Question NW3065 to the Minister of Health

Reply:

a) As the Department we understand Red tape as set of processes/ systems that requires excessive formality or routine to perform or execute functions that impediments the department to achieve its set objectives within a reasonable time period.

b) (i) The department holds monthly management meetings to address all challenges faced by the department. Furthermore, there are Forums in place and functional i.e. Chief Financial Officers Forums, Technical Advisory Committee to National Health Council and National Health Council.

(ii) (aa) (bb) (aaa) The Department has approved policies in place and fully implemented, are in line with national policies and regulations. The department has management tracking system register in place and fully functional to track and reduce the red tapes.

The public entities reporting to the Minister of Health defines red tape as follows:

• The Office of Health Standards Compliance: excessive regulation of external stakeholders (health establishments) and internal business operations which hinders flexibility in the business operations of the regulated stakeholders and internal business operations of the entity.

• The National Health Laboratory Service: excessive regulation and bureaucratic practices which hinder timeous decision making.

• The South African Medical Research Council: there is no legal / public policy instrument that gives an official meaning to the concept of “red tape”. However, the general understanding is that the concept would refer to an “unnecessary delay”.

- The Council for Medical Schemes: excessive regulation as well as rigid conformity to formal policies and procedures and as bureaucratic processes between the entity and the Executive Authority.

(b) (i) The specific interventions and/or (ii) systems implemented to identify (aa) and (bb) reduce red tape in the (bbb) entities reporting to the Minister of Health are as follows:

• The Office of Health Standards Compliance (OHSC): Regulates health establishments in the country through regulations which get processed for promulgation by involving stakeholders through publication of the draft regulations for public comments to identify through comments received, any provisions in the draft regulations which may be considered Red Tape by stakeholders. Review of the comments received provide the OHSC an opportunity to identify and reduce “red tape” by ensuring that provisions in the regulations allow for flexibility in how the regulated stakeholders conduct their business, but without compromising on the compliance requirements (public protection) to ensure quality in the provision of health services by health establishments.

Internally OHSC also has policies in place which provide guidance in terms of how decisions should be made to avoid “red tape”. The policies go through a rigorous process of review by OHSC governance structures (Management and Board Committees) before approval by the Board as the ultimate Accounting Authority. This review process is meant to ensure that any provisions in the policies of the entity which may be considered “red tape” are identified and reduced by considering flexible ways for decision making. The OHSC has a delegation of authority policy which also assists in dealing with “red tape” by ensuring that operational decisions are left for management to take and that only strategic decisions are reserved for the Board.  

• The National Health Laboratory Service (NHLS): The NHLS Board has clear mandate as outlined in the NHLS Act and Board Charter. These instruments allow the Board and Executives to make decisions within the confines of the delegated powers and authority. Issues requiring Ministerial approval are referred to the Department in writing and feedback is received timeously.

• The South African Medical Research Council (SAMRC): Due to the lack of legal / authoritative premise to support the concept, the SAMRC does not have a standing policy on identifying “red tape”. However, the SAMRC has the internal policies that guide it on delivering its mandate and engagements with other health / science cluster entities or with the ministry or the departments.

In particular, among others, the SAMRC uses the following processes to ensure that no unnecessary delays result from any of the SAMRC processes:

• A review of the key processes to identify bottlenecks and areas that can be improved from an efficiency perspective without compromising compliance with the relevant legislation; and
• Feedback from customers and staff.

The following interventions have been introduced to reduce delays”:

• Automated processes wherever possible to speed up transaction times and reduce manual intervention;
• The coordination of key processes in a shared services environment to ensure processes are consistent and as efficient as possible;
• Automated help desks in areas such as IT, facilities, finance and supply chain management to enable staff and customers to communicate problems quickly and enable their resolution to be tracked; and
• Service level agreements for departments with target turnaround times for services provided which are tracked and published to staff and customers.

Laws such as the Inter-governmental Relations Framework Act, existence of the Research Ethics Committee as well as the Significance and Materiality Framework agreed between the SAMRC and the Ministry of Health in terms of the Public Finance Management Act, form part of the regulatory regime the SAMRC utilises to manage its engagements.

• The Council for Medical Schemes (CMS): The CMS develops Memorandum of Understanding with entities it works with and departments within the CMS, this allows for more efficient processes to be followed. Policies and procedures are presented to the different governance structures within CMS where the policies are interrogated to ensure that they are not cumbersome and that CMS is able to carry out its mandate with minimal amount of “red tape”, it allows for flexibility without compromising CMS in terms of compliance with relevant legislation. Through its risk management process CMS is able to identify key areas where there are delays in processes that may hinder CMS in executing its mandate. Automated processes e.g. Real time monitoring of schemes financials have been introduced to stakeholders to allow for submission of regulatory information with as little “red tape” as possible. CMS deals with the Executive Authority through the office of the Health Regulation and Compliance division at the National Department of Health (NDoH) and further a task team has been established between CMS and NDoH in order to promote communication to avoid unnecessary “red tape”.

END.