agency. How far was the process of transferring the grant administration system from the provinces to the Agency?

Mr Waters noted that expenditure on foster care grant (FCG) had increased and this was probably due to the fact that the Department of Justice had given additional personnel to assist Social Development. Research had shown that children were being left destitute as a result of HIV/AIDS related deaths. As a result family members and friends were forced to become foster parents. There had also been a massive uptake of disability grants. People living with HIV/AIDS were receiving disability grants. However, those who were receiving anti-retroviral drugs were not supposed to get the grant because they could lead a normal life and participate in the labour market. Following the establishment of the Agency, there would be a transfer of staff from provinces to the Agency. There were some corrupt officials within the social development system. One would transfer the problem of corruption to the Agency if corrupt officials were also transferred to the Agency. He asked if there was a vetting procedure to ensure that corrupt officials were not transferred.

Mr Jehoma replied that it was initially agreed that the transfer would take place in terms of section 197 of the Labour Relations Act. It was well known that there some corrupt officials within the system. Some of the Department's data interrogation mechanisms were beginning to give names of the corrupt officials. The Minister had given an amnesty and both officials and members of the public were coming to the fore. People were also using the fraud hotline and around 1200 people were reported. Officials were also reporting other officials who were involved in corruption and fraudulent activities. The Department and the Special Investigation Unit would deal with the officials. In addition, the Department had asked the South African Management Development Institute (SAMDI) to retrain some of its frontline staff. It was also implementing a change management strategy to ensure that people's competencies and posts were identified before the transfer to the Agency took place. Those who did not have the necessary competencies would be given other jobs within the social development system.

A process of identifying positions of staff that should be transferred to the Agency had been undertaken and management in five provinces had already signed off some social security staff. A process of financial ring fencing whereby provinces would identify assets and liabilities to be transferred to the Agency, would be completed by April 2005.

On the issue of HIV/AIDS and grants he said that one could not say how many people in each province applied for grants due to ill health. However, this was possible in the Eastern Cape province and the information management system used there would be rolled out to other provinces by April 2005. The system was important because it allowed the Department to see which doctor was more generous when it came to recommending that a person should receive social grants.

The Chair said that there were beneficiaries who had been cut in 1998 and had not received anything since then. She was aware that the Department had allocated some money to address the issue. Temporary beneficiaries presented another challenge. Some of them claimed to be disabled. She asked if such beneficiaries were going back for further check ups.

Mr Jehoma replied that the Department had initiated plans to improve the integrity and delivery of social grants. Provinces were requested to make sure that all temporary grants were reviewed by 1 April 2005. The Department had paid out around R1.9 billion out of the R2 billion to people who were owed by the Department.

Ms S Rajbally (MF) asked what documents one was expected to produce when applying for grants. Were there still people who approached the Department without the required documents? She complained that the waiting period before one could get identity documents from the Department of Home Affairs still posed a challenge.

Ms Mguye replied that an applicant for a grant was required to have an identity document or a birth certificate and proof of income or affividant in cases of those who did not have pay slips. She was aware that some provinces had extra requirements. There would be uniformity once the Agency was fully operational.

Mr Masutha asked if the Population Register was authentic and reliable for the purposes of social security. The Department of Home Affairs had conceded that the only time a person's details were entered into the Population Register was when a person applied for an identity document. This meant that there was no way of verifying the identity of people below 16 years. Consequently, more than one person could apply for a late registration of birth in respect of the same child and access social grants. He was aware that the problem was with the Department of Home Affairs but this was having a negative impact on the Department of Social Development. He asked if there was any makeshift strategy to prevent fraudulent acts by members of the community.

He said that the Bill attempted to bridge gaps. However, it was unclear under what circumstances a person would qualify for a particular grant. He wondered if the Department envisaged a universal grant irrespective of whether one was poor or not. There was virtually no difference between the criteria for accessing the foster care grant and a child support grant if the applicant was not a parent. He asked if this situation would be rectified.

Mr Jehoma replied that the intention was to have a universal child grant system.

The Chairperson said that she had received a complaint by an old lady in Gauteng who had received R32 000 and the Department was claiming it back. It was difficult to see how the lady would be able to repay the money. It was also questionable how the money was paid to her in the first place.

Mr Jehoma could not understand how the money was paid in the first place. There was an instruction to provinces that any amount over R10 000 had to be paid into a bank account. Some officials processed grants for themselves into bank accounts or for beneficiaries and then split the money with the beneficiaries. This person could approach the Department and prove that she had little or no income and the amount could be written off. The Department would not claim the money if it would leave the person destitute.

Mr Morwamoche and the Chair complained about the insufficent accommodation of people with disabilties and referred to the lack of Braille machines and wheelchairs.

Mr Jehoma responded that the Social Security Unit only provided cash grants and not other services.

Dr Mabetoa added that she was aware that the Department was lagging behind accommodating people with disabilities. The Basic Conditions of Employment Act provided that any person with disability in a working environment had to be provided with an assistance device such as wheelchairs. The provincial Departments of social development should be asked what they were doing to assist disabled people.

Ms I Ludwabe (ANC) said that some wheelchairs were in a very bad condition.

Ms Rajbally asked who monitored agents responsible for payments at the pay points. She also asked if the pay points were safe and had adequate facilities such as toilets, seats and fans. She proceeded to highlight that her questions had arisen due to a recent visit to a Pietermaritzburg pay point where safety was found wanting. The Chairperson also highlighted the inadequacy of facilities in deep rural areas and asked how these could be improved. Some people received their pensions under trees or from a shop.

Mr Jehoma replied that at some stage there had been about 7 000 pay points countrywide and the number had grown to roughly 11 500. Improving all these was simply neither feasible nor sustainable. However, all provinces would take steps to improve conditions at pay points. An amount close to R30m was set aside for this purpose. The Agency would monitor progress made by each province in this regard. There were plans in place to improve over 100 to 200 pay points in the next year. Research had been conducted around a whole new payout model and approach. He stated that part of the answer could be paying grants directly into bank accounts, which would make the process safer for individuals. The Department was in discussion with banks on the possibility of having a product similar to but yet different from the Mzantsi account. The Committee would receive further information on this after or during the budget discussion.

The meeting was adjourned.