Department Budget and Strategic Plan: briefing

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Health

14 March 2005
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Meeting report

HEALTH PORTFOLIO COMMITTEE

HEALTH PORTFOLIO COMMITTEE
15 March 2005
DEPARTMENT BUDGET AND STRATEGIC PLAN: BRIEFING

Chairperson:
Mr L Ngculu (ANC)

Documents handed out:
Department Strategic Plan and Budget briefing
Department Medium-term Budget 2005/2006
Department Budget

SUMMARY
The Committee was briefed on the Department's strategic budget plan. It highlighted major achievements such as the near completion of polio vaccination by December 2005; the stabilising number of new HIV infections, and the low number of new cases of malaria. Challenges facing the Department included the rise in tuberculosis (TB) and TB multi-drug resistant cases; the high staff turnover, and the transformation of the Medical Research Council. Members raised concerns about the lack of electricity, water and sanitation at rural hospitals, as well as the health promotion programmes that were not accessible to the illiterate.

MINUTES

Department briefing
Mr T Mseleku, Department Director-General, briefed the Committee on the Strategic Plan based on the strategic priorities for 2004-2009. He provided a summary of progress, challenges, strategic objectives and key activities. March 24 was the World Tuberculosis (TB) Day but the Department would commemorate TB day on the 17 March 2005 instead. The Department would strive to strengthen support services such as the blood transfusion facilities.

Discussion
Mr R Coetzee (DA) asked who owned the 60% shares of Biovac? Which NGOs were funded by the Department, and which ones had defaulted in submitting their audited reports? What was ‘hospital revitalisation’ and what was being done to construct new hospitals?

The D-G replied that the Department had to answer to the Standing Committee on Public Accounts (SCOPA) about the problematic NGO funding. SCOPA had asked the Department what corrective measures had been taken to solve faulty auditing of those NGOs. The Department had been given a month to table a report for SCOPA. The compensation issue would be discussed with the Department of Labour.

The Chief Financial Officer, Mr G Muller, replied that the 60% of Biovac shares were held by its holding consortium, comprised of an international technical partner, a Cuban partner, a Black Economic Empowerment scheme, and a disabled persons’ consortium.

’Hospital revitalisation’ would also include the construction of hospitals, but the provinces would also contribute some resources. He made an example of Nkosi Albert Luthuli Hospital in KwaZulu-Natal that had been built by the province and donors. This partnership would be used by the Department as a pilot on how public-private partnerships could be utilised in constructing new hospitals.

Mr I Cachalia (ANC) asked why the tertiary services grant had stopped in 2005. Mr Mseleku replied that new requirements expected provinces to draft a business plan before transfers could be made.

The Chairperson asked for more details on the HIV/Aids Comprehensive Plan. The D-G replied that the comprehensive plan was very broad and included treatment, home-based care, vaccine research and the Khomani project

Ms Rabinowitz (IFP) asked which HIV/AIDS NGOs were funded, how the Department allocated funds, and what criteria were used when selecting NGOs. Why was the US$2 million from the Global Fund administered by the provincial government of KwaZulu-Natal, instead of the NGOs that applied for it? Who was responsible for conditional grants and how were they allocated? What had been the cause of delay on the procurement of antiretroviral drugs? Was there any obligation on the part of the winning company to ‘plough back’ through social responsibility? What was the role of the internal Audit Committee?

The D-G replied that for NGOs to qualify for funding, they had to operate in at least three provinces. After the initial screening, the Department would meet the boardmembers and visit the NGO’s areas of operation for site visits. A committee from the Social Development and Health Departments, as well as other NGOs, would then make a decision. The funded NGOs would be evaluated and monitored on regular basis. Companies already operating in South Africa were not expected to plough back because they had already invested in this country. The investment part was meant for companies that wanted to produce their goods in another country and ship them here. The Department wanted the foreign company to build capacity in the country or partner with a domestic company for skills transference and job creation.

The Audit Committee’s role was to ensure that correct systems were followed when books were audited. Skills shortages was a problem as the private sector offered better salaries for skilled auditors. Government departments were also ‘poaching’ from each other.

Mr S Njikelana (ANC) recommended that the Department supply quarterly reports or establish a web page that would supply regular reviews. He then asked about the rate of staff turnover and its impact on services and staff morale. What were the problems with the statutory bodies like the Medical Research Council? What was the current role of the National Health Act? What were the other problems with the Department Auditing Committee? Which hospitals were to undergo the revitalisation programme in KwaZulu-Natal? Nothing had been happening in the hospitals he had visited, for example Prince Mshiveni Hospital in Durban.

The D-G replied that Audit Committee meetings were linked to the D-G’s diary. As a result, Audit Committee meetings were not taking place because the D-G’s diary sometimes change at the spur of the moment. The Chairperson of the Audit Committee would meet with the Director of Auditing to iron out any problems. Some provinces had not received their allocated conditional grants for the Hospital Revitalisation Programme, including KZN. The clusters would try and fit their briefings according to the programme of the Committee.

High staff turnover had impacted on service delivery but there had still been an improvement in service delivery. District and provincial variances often depended on hospital managers as well. The Free State offered some of the leading health centres in terms of service delivery. The quality of management positively or negatively reflected on service. The Department was in the process of analysing the causes of turnover and low staff morale. The survey results would be reported to the Committee in due course.

The D-G replied that transformation of the statutory bodies needed to be addressed because they were faced with internal problems. They needed an enabling legislative framework for transformation to be successful. The National Health Act was an enabling tool for the regulation of certain areas of transformation.

Ms M Madumise (ANC) asked what measures had been taken to address the skills shortage within the Department. He also asked why TB infection was on the increase.

The D-G replied that some people would sometimes cease to consistently take their TB treatment drugs. The patient might then develop ‘multi-drug resistance’. He added that the Department had been refining and reviewing skills development to address the turnover rate.

Ms N Nkabinde (UDM) asked why, if 5.3 million people were infected with HIV, the Department had not made AIDS a notifiable disease. The D-G responded that people living with HIV/AIDS (PLWHAs) felt that it was harmful to make it a notifiable disease because of the stigma attached. Many felt notification would lead to the social isolation of PLWHA.

The Chairperson asked what had been done to electrify and provide water and sanitation in rural hospitals.

Mr Njikelana asked what had been done to ensure that illiterate people had access to health promotion. What was the role of the National Complaints Centre?

The D-G replied that the FOSAD cluster was co-ordinating efforts to providing water and electricity in rural hospitals. Health educators would have to research appropriate programmes that could be used to reach illiterate citizens. The National Complaints Centre was following up on complaints regarding the health sector. The Centre had to sort out problems with the help of provincial officials within three weeks after the complaint. All provinces were co-operating thus far, except the Eastern Cape.

The meeting was adjourned.

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