Question NW1319 to the Minister of Social Development

Reply:

1. All clients seeking to apply for disability related grants are booked at SASSA Local Offices using the Electronic Medical Assessment Statistical Template. Such clients are booked for an assessment at a particular assessment site on a particular date and there is no differentiation between new and existing beneficiaries. Thebooking is to assist the Agency to monitor service demands and monitor the time it takes for clients before they are assessed. As at 29 June 2020, status is as below:

Region	Assessments
Eastern Cape	835
Free State	309
Gauteng	2 553
KwaZulu-Natal	1 632
Limpopo	1 664
Mpumalanga	1 165
Northern Cape	359
North West	4 574
Western Cape	4 945
Total	19 053

2. SASSA strives to ensure that all clients booked are assessed within a month and clients waiting for more than a month are referred to as backlogs.Programme managers are required to come up with innovative measures to address backlogs and avoid the emergence of backlogs. The current numbers have been exacerbated as a result of the lockdown and closure of SASSA Local Offices under level 5; as well as the limited resources at local offices during levels 4 and 3.

3. SASSA implements a hybrid model for disability management, which relies on both contracted medical officers as well as medical officers from Department of Health. The numbers of doctors provided by Department of Health is not a fixed number – it depends on resources available within the various assessment sites.

The total number of doctors contracted directly by SASSA is 475 nationally. The number per province is indicated below:

Region	Contracted doctors
Eastern Cape	28
Free State	44
Gauteng	52
KwaZulu-Natal	134
Limpopo	72
Mpumalanga	27
Northern Cape	80
North West	28
Western Cape	10
Total	475

4. All requests for assessments are captured on the Electronic Medical Assessment Template (EMAST) which flags all clients waiting more than 30 days for an assessment from the date of booking. In such situations programme managers are expected to either add a resource in the form of a doctor, another assessment day within that week or recruit either doctor from other further areas and in certain instance ask for services of doctors from neighbouring provinces.

The backlog has been exacerbated as a result of the lockdown. Limited disability related services at Local Offices have resumed under Level 3 lockdown. A strategy has been developed to progressively resume with the assessment related activities as from 1 July 2020. The ability to provide these services does depend on the ability for assessments to be undertaken, as there is still limited access to health facilities.

The strategy prioritises the following categories of applicants in order of priority:

• Those who were assessed prior to lockdown but who were unable to complete the application process;
• Those who were booked for assessments but could not be seen as a result of the lockdown – these clients will be rebooked for assessments;
• Urgent new applications, where the assessment is already done by the health facility and only the application needs to be done;
• New applications in accordance with available capacity of assessing doctors.

The number of assessments booked per assessment schedule has been reduced to 20 from 40 to ensure compliance with the COVID-19 protocols related to sanitation, social distancing and hygiene.

A particular challenge exists in Western Cape, where the majority of the assessments are undertaken in health facilities. The ability of SASSA to accept new applicants for disability grants is there for seriously, negatively impacted by this. In order to address this, SASSA Western Cape has been granted authority to deviate from normal tender processes by National Treasury to appoint doctors in the George and Boland areas through a closed bidding process by approaching all doctors listed on the HPCSA database as a fairness measure.