2005/6 Audit Reports: Department of Health & National Laboratory Services. Status of South African National Aids Trust: interrog

Public Accounts (SCOPA)

16 February 2007
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Meeting Summary

A summary of this committee meeting is not yet available.

Meeting report


16 February 2007
: Mr TN Godi (PAC)

Documents handed out:


Audio Recording of the Meeting

The Auditor General’s report for the Department of Health raised a number of issues on compliance with the Division of Revenue Act that were interrogated by the Committee. These included late submissions of reports, money transferred before approval of business plans and reports not being submitted. The committee was concerned whether there was adequate monitoring of funds and adequate monitoring in the provinces. It questioned the improvements planned for compliance and whether there would be improvements to the internal audits, as well as plans to combat corruption. The Provincial Departments of Health were asked to deal with the reasons why they were unable to submit their business plans on time, and secondly with their apparent inability to submit the periodical reports on time.

The National Health Laboratory Service had improved, but members of the Committee queried the vacancy rates and staff complement, including that at top management.  Training efforts were noted. The increase in the temporary staff was attributed to the staff who had not yet graduated. The evaluation of the inventory numbers was questioned, as was the recurring problem of properties still requiring to be transferred. The accounting controls on grants had been reported as a problem for a number of years but a model was being sought. The materials framework and the prevention plans were also debated. The register of members’ interests was also discussed. The relationship with the vaccine producers, and the status of the subsidiary companies was explained. The question of bad debts and board salaries were also discussed.

The Director General gave a report on the current position of the South African National Aids Trust, which had inadvertently become dormant through the lack of operation of the South African National Aids Council. It was clear that its role was ambiguous, and there had to be resolution on the status. Whilst there had been expenditure that had subsequently turned out to have had no effect, this was a risk of the contracts.

Department of Health (DOH): Interrogation of 2005/6 Audit Report
Mr EW Trent (DA) asked for comment on the fact that there seemed to be inadequate observance of the Division of Revenue Act (DORA) requirements in respect of monthly reports and monitoring.

Mr Thami Mseleku, Director General, Department of Health replied that as DORA had developed matters had changed and he noted that the 2004/5 and 2005/6 requirements had differed. He said that briefly most of the issues were developmental.

Mr Trent asked whether the Director General was accepting responsibility for the prevalent non-compliance and why there seemed to be inadequate monitoring of whether the funds were used for the intended purposes.

Mr Mseleku replied in the affirmative. He accepted that DOH had not complied with DORA requirements of getting monthly reports from the provinces. Monitoring was regarded as a broad term, and the National office considered that it had done sufficient by requesting the provinces to comply with DORA. For example if they requested a business plan from the provinces, which was then filed by the provincial accounting officer and was in accordance with the conditions and prescriptions of DORA, there was no need to distrust the report. It would of course be more difficult to verify that the amount used for a stated purpose was indeed used for that particular purpose, as this required capacity and the legal means to audit each report.

Mr Trent said that the problem was that the reports and the business plans were not being submitted in the first place. He asked the Drector General why money and grants were being transferred to departments without any approval of the business plans.

Mr Mseleku accepted that indeed it was National Department’s responsibility to approve of business plans before any transfers occurred and the fact that there were grants transferred before approval was not in compliance with DORA requirements. However the difficulty faced was that the DOH essentially worked with people. This human element meant that if a province had started a project such as HIV/AIDS treatment it was difficult to stop it when business plans were not submitted in time. For DOH it was more a question that the patients received the treatment than the issue of plans and figures. However, DOH was aware of the fact that it was contravening the DORA specifications.

The Chairperson asked the Director General to supply the names of the provinces that were prevalently using this apparent blackmail that they could not stop treatment and therefore must get money. These provinces should address the questions themselves.

Mr Mseleku replied that he was aware of some, but he could not specifically recall them now. The Auditor General (AG) had the information.

Mr Trent noted that that whilst SCOPA was aware of the argument that people were dying he was rather concerned that the situation had been going on for a while. He then asked what DOH intended to do to rectify the situation.

Mr Mseleku replied that the particular question centered on the 2004/05 HIV/AIDS grant, which had been around for two years. He added that there had been improvements on the performances of provinces in relation to this particular grant. However, the difficulty lay with the lack of capacity at both national and provincial levels to be able to put together business plans on time, and it also included other administrative matters such as budgets. DOH was, however, thinking of ways to improve the business plans and one of the ways was the suggestion that provinces take more responsibility and accountability.

Mr Trent asked what DOH was doing to ensure that reports were submitted on time, as opposed to the dismal performance of 2006, since these reports helped in monitoring and ensuring that the money was being used according to the prescriptions of the Act. Moreover, he asked what percentage of the health budget and the equitable share were conditional grants.

Mr Mseleku replied that the conditional grants on average were 20% of the whole Health budget. With regard to ensuring that provinces met the time frames DOH has put steps in place. Firstly, it would request the provinces themselves to comply with the DORA framework. Moreover, DOH dealt with the issue on various levels of intergovernmental forums, such as the CFOs’ Meetings, that met about six times a year. During the meetings this issue would be discussed in detail. In addition, the national health committee, consisting of the heads of department and Mr Mseleku, discussed the very issue of compliance. The system was improving.

Mr Trent asked why there were infrequent visits to the provinces. He noted that this might be the reason why the systems being put in place were not working.

Mr Mseleku replied that he believed the substance of compliance had more to do with the nature of interactions he had with the provinces rather than the exact number of flights taken to visit the provinces. For example he would meet the respective provinces on various other platforms, such as the CFOs’ meetings, about 10 terms a year. At this meeting their discussion would certainly be far more in depth than any that could take place during the physical four visits that he was required to undertake on site. In addition, if the province was facing a particular problem and it invited him he would visit the province in order to work it out. He pointed out that the systems were dynamic.

Mr Trent asked whether DOH was monitoring the expenditure of the R4.7 billion allocated to tertiary education adequately.

Mr Mseleku replied that DOH had intergovernmental systems put in place to monitor the grant. However; they monitored it more as a Schedule 4 than a Schedule 5 grant. This grant would be transferred to the provinces and they sent in periodic reports. Nevertheless, DOH was monitoring the grant closely and was even looking at reviewing it with National Treasury (NT).

Mr Trent asked whether he was satisfied that there was compliance

Mr  Mseleku replied that some provinces had complied.

Mr Trent asked whose responsibility it was to monitor the grant, whether this was the responsibility of the provinces, which would then report to him, or if there was direct monitoring.

Mr Mseleku replied that the grant was not monitored directly. Despite this he would guarantee that this was the proper procedure. If the method was not sufficient then approval would not have been given by NT Schedule 4. Moreover, the provinces themselves had systems of monitoring such as the Public Finance Management Act (PFMA) and they had structures that allowed for the accounting officers to account for the grant.

Mr Trent asked whether the committee was going to witness an improvement in the current year in terms of compliance.

Mr Mseleku replied that definitely there would be significant improvements. However, there still were developmental problems.

The Auditor General commented that whilst he noted what was said by the Director General, the AG tended to give more weight to the DORA specifications that were in writing. Hence, he informed the Director General if there was a change in the system there should be amendments to the procedure because the AG would not be able to back up any measures if these were not in the Act 

Mr Trent remarked that the DOH should not have business plans that they did not later adhere to as this caused problems, as had just been noted by the AG.

Mr Trent asked whether all the 1 547posts were funded.

Mr Mseleku replied that some of the posts were not funded.

Mr Trent said that in this case the posts vacancy rate would presumably not give an accurate picture.

Mr Mseleku replied in the affirmative.

Mr Trent asked for the number of posts that were not funded.

Mr Mseleku replied that currently about 20% of them were not funded.

Mr Trent asked whether the current vacancy rate was as bad as last year’s considering that there were some posts that were not funded

Mr Mseleku replied that the situation had improved but DOH noted that in the current market environment it was difficult to acquire the skills.

Mr Trent asked to what extent the vacancy rate was affecting the monitoring of DORA.

Mr Mseleku replied that certainly vacancy did affect the monitoring and the performance because with more people DOH would be able to perform better.

Mr Trent asked whether DOH was going to fill the remaining vacancies.

Mr Mseleku replied that he was confident and would do his best to fill them. Whether he would succeed was a different matter, since some skills, such as pharmacists, were difficult to find.

Mr TJ Bonhomme (ANC) asked the reasons why the internal audit was ineffective and the impact of this.

Mr Mseleku replied that one of the reasons was that there was a high turnover of the interns DOH had hired, who would leave for more lucrative job offers. This had an impact on the performance as DOH were constantly on the look out for the required skills, and even if they managed to acquire them for a while people would not stay long enough for skills transfer so capacity building was stalled. The audit had requested an orgarnogram to discuss the way forward on building capacity.

Mr Bonhome asked whether the audit committee was operational as required for the year 2005/06.

Mr Mseleku replied that the previous audit committee was a problem and as a result it was dissolved. Consequently DOH had made new appointments. The new committee first met in November 2006. Their second meeting was two days ago and it looked like a more promising committee.

Mr Bonhomme asked whether DOH could assure the Committee that there would be active compliance with the PFMA.

Mr Mseleku replied that the audit committee was operative and functional and it did not appear as if it would have the same problems as the previous one.

Mr Bonhomme asked what kind of mechanisms DOH had in place to combat corruption.

Mr Mseleku replied that despite the fact that the Auditor General commented that the internal audit could not be relied on, and that they could not finalize the work because of the delay experienced, the Committee was very strong in some of the strategic areas identified, which included fraud. Since DOH did a number of money transfers it had an increased financial risk and the major risk lay in the area of negative control. DOH was doubling their efforts of vetting the personnel, and would in addition improve and implement the fraud line. It was confident of the audit unit,which had drawn clear lines pertaining to fraud.

Mr Bonhomme asked what steps DOH had taken, in conjunction with the accounting officers, to ensure that the departments produced the performance information as required.

Mr Mseleku replied that this was an area that would take time to improve but DOH was managing to make progress. It was moreover working to build capacity that would help improve the situation. However DOH would like to have more discussions on this area and had visited provinces to help them.

The Chairperson remarked that his assumption was that compliance was a necessary element of producing the required output

Mr Mseleku replied that this was the ideal but that compliance sometimes could be an obstacle to output. That was why there was need to have a balance between the two.

Mr Bonhomme asked whether DOH would  be able to submit all the performance information for 2006/07.

Mr Mseleku replied that to the extent DOH had been able to improve, and thus would be able to submit the information for this year. Although the previous year’s information could be used, it was not 100% accurate as there was still need to improve the verification process. He assured the Committee that he was working on the matter and was confident that DOH was going to improve on the reliability of the data.

Mr Bonhomme asked whether DOH could assure Parliament that it would monitor compliance of the Environment Act.

Mr Mseleku replied that this question presupposed that they had responsibility across the board. However, DOH’s understanding was that it was more an internal issue. Moreover the issue was still very ambiguous and they needed to go back to the Act to figure out their exact responsibility.

Mr Bonhomme asked whether DOH was confident that there would be compliance to the 2006/07 financial issues.

Mr Mseleku replied in the affirmative

Mr Terence Nombembe, Auditor General, remarked that there was a need for a clear management plan that was going to be carried out.

The Chairperson commented that the problem lay with the different interpretations of the Act, which had led to the ambiguous situation where the Health Department was not aware of its position.

Mr Mseleku agreed that it was true since DOH was not sure as to what was their role.

Mr Bonhomme asked whether DOH had a committee for environment coordination, and if they did, whether they reported their plans.

Mr Mseleku replied that DOH did not have an environmental coordinating committee with a focus on environmental health. There was an environmental health committee in the Department of Environmental Affairs and DOH reported to it.

Mr Trent asked why the new concept of supply chain management, which was established two years ago, was still not fully operational and whether this problem was being fixed

Mr Mseleku replied that this was a new area that had just been introduced and DOH was working on improving on it by increasing its in-house capacity

Mr Trent remarked that DOH was taking a long time to do so, considering that it formed part of the legislation, and asked whether DOH thought its policies to be adequate.

Mr Mseleku replied that in his view their policies were adequate.

Mr PA Gerber (ANC) asked the Director General when in July he had signed the report.

Mr Mseleku replied that it was around the same time as the Auditor General had signed. This was probably around 31 July, and he did not know why the date was omitted.

Mr Gerber suggested that the Moratorium Act be extended to doctors who worked in remote or inaccessible areas where no others would be prepared to work. This would basically mean that such doctors who had just finished university and were doing their housemanships would be exempted from repaying a year’s fees or repayments.

Mr Gerber asked why in there had been under expenditure on filling vacancies of about 36.96 % and also why there was a difference between the 2004/5 and 2005/6 advertising allocations, being R7.4 million as opposed to R9.6 million.

Mr Mseleku replied that the 36% would refer to the totality of programmes of human resources. But within the specific area the percentage should be less. As regards the difference in the amounts he would have to give this answer in writing as he was not aware of the reasons immediately.

Mr Gerber asked whether the high vacancy rate was not due to the fact that DOH spent little money on advertising its jobs, as was apparent from the figures.

Mr Msekelu replied that this was not necessarily the case and the vacancies were attributable not to lower expenditure but rather to the unavailability of the skills in the market.

Mr Gerber remarked that the Department’s vacancy rate of 37% of senior management was totally unacceptable. Moreover, the CFO appointment was not yet equated to the higher level of responsibility of a DDG appointment, and he asked whether DOH was working to correct this.

Mr Mseleku replied that DOH was rectifying this.

Mr Gerber asked the DG how much the DOH was spending on diseases that were caused by cigarettes.

Mr Mseleku replied that though he did not have the figure, he could assure the committee that it was a huge amount of money. Those working on the amendments to the tobacco control legislation were directly dealing with the matter and were spending about 30-40% of the health budget.

Mr Gerber asked when DOH would put health warnings on wine labels, as they had promised months ago, considering that it was spending considerable amount of money on wine health related problems.

Mr Mseleku replied that DOH was in the process of finalising the matter and he reassured the Committee that something would be proposed in the first half of the year.

Mr Gerber asked why consultancy work for one day had cost around R11 000.

Mr Mseleku replied that this quotation was the cheapest of three quotations received for the work.

Mr Gerber asked about the other Biovac shareholders, since the Department held 40%, and what the Institute meant when it referred to competitive prices.

Mr Gerrit Muller, Chief Financial Officer, DOH replied that the other shareholders of Biovan Institute stitute were the Biovac consortium that constituted of the Biovac Holdings, the Cuban government and a Trust for disabled people. The competitive prices were derived from a certain process to be followed, would be fixed and declared by the World Health Organisation (WHO). This would then form the basis of the guidelines for the subsequent years and would keep them at competitive prices.

Interaction with the Provincial Departments
The Chairperson thanked the various provincial representatives for coming in on such short notice. His said that the Committee was primarily concerned with the reasons why the provincial departments were unable to submit their business plans on time, and secondy with their apparent inability to submit the periodical reports on time as required by DORA

Mr R Chapman, Acting Head of Department (HOD), Free State Health Department replied that the Free State was among the provinces that had received money before the business plans were approved. There had been a delay caused by a difference of opinion on the business plan with the National DOH. National DOH had wanted to give Free State less money than was allocated, but Free State had called for the full amount. This difference of opinion was informed by the different calculations that occurred. However, this had been rectified this year and the business plan was on target. Free State had ultimately received the full amount. 
Ms S Ngcobe, HOD, Gauteng Health Department replied that his Department were affected by capacity issues which had then not been properly addressed in relation to the monitoring and evaluation. It now had a strategic unit that was not split, and a director responsible for monitoring and evaluation. It was busy making appointments. It had also appointed a corporate service manager at the chief director level, who would assist in monitoring and evaluation. It had also reviewed the system and had come up with an integrated system that would complement the medicomp system and assist to monitor and review the structure. The other issue was in relation to the uptake which impacted monitoring and it wanted to ensure that service delivery was not compromised

The chairperson asked whether the uptake problem was not an indicator of poor planning.

Ms Ngcobe replied that although poor planning was part of the problem the major reason was capacity. Skills such as pharmacists were so scarce that the Department had to look at other partnerships and create a relationship between doctors and pharmacists. Other issues that compounded the problem were unsatisfactory pay. She noted that the Department should not delay service delivery just because they lacked capacity.

Mr J Jooste, Chief Director: Financial Management, Western Cape Health Department replied that as far the HIV/AIDS conditional grant was concerned the business plan was in order. THe HIV grant had caused a few problems in two hospitals but these problems had been resolved.

The Chairperson asked KwaZulu-Natal Department of Health why its business plans were not aligned to measurable objectives and why its objectives were not always met.

Dr B Nyembezi, Head of Department , KwaZulu Natal Department of Health replied that it recognised that the problem was the inadequacy of the structure at the head office of the Department, and so it had reviewed the structure at the head office so as to strengthen it. Without a strong center, there could not be proper direction, and the strengthening would also make it easier to monitor and evaluate. In addition it had appointed a new Chief Director and did not anticipate the problems recurring.

Ms M Thuntsi, Acting HOD, Northern Cape Health Department replied that she had noted the concerns and had listened closely despite the fact she had been only two weeks in her post.

The Chairperson remarked it was apparent that there was instability at the top structures, and this might be part of the problem that was affecting the ground level. Northern Cape had made a substantial number of mistakes.

Ms Thuntsi remarked that she was going to report all the issues that had been raised to the MEC, and the Chairperson asked her to report back on what other measures she would take besides the report to the MEC.

Ms J Dlamini, HOD, Limpopo Health Department replied that everything was in order except for their HIV plan that had not been met because the Department had anticipated the rollout to be faster than it actually was. Limpopo had been able to increase the accredited sites.

Dr E Moloko, HOD, Mpumalanga Health Department replied that its grant was not properly monitored. However, there had been meetings now to monitor and evaluate the grant and appointments were being made.

Mr M Febson, CFO, Eastern Cape Health Department replied that this Department had one major challenge, which was a court case based on the contracts awarded in respect of two hospitals. The problems had caused delays in construction. The challenges to the contracts had finally been withdrawn as they were baseless. The Department was very confident that by the end of the financial year it would have utilized the budget allocation. 

The Chairperson asked why there seemed to be problems with submitting reports on time.

Mr Chapman replied that Free State was one of the provinces that was trying to comply, but had to inform the Committee that the system was difficult and very complex. Moreover, the objectives were too ambitious and the whole system had to be reviewed.

The Chairperson remarked that if the Free State, being one of the provinces that actually complied, was complaining that the system was complicated this was probably the same complaint every other province had. As a result he suggested that it was not necessary for all provinces to respond to the question.

The Chairperson and Mr Trent asked the Director General whether there were improvements in the reporting.

Mr Mseleku replied that the trends showed that there was an improvement in the reporting and this would show in the audit.

The Chairperson remarked that maybe there should be changes in the reporting style which currently appeared too complex.

Mr Mseleku replied that this would have to be done for the next financial year so as not to produce a disjuncture.

National Health Laboratory Service(NHLS): Interrogation of Audit Report for 2005/6
The Chairperson indicated that the Committee had generally been satisfied with the report, except for issues such as conflict of interest. He noted that the NHLS report had improved considerably

The Chairperson asked what was the vacancy rate and the staff complement. He also remarked that NHLS were having problems with attracting and developing and retaining staff.

Mr John Robertson, CEO, NHLS replied that in November 2006 there were about 4 000 NHLS staff but with the integration of KwaZulu-Natal there were now around 5000. He added that when it came to the challenge of vacancies the NHLS did not work on specific posts. They rather looked to the programmes that were being implemented, so that as the programmes were rolled out staff were added. Moreover NHLS were also trying to improve on efficiency to compensate for the shortage of staff. For example it was around 10 to15% short on the number of pathologists needed, and around 20 to 25% short on the number of technologists.

The Chairperson asked about the staff complement and structure of the top management.

Mr Robertson replied that NHLS did not have personnel or skills problems at the top and next level of management. The regional structure was that there were four provinces with a regional manager in charge of each province. They also had Surveillance Services, National Institute of Occupational Health and the National Institute of Communicable Diseases. These positions were filled. There was a business structure with about 45 people, in which 24 were line managers. KwaZulu-Natal was in the process of defining the positions, and the remuneration was at the point of finalisation with the board.

Mr Gerber asked how NHLS were going to deal with the issue that their business was growing rapidly, at 20%, but their staffing was not increasing at a complementary rate. He asked if they had adequate capacity..

Mr Robertson replied that the pathologists were under the control of the NHLS and with a joint effort with medical school there was more training of pathologists. Since the inception of the 4 to 5 year programme they graduated about 34 students. This was a dramatic increase from the previous years. However, as far as technologists went there was a dual function between the Department of Education and the NHLS. In this field there were insufficient graduates and people interested in registering in medical technology. Insofar as access to professions was concerned there was a high failure rate of students and that was the root cause of the shortage. NHLS had tried to work with the universities of technology to try to establish an examination that acted as an exit point that would be acceptable to the Health Professions Council to ensure that students did not go through the process twice.

The Chairperson asked why there was an increase in the temporary staff.

Mr Robertson replied that middle management had just been relocated to the contracts staff. The temporary staff has not been distorted but was only a redefinition of the position. The temporary staff stayed with the department for four years, and upon graduation either they were employed by the NHLS or they went into private practice.

The Chairperson asked whether the question of the evaluation of inventories had been satisfactorily resolved.

Mr Robertson replied that at the end of March 2005 NHLS did not have an inventory number which rolled over to 2006, but at the end of 2006 it had a full inventory of the whole organisation. This was no longer an issue.
The Chairperson asked about the question of title deeds for land and building, as it appeared from the last four audits that there had been no developments.

Mr Robertson replied that he fully anticipated the issue to crop up again in 2007 but it would more likely disappear in 2008. The properties involved were properties in Port Elizabeth, Bloemfontein and Johannesburg which were in the various stages of transfer. This transfer was tied up in the three entities of Departments of Land, Public Works and the NHLC. 

The Chairperson noted that the accounting control on grants had been a challenge to NHLS for the past three years

Mr Robertson replied that NHLS would probably carry this matter also into 2007, but NHLS was currently working with the auditors to try to find a model, and that would be shown in the report.  The grants generally were not funded by the NHLS and the potential grant holders would send out numerous applications to NGOs, governments and other institutions for grants, and often they did not know the status of the applications. However, once the grants were received by the NHLS they were properly disbursed and managed.

The Chairperson noted that for three years running the AG had reported that the materials framework should have been included in the strategic plan.

Mr Robertson replied that in the earlier periods NHLS put in authority levels throughout the organisation, and this had seemed to be effective enough. However, NHLS had finalised a full materials framework at the beginning of this year and this would be approved by 8 March. 

The Chairperson asked why the prevention plans had not been implemented for three years running.
Mr Robertson responded by saying that some issues were caused by inadequate capacity, including the lack of a company secretary. However, one had been appointed last year. He added that the prevention plan was part of the risk management plan and the prevention plan had been held back so that more detail could be included. This was approved last year.

The Chairperson asked if NHLS had adequate capacity to carry out and monitor the full prevention plan.

Mr Robertson said that NHLS had passed some of the mark downs and the final mark downs would be in the middle of this year. It would include exposure, publicity and the rollout of the staff.

The Chairperson asked how it was possible that NHLS had an audit committee that met six times in the year, but for the third year running there was no complete register of members’ interests.

Ms Baloyi, NHLS replied that to a great extent the finalization of the members’ interests register had been a result of the capacity problem that resulted from no company secretary. However, because of the recent appointment NHLS was resolving the issue. It used to use a declaration form. This issue was being prioritized.

The Chairperson asked if she was saying that there were disputes over the declaration form.

Ms Baloyi replied that the situation was not exactly a dispute. Some members, having different views, would argue from different perspectives, which led to a delay in resolution of the issue. It would be resolved. 

The Chairperson asked how much work was completed during the disagreements. 

Ms Baloyi replied that the register was important, and did not believe it should have necessarily been pushed through because it was not core priority

Mr Trent asked if NHLS had a contract now.

Ms Baloyi replied in the affirmative.

Mr Trent suggested that they find about 20 people to sign it.

Ms Baloyi replied that she was not expecting this to be an issue.

The Chairperson asked how NHLS would characterise its relationship with the South African vaccine producers.

Mr Robertson replied that the vaccine producers was a wholly owned subsidiary in the NHLS. The historical background was that the vaccine producing portion was moved to Biovac but the anti venom portion was left with the NHLS.

The Chairperson asked how NHLS characterised the money it gave to its subsidiary. He asked if the funds were loans or grant, and, if they were loans how would NHLS get them back.

Mr Robertson replied that these were loans that were treated like grants.

Mr Trent asked whether a public entity could own a private limited entity.

Mr Robertson and the National Treasury replied that they would give written opinions on this issue.

Mr Gerber asked why the bad debts had doubled and if NHLS could provide details of the services outsourced.

Mr Robertson replied that bad debts were a peculiar problem with an organisation like NHLS that did not deal directly with the patients but came via another entity. In terms of the public sector it did not have bad debts at all. In terms of patients that were private initially or who converted to private, or foreign patients the province and NHLS would each collect their own funds.

Mr Trent asked for elaboration of the board salaries.

Mr Robertson replied that only the board members that were not employed by the government were remunerated and this was based on the number of board meetings and committees they attended.

The South African National Aids Trust (SANAT): Current position
Ms LM Mashiane (ANC) asked whether it would not be wise to transfer trust funds to a less dormant entity.

Mr Mseleku replied that this matter was one that was still under discussion. He however, promised to combat the dormancy of the trust. The major reason for the dormancy was the South African National Aids Trust (SANAC). If this was not an operational body then inadvertently the SAAT became dormant. It was a matter of public knowledge that SANAC was an entity under review and the review was only being finalized now.

Secondly, since the activities of SANAC were related to the review and the development of the national strategic plan a lot of the funding was being used to finalize the programme, such as facilitating sector summits for young people. At this stage they were a number of these related activities. It would not be possible to transfer to SANAC because the trust had been established to assist SANAC. The matter was still under investigation and discussion by the trustees.

The other problem was that the role of SANAC was ambiguous as it was not clear whether it was a forum for programme implementation or it was a forum for sharing ideas. However, this had been reviewed and it was concluded that it could not be given certain authority as it would have to deal with serious bureaucracy and plans. This was nevertheless a still-contested terrain and there would have to be resolution on the status of SANAC before moving on. He said the trust was not properly constituted. It composed of the Deputy President, two Ministers and himself as Direcgtor General, with the deputy minister accountable to him, which did not sit well with co-operative governance.

Ms Mashiane remarked that their expenditure had been wasteful.

Mr Mseleku replied that the decisions taken that led to SANAC and the trust occupying space were properly taken. Unfortunately, when the contract was signed then it was binding and had to run its course. In the process it led to some wastefulness of the funds. The decision, which was supposed to be useful, ended up being wasteful and this was unfortunate.

Ms Mashiane asked about the relationship between the trust and global funds.

Mr Mseleku replied that the trust was an independent trust and had nothing to do with the global fund.

The meeting was adjourned.


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