Questions and Replies

Reply:

The Tribunal outcomes were issued to the Accounting Officer of OR Tambo District Municipality. No steps will be taken against the municipal officials by the National Treasury as the National Treasury does not have jurisdiction in the disciplining of any organ of state employees or officials. OR Tambo District Municipality will be required to take action against any transgressions of its employees.

The National Treasury are able to monitor to ensure that necessary actions are taken against the implicated officials.

Reply:

First, proposals to address a broad public policy on dealing with wage gaps in industry, were developed and drafted into legislation, in the form of a Companies Amendment Bill, 2021 (the Bill)

Second, these proposals were discussed with social partners in Nedlac, where the principle of disclosure of the wage gaps and responsibilities assigned to shareholders, were agreed

Third, Cabinet was briefed on the proposed changes

Fourth, the proposals were published for public comment.

The public comments are currently being considered and in the Department’s Budget Vote this year, I indicated that the anticipated timeframe for the Bill be submitted to Cabinet for consideration, which is within the next three months.

-END-

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Reply:

(1) The following table reflects the details in this regard:

Year	Measles 1st dose		Measles 2nd dose
(a)	2019	966,002	84,1%		920,084	80,2%
(b)	2020	974,179	84,8%		888,383	77,2%
(c)	2021	1,000,082	87,5%		939,138	82,2%

(2) The following table reflects the details in this regard:

PROVINCE	MEASLES	2019	2020	2021
Eastern Cape	1st dose	115,357	111,609	114,320
	2nd dose	118,254	108,060	110,055
Free State	1st dose	41,999	43,710	44,670
	2nd dose	38,634	38,721	39,406
Gauteng	1st dose	228,967	224,802	234,553
	2nd dose	203,020	197,829	218,545
KwaZulu-Natal	1st dose	208,524	208,825	213,695
	2nd dose	216,419	213,090	223,628
Limpopo	1st dose	113,671	121,443	114,731
	2nd dose	102,155	103,199	101,441
Mpumalanga	1st dose	78,956	81,911	94,505
	2nd dose	82,248	73,931	83,496
Northern Cape	1st dose	21,038	19,875	20,802
	2nd dose	18,404	17,596	18,007
North West	1st dose	57,099	57,225	57,624
	2nd dose	54,368	49,922	55,187
Western Cape	1st dose	100,391	104,779	105,182
	2nd dose	86,582	86,035	89,373

(3) The Department is implementing four streams of the primary health care (PHC) re-engineering which contribute to the increase in uptake of measles vaccination, namely, PHC Ward-Based Outreach Teams (WBOTS), Integrated School Health Programme (ISHP), the District Clinical Specialist Teams (DCST) and contracting of private healthcare providers. Each of the streams significantly contribute to the immunisation program in the following ways: the WBOTS have a potential role in defaulter tracing. ISHP provide immunisation catch-up at schools to increase coverage. The DCSTs have a role to play in clinical governance (ensuring implementation of all policies and guidelines). The private healthcare providers help in identifying and referring children who have missed immunisation doses.

In order to address long-standing inequities in immunisation access thereby reducing the number of zero-dose children, the Department of Health is implementing the followings:

• Reach Every District (RED) Strategy to reduce missed opportunities in childhood vaccination uptake. The RED Strategy emphasizes important areas for vaccination uptake in the country: (1) reducing inequity in immunisation coverage, integration of health services, delivering vaccines beyond infancy using a life course approach, focusing on urban, poor and marginalized populations, and paying special attention to poor performing districts.
• Under-5 Side-by-Side campaign by the Department that ensures all children survive and thrive, by improving coverage of key promotive, preventive and curative interventions with inclusive of measles vaccination and childhood vaccination in general. Five key themes of under-five are: (1) good nutrition to grow and be healthy; (2) love, play and talk for healthy development; (3) protection from preventable childhood illnesses and injuries; (4) health care for sick children and (5) special care for children who need a little more help. This campaign also focuses on the supportive relationship between child and caregiver, as well as the relationship with practitioners, including health-care workers, who help and advise the caregiver
• In November 2020, the country intensified immunisation catch-up drive in all districts. The catch-up drive reduced number of zero-dose children from 125,923 in 2020 to 104,153 in 2021. The delivery of both routine and catch-up immunisation doses forms part of a coordinated effort to improve access to high-quality, affordable primary health to achieve universal health coverage and accelerate progress towards the 2030 Sustainable Development Goals (SDGs)
• The country as a member state of the global community has endorsed the global Measles and Rubella Strategic Plan (MRSP) 2021 - 2030 which outlines guiding principles that provide a foundation for all measles and rubella control efforts. The Department is using this strategic plan as a guiding principle to secure the commitment and action required for a country free of measles transmission. In line with global measles strategy, the Department has endorsed international measles coverage target of reaching 90% of children with both 1st and 2nd dose in all districts to reach desirable population immunity levels. As part of implementing Global Measles and Rubella Strategic Plan, the Department together with NICD implement Integrated Disease Surveillance and Response (IDSR) system. The system makes case-based surveillance and laboratory data more usable and strengthen outbreak response measures at all levels of healthcare. Through implementation of IDSR, the country is utilising Notifiable Medical Conditions Surveillance (NMC) Application (NMC APP) for mobile devices. The NMC App enable healthcare practitioners to promptly report NMCs for appropriate and timely public health response. The IDSR uses outbreaks as an entry point to identifying unvaccinated communities and strengthening immunisation system.
• The Department is also using Stock Visibility System (SVS) that enables the electronic communication of medicine availability data from PHC level into upstream electronic stock management systems. The SVS helps to monitor availability of vaccines in facilities and expedites vaccine deliveries to prevent stock outs.

(4) The following table reflects the details in this regard:

PROVINCE	MEASLES	2019	2020	2021
Eastern Cape	1st dose	80.3%	80.1%	85.2%
	2nd dose	82.3%	77.2%	80.9%
Free State	1st dose	78.6%	83.3%	87.3%
	2nd dose	72.3%	73.5%	76.4%
Gauteng	1st dose	89.4%	86.5%	89.5%
	2nd dose	79.1%	75.9%	83.4%
KwaZulu-Natal	1st dose	83.3%	82.5%	83.9%
	2nd dose	87.1%	84.9%	89.0%
Limpopo	1st dose	85.7%	93.4%	90.4%
	2nd dose	76.7%	78.5%	78.6%
Mpumalanga	1st dose	83.7%	85.6%	97.9%
	2nd dose	87.6%	77.8%	87.7%
Northern Cape	1st dose	82.8%	77.5%	80.8%
	2nd dose	73.0%	69.2%	70.8%
North West	1st dose	70.9%	70.6%	71.1%
	2nd dose	67.7%	61.9%	68.7%
Western Cape	1st dose	89.5%	94.0%	95.5%
	2nd dose	76.8%	76.6%	80.3%

END.

Reply:

(1) (a) Currently, Mental Health Nursing, also known as Psychiatric Nursing Science is offered either as a subject or as a module in a comprehensive programme, or as a stand-alone specialist programme. It is offered in the following ways:

(i) As one of the subjects of the legacy four-year Diploma in Nursing (General, Psychiatric & Community) and Midwifery (R425) that is currently being taught out in public nursing colleges. All 9 public nursing colleges are currently teaching out the R425 diploma programme, which is being taught at their 31 campuses.

(ii) As one of the subjects of the legacy four-year Degree in Nursing (General, Psychiatric & Community) and Midwifery (R425) that is currently being taught out in universities. There are currently 17 universities that are teaching out the R425 degree programme.

(iii) As part of the modules for the new 3-year Diploma in Nursing. To date, 6 public nursing colleges are offering the R171 programme in 24 campuses, whilst 1 university is offering the programme.

(iv) As part of the modules for the new 4-year Bachelor’s degree in Nursing and Midwifery (R174). To date, 19 universities are offering this programme. 1 college has been accredited for this programme but is not yet offering it.

(v) As a new specialised postgraduate diploma programme (PGD) in Mental Health Nursing). To date, 2 universities have been accredited to offer this programme. 1 college has been accredited for this programme but is not yet offering it.

(b) Table 1 below illustrates the total number of mental health care training facilities in the Republic and in each province.

Table 1: The total number of mental health care training facilities in the Republic and in each province

No.	Province	Number of institutions offering the Mental Health Nursing (Psychiatric Nursing) programme per programme
		R425 diploma	R425 degree	R171 diploma	R174 degree	Postgraduate Diploma in Mental Health Nursing
1	Eastern Cape	5 college campuses	3 universities	Not yet offering	3 universities	None
2	Free State	3 college campuses	1 university	3 college campuses	1 university	None
3	Gauteng	3 college campuses	5 universities	4 college campuses	5 universities	None
4	KwaZulu-Natal	10 college campuses	3 universities	11 college campuses	3 universities	None
5	Limpopo	3 college campuses	2 universities	Not yet offered at college; 1 university	2 universities	None
6	Mpumalanga	1 college campus	None	1 college campus	None	None
7	North West	2 college campuses	2 university campuses	2 college campuses	2 university campuses	None
8	Northern Cape	1 college campus	None	Not yet offering	None	None
9	Western Cape	3 college campuses	1 university	3 college campuses	3 universities	2 universities
TOTALS IN THE REPUBLIC	31 college campuses	17 universities	24 college campuses, 1 =university	19 universities	2 universities

(2) The outdated criteria for nursing cover for Psychiatric Nursing Science subject in the R425 programme offered by both nursing colleges and universities entailed the following:

• Nursing patients of different age groups receiving treatment in a psychiatric hospital, psychiatric unit or psychiatric community service, on both short term and long-term basis.
• Executing a nursing regimen to ensure continuity of nursing for a meaningful number of the above patients – both short-term and long term. Before being implemented, the nursing plan for each patient shall be approved by the registered nurse responsible for the nursing regimen for the patient.
• Conducting group sessions/activities, taking cognisance of cultural differences/preferences where relevant.
• Conducting therapeutic interactions for evaluation purposes.
• Developing an assessment and plan care for a patient who is being cared for in the community and who requires psychiatric nursing.
• Recognising a crisis situation and applying appropriate crisis intervention skills, timeously referring to appropriate members of the multidisciplinary team and/or appropriate support systems.
• Nursing care of a mentally retarded person in a care and rehabilitation centre or any other institution for the care of mentally retarded persons, or of a family with a mentally retarded member.

(3) (a) In the new nursing programmes, Mental Health Nursing is covered in modules in the 3-year Diploma in Nursing (R171), modules in the 4-year Bachelor’s Degree in Nursing and Midwifery (R174), as well as a speciality Postgraduate Diploma in Mental Health Nursing programme.

(b) The new programmes mentioned in (a) cover mental health service demands in the following ways:

(i) The 3-year Diploma in Nursing (R171):

• Psychology and Sociology are applied in ways which benefits the quality of healthcare delivered to health care users.

• Knowledge of human behaviour and psychological development throughout the life span is applied.

• Students implement social and diversity-sensitive care in nursing practice.

• A range of psychological emergency situations are identified and managed accordingly.

• Emotional demands of nursing practice are dealt with effectively.

(ii) The 4-year Bachelor’s Degree in Nursing and Midwifery (R174) has modules that deal with the following aspects pertaining Mental Health:

• Development of individualised plans that reflect comprehensive and integrated assessment of mentally ill persons,

• Understanding of common emotional and behavioural disorders, as well as major psychiatric disorders (perceptual and severe mood disorders).

• Execution of nursing interventions and therapeutic management of mentally ill persons utilising accepted psycho-social techniques.

• Providing support provided to patients recovering from mental health illness in preparation for discharge in ways that enable the patient, family and significant others to cope with the management of the patient at home.

(iii) Post-Graduate Diploma (PGD) in Mental Health Nursing is a standalone specialised programme on Mental Health Nursing that covers the following aspects:

• Rendering and co-ordinating of patient-centred mental health nursing within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology.

• Mobilising appropriate resources to implement mental health standards of practice, to ensure quality patient care and safety.

• Collaborating within the inter-professional team by engaging in health dialogue, shared leadership, decision-making and sound clinical judgment aimed at better mental health care outcomes.

• Participating in the design, development, implementation and evaluation of nursing policies, programmes and projects related to mental health nursing.

END.

Reply:

1. Government is extremely concerned about the killing of traditional leaders, I have requested the Minister of Police to put together a team to investigate this matter. We have also raised the matter with the Kwa-Zulu Natal CoGTA and they have advised that they are collaborating with law enforcement agencies. A number of interventions have been effected including entering into a Memorandum of Understanding (MoU) with the Department of Community Safety and Liaison and the Provincial House of Traditional and Khoi-San Leaders, hosting of Imbizo’s in all eleven (11) Districts and a Provincial Imbizo to listen to the views of traditional leaders and reporting this matter to the Justice Crime Prevention and Security Cluster (JCPS) and the KwaZulu-Natal Provincial Executive Council that has directed that the Provincial Priority Committee on Chieftaincy be re-established as a sub-committee of the Provincial Joint Operational and Intelligence Structure and further that the incidents of killings of traditional leaders be filtered within the Provincial Peace and Stability Strategy.

(2) A Commission of inquiry has not been established; however, a number of interventions have been put into place including the establishment of the Community Safety Intervention Unit within the Department of Community Safety and Liaison to primarily deal with these violent crimes.

(3) The Provincial Department has advised that a total of twenty-six (26) arrests have been made.

Reply:

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Reply:

The National Disaster Management Centre each year monitors legislative compliance to the Disaster Management Act, 2002 (Act No. 57 of 2002) in all Provincial Disaster Management Centres (PDMC) and two Municipal Disaster Management Centres (MDMC) located in each province. These assessments are done with the PDMC and then feedback is provided immediately on key issues that have been identified.  Provinces and each municipality to ensure that they comply with the requirements of the Disaster Management Act, 2002 (Act No. 57 of 2002), including to develop and implement a comprehensive disaster management plan. The District Development Model (DDM), presents an opportunity that, in the context of “Joint One Plans” and  “One Budgets”, organs of state and institutional role-players will be able to coordinate and align the implementation of their disaster (risk) management plans within each District and Metropolitan space across the country.

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Reply:

(a) The Minister met with both the management of Sibanye-Stillwater and Labour representatives and emphasized the importance of them reaching an amicable solution.

(b)(i) The Department cannot give any guarantees in this case as the relationship between Employer and Employee is governed by both the Labour Relations Act and Basic Condition of Employment Act, and both are the competency of the Department of Employment and Labour.

(ii) The competent authority to respond to these questions is the Department of Employment and Labour.

Reply:

a) The core business in the health sector is born in health services as provided by health professions that requires various skills mix to respond to the burden of diseases in South Africa. In response to the question, the following critical skills that are required in majority numbers were concentrated on (i.e. Medical Practitioners Categories, Nursing Categories, Pharmacists and Emergency Medical Services)

(i) The table below indicate the total identified critical skill personnel per province

Critical Skills employed per Province - All citizenship categories as at May 2022
	Eastern Cape	Free State	Gauteng	KwaZulu Natal	Limpopo Province	Mpumalanga	North West	Northern Cape	Western Cape	Grand Total
NURSE CATEGORIES	20327	7158	31255	34714	16525	10256	9866	2618	13735	146454
EMS / PARAMEDICS	264	194	351	335	238	79	156	57	330	2004
MEDICAL PRACTIONER	2208	1116	6271	4639	1510	1227	1307	437	3400	22115
PHARMACIST	417	151	538	803	567	315	312	109	319	3531
Grand Total	23216	8619	38415	40491	18840	11877	11641	3221	17784	174104

 

(ii) A total of South African Citizens health professionals trained locally and employed in critical skills categories per provinces:

Critical Skills employed per Province - South African Citizenship as at May 2022
	Eastern Cape	Free State	Gauteng	KwaZulu Natal	Limpopo Province	Mpumalanga	North West	Northern Cape	Western Cape	Grand Total
NURSE CATEGORIES	20304	7143	31180	34687	16510	10237	9837	2614	13693	146205
EMS / PARAMEDICS	263	194	351	335	238	79	156	57	329	2002
MEDICAL PRACTIONER	2020	985	5643	4338	1402	1139	975	339	3266	20107
PHARMACIST	404	139	511	781	558	303	291	103	313	3403
Grand Total	22991	8461	37685	40141	18708	11758	11259	3113	17601	171717

*Data source is PERSAL System extracted on May 2022

(iii) Other citizenship critical skill categories sourced from Countries

Critical Skills employed per Province - Other Counties as at May 2022
	Eastern Cape	Free State	Gauteng	KwaZulu Natal	Limpopo Province	Mpumalanga	North West	Northern Cape	Western Cape	Grand Total
NURSE CATEGORIES	23	15	75	27	15	19	29	4	42	249
EMS / PARAMEDICS	1	0	0	0	0	0	0	0	1	2
MEDICAL PRACTIONER	188	131	628	301	108	88	332	98	134	2008
PHARMACIST	13	12	27	22	9	12	21	6	6	128
Grand Total	225	158	730	350	132	119	382	108	183	2387

*Data source is PERSAL System extracted on May 2022

b) The following data indicates the countries the specified personnel come from.

Critical Skills employed per Province - Other Counties as at May 2022
	Eastern Cape	Free State	Gauteng	KZN	Limpopo	Mpumalanga	North West	Northern Cape	Western Cape	Grand Total
ANGOLA			1	3						4
ARGENTINA				1						1
ARUBA			1							1
AUSTRALIA			1	1					1	3
AUSTRIA		1							1	2
BANGLADESH	1	1	1	9	2		3			17
BELGIUM	1		5	3	1	1			2	13
BOTSWANA	4	3	29	2	6		20	2		66
BRITISH INDIAN OCEAN TERRITORY	1					1				2
BULGARIA				3		1				4
BURKINA FASO									1	1
BURMA	1			1						2
BURUNDI				2					5	7
CAMEROON	1	1	8	1	2			1	4	18
CANADA			1	1	1				1	4
CENTRAL AFRICAN REPUBLIC	1	1		1			1			4
CHILE			1							1
CHINA			5	2						7
COLOMBIA					1					1
COOK ISLANDS			1					2		3
COSTA RICA			1	1						2
COTE D_LVOIRE			2	1						3
CROATIA			1							1
CUBA	20	21	22	15	24	16	40	27		185
CURACAO					1			4		5
CZECH REPUBLIC									1	1
DENMARK			1							1
DOMINICAN REPUBLIC		1	1							2
EAST GERMANY	1			1						2
EGYPT	1		2		1		1			5
ENGLAND	3		1	2					10	16
ERITREA			4	1			1			6
ETHIOPIA		1	3	1	2		1		1	9
FRANCE	2		1	2						5
FRENCH GUIANA					1		1			2
FRENCH SOUTHERN TERRITORIES			1							1
GABON			1							1
GEORGIA					1					1
GERMANY	2		1			1	1		2	7
GHANA	10		6	6	1				1	24
HONG KONG						1				1
INDIA	18	6	37	14	10	3	14		3	105
INDONESIA			1							1
IRAN:ISLAMIC REPUBLIC OF			6	1	1	3	3		1	15
IRAQ				1						1
IRELAND						1			1	2
ITALY	1		1							2
JAMAICA					1					1
JAPAN				1						1
KENYA	6		12	4	1	1	7	1	2	34
KOREA(NORTH)		1	1		1					3
KOREA(SOUTH)	2		1	1			2		4	10
LEBANON			1							1
LESOTHO	6	34	18	6	5	1	12	1	3	86
LIBERIA				2						2
LIBYA	4	1	1	6		1	7			20
MALAWI		2	8	4	3		2		3	22
MALI			1							1
MAURITANIA			1							1
MAURITIUS	2		6	5	1		1		7	22
MEXICO			1							1
MOZAMBIQUE			9	1		2	2			14
NAMIBIA	2	1	9	4	4	1	3	2	5	31
NEPAL						1				1
NETHERLANDS	1			1			1		7	10
NEW ZEALAND									1	1
NIGER							1		1	2
NIGERIA	36	14	66	45	14	26	33	9	18	261
NORWAY			1							1
PAKISTAN	6		8	2			1	1	1	19
PALESTINE: STATE OF		1								1
PHILIPPINES	2									2
POLAND					2				1	3
PORTUGAL			2							2
QATAR							1			1
REPUBLIC OF CONGO	42	37	266	87	9	13	152	44	36	686
ROMANIA			2							2
RUSSIAN FEDERATION			1							1
RWANDA		2	2	7	2	1		1	10	25
SCOTLAND								1		1
SENEGAL			1							1
SOMALIA	2									2
SOUTH SUDAN					1		1			2
SPAIN			1	2	1					4
SRI LANKA							1			1
SUDAN			4	1		1	1			7
SWAZILAND	2	3	16	6	2	10	2		1	42
SWEDEN									1	1
SWITZERLAND			1						1	2
SYRIAN ARAB REPUBLIC				1						1
TAIWAN	1			1						2
TANZANIA	2		1	1			2			6
TOGO							1			1
TUNISIA	2	4	1	13		7	6	3		36
TURKEY					1					1
UGANDA	7		9	7	2	2	3		1	31
UKRAINE		1				1	2		1	5
UNITED KINGDOM			3	5					5	13
UNITED STATES OF AMERICA	4		3	1					3	11
URUGUAY			1							1
USSR			3	1	2					6
WEST GERMANY		1	3	1					3	8
YUGOSLAVIA			1							1
ZAIRE	3	6	8	2			5	3	1	28
ZAMBIA	2		8	7	3	5	7		4	36
ZIMBABWE	23	14	102	49	22	18	40	6	28	302
Grand Total	225	158	730	350	132	119	382	108	183	2387

*Data source is PERSAL report extracted in May 2022

c) The following is the current vacancy rate of critical skills in each province.

Critical Skills employed per Province - Vacancy rate as at May 2022
	Eastern Cape	Free State	Gauteng	KwaZulu Natal	Limpopo	Mpumalanga	North West	Northern Cape	Western Cape	Overall % Vacant
NURSE CATEGORIES	15.38	10.13	20.40	29.33	8.51	3.74	5.94	2.02	4.57	15.47
EMS / PARAMEDICS	10.72	11.60	49.21	8.96	3.69	0.53	5.27	1.76	8.26	28.39
MEDICAL PRACTIONER	8.42	13.58	16.15	23.95	20.97	3.12	4.21	2.40	7.19	16.22
PHARMACIST	13.76	8.56	10.40	16.51	25.99	4.89	11.31	2.75	5.81	9.26
Grand Total	14.34	10.59	20.32	28.04	10.26	3.60	5.76	2.07	5.01	15.59

*Data source is PERSAL report extracted in May 2022

 

d) The breakdown of the type of critical skills shortages in each province is as follows:

Vacant Posts in the Public Health Sector
JOB TITLE	Eastern Cape	Free State	Gauteng	KwaZulu Natal	Limpopo Province	Mpumalanga	North West	Northern Cape	Western Cape	Grand Total
NURSE CATEGORIES	3484	2294	4621	6644	1927	847	1346	457	1035	22655
EMS / PARAMEDICS	61	66	280	51	21	3	30	10	47	569
MEDICAL PRACTIONER	302	487	579	859	752	112	151	86	258	3586
PHARMACIST	45	28	34	54	85	16	37	9	19	327
Grand Total	3892	2875	5514	7608	2785	978	1564	562	1359	27137

Data source is PERSAL report extracted in May 2022

END.

Reply:

a) (i) The Council for Medical Schemes (CMS) regulates medical schemes, and in terms of the Medical Schemes Act 131 of 1998, any entity that conducts the business of a medical scheme must be registered with CMS. Insurance companies that were previously offering primary health care products as insurance products are prohibited by the Demarcation Regulations from doing so, as primary health care products are no longer regarded as insurance products but products doing the business of a medical scheme. This has been in effect from 1 April 2017. These insurance companies could not afford to immediately convert into medical schemes due to the nature and pricing of insurance products as opposed to those for pricing health insurance products.

(ii) Medical insurance products, as defined by the Demarcation Regulations published in terms of the Long- and Short-term Insurance Acts on 23 December 2016 (Government Gazette No. 40515), are regulated by the Financial Sector Conduct Authority (FSCA).

b) To safeguard the interests of people who were already policyholders of the primary health care products offered by the affected insurance companies (prior to 1 April 2017), the Ministers of Health and of Finance concurred that the insurance companies must approach the CMS to apply for an exemption from complying with the provisions of section 20(1) of the Medical Schemes Act, until a Low-Cost Benefit Option (LCBO) framework is adopted. This would allow current policyholders to migrate into the LCBO medical schemes environment when finalised and implemented. Insurance companies that applied and received an exemption from the CMS in terms of section 8(h) of the MSA are now offering primary health care products under the oversight of CMS.

END.

Reply:

a. Department of Cooperative Governance & MISA

During the last five years, the Department has found no ghost workers within its system. No ghost employees were found within the Department of Cooperative Governance and MISA in the past five years. The department and MISA conducts regular employee verification and ensures payroll certification by employees monthly.

b.Community Work Programme

(i) & (ii) The Department identified that some implementing agents made payments to 909 deceased participants totalling R2,483,605.50.

(iii) Payments to deceased participants are being recovered from CWP Implementing Agents.

 

Reply:

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Reply:

a) The In-Kind Grant 2022/23 budget is R1.5 Billion. See below a detailed list of approved Infrastructure In-Kind Grant Projects that will be undertaken within the National Department of Health during the 2022/23 financial year.

b) It should also be noted that these projects are at the different stages as per the Framework for Infrastructure Delivery and Procurement Management (FIDPM) and the Infrastructure Delivery Management System (IDMS).

END.

Reply:

The department is currently obtaining the responses from the abovementioned munucipalities and we will provide response as soon as we receive it.

Reply:

During the Budget Vote on Trade and Industry, I noted that building an enabling environment for industrialisation requires securing our key network infrastructure, such as energy and logistics, and protecting our electrical grid and rail network from the continued threat of scrap metal syndicates. I committed that by the end of July, the Department will have developed and tabled a draft policy on scrap metal, which will introduce a blend of domestic and export measures to address illegal trade in copper cable and scrap metal.

Since then, research has been completed and Cabinet has been briefed on the overall strategy. A document setting out the draft policy is being developed and will be published for public comment shortly.

-END-

Reply:

The intervention team in Managung Metropolitan Municipality is not empowered to determine whether motions of no confidence in elected office bearers may be allowed or not, while the intervention is in place. Thus, the scope and responsibilities of the intervention team are mainly related to the implementation of the Financial Recovery Plan, and not extended to cover matters relating to political decisions, and thus, Municipal Council resolutions on whether or not to remove an elected office bearer is not part of the implementation of the Financial Recovery Plan. The procedural requirements pertaining to a political decision that a Municipal Council is entitled to take, are prescribed in sections 29, 30, 40 and 58 of the Municipal Structures Act, No. 117 of 1998.

Reply:

a) The application for permanent residence with reference number PRP2700955 is currently in final stage of the adjudication and quality assurance the process.

b) The application will be finalised on or before 30 June 2022.

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Reply:

Development of oil and gas has great potential to offer South Africa energy independence (and security), economic growth and jobs as long as is developed within the principles of sustainable development.

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1. Yes. Section 231 (1) of the Constitution is clear that the negotiation and signing of all international agreements is the responsibility of the national executive. Meaning that international agreements become national law only upon ratification by Parliament. The Minister of Health is therefore enjoined by the Constitution to submit the treaty to Parliament for consideration and approval.

2. No. The draft Pandemic Treaty will be subjected to legal scrutiny by State Law Advisers at the Department of Justice and Constitutional Development to ensure its compliance with the Constitution of the Republic of South Africa.

3. For South Africa, it is crucial that the treaty is anchored on human rights to ensure equitable access to available medical solutions in order to improve the health and well-being of all, regardless of socio-economic status or geographical location. Therefore the main points to be pushed by South Africa in this regard are access and equity.

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Reply:

(a) There is no specific budget allocated for termination of pregnancy services, however the services are covered under Equitable Share

(b) There is no specific budget calculation for termination of pregnancy, the service/program is not a stand-alone programme it falls within the Women, Maternal and Reproductive Health at all level of care, therefore the calculation is done under Equitable share budget.

(c) The clinic cannot turn away the clients however; clinic can only refer clients on the following basis:

• 1. If there is no one trained and providing the termination of pregnancy services in a facility; the health care workers, don’t turn them away BUT refer clients where services are rendered
  2. If the client is above 12 weeks, and there is no Doctor who can provide the above 12 weeks’ cases in a facility as stipulated in the Choice on Termination of Pregnancy Act, 92 of 1996, then the client can be referred to next level of care where second trimester termination of pregnancy is offered;
  3. If the client is above 20 weeks, however the client can be counselled on pregnancy resolutions e.g. adoption etc.

(d) The National Department of Health did not receive reports from provinces indicating challenges related to backlog on termination of pregnancy

(e) The National Department of Health has developed the Sexual and Reproductive Health and Rights Training Package/Curriculum consisting of 14 modules.

1. Module one is compulsory and covers value clarification and mind transformation and

2. Module 7 is a specific module for termination of pregnancy (theory and practical session).

(f)-(g) Staff vacancy rate. The Department do not have the vacancy rate specific for termination of pregnancy however the service is being rendered under Women, Maternal and Reproductive Health programme. There is no breakdown of vacancies because termination of pregnancy is not a standalone programme it is offered under the Women, Maternal and Reproductive Health programme.

(h) The Department Conduct Value Clarification and mind transformation workshop to address unwillingness and negative attitude of the health care workers at all levels of care. Choice on termination of pregnancy guidelines (2019) provides guidance to managers, frontline workers and service users to respond to issues on conscientious objection which is described as blocking access to care .

(i)-(j) The following table reflects the details in this regard.

	Year	Total number of TOP’s performed in the last five years per province and National
		Province (i)	South Africa (National) (j)
		Eastern Cape	Free State	Gauteng	KwaZulu-Natal	Limpopo	Mpuma-langa	Northern Cape	North West	Western Cape
	2017	9,905	5,397	11,929	17,700	6,703	3,080	1,149	4,859	15,415	76,137
	2018	14,130	7,404	18,827	27,032	11,297	5,738	1,671	7,840	18,785	112,724
	2019	13,342	7,666	19,881	28,344	14,323	7,584	1,533	9,557	18,831	121,061
	2020	10,922	7,242	23,338	22,399	14,494	4,449	1,337	8,325	17,209	109,715
	2021	12,118	7,617	25,827	23,688	13,828	5,014	1,705	9,002	16,129	114,928
Source DHIS

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Reply:

The Honourable Member should note that the Municipal Finance Management Act (MFMA), vests financial governance, accountability and responsibility for a municipality with the municipal council and its administration. This includes appointment of relevant and appropriate skills, ensuring proper internal controls are implemented and to prevent the incurrence of unauthorised, irregular, fruitless and wasteful expenditure (UIFW).

Specifically, section 62 of the MFMA provides that the accounting officer of a municipality is responsible for managing the financial administration of the municipality, and must for this purpose ensure internal controls, take all reasonable steps to ensure that unauthorised, irregular or fruitless and wasteful expenditure and other losses are prevented, amongst others.

The National Treasury has issued cost containment regulations that elaborate on the process to be followed and measures to be implemented by municipalities on the use of consultants with the objective of reducing reliance thereon. The Regulations requires a thorough needs assessment to be undertaken to demonstrate the need for appointing a consultant. In cases where consultants are appointed, a municipality must ensure the transfer of skills by consultants to municipal officials are included in all contracts.

A number of MFMA Circulars have been issued and officials trained in implementing their financial management responsibilities, including regulating a set of minimum requirements. These address all financial management disciplines, including revenue management, asset management, expenditure management and liability management.

Additionally, the National and Provincial Treasuries, have collaborated to render support to municipalities in various ways, both technical, financial and at knowledge sharing platforms. The issuance of the UIFW reduction strategy documents, preventative controls and assistance in preparation of support plans for implementation by municipalities are geared to address these financial challenges. Furthermore, all municipalities are required to assess their Budget and Treasury Office capability, capacity and competencies in financial management and to implement corrective measures to address gaps and audit findings. These have been communicated in MFMA Circulars available on the National Treasury website. Training has been provided and will continue in the use of these tools, interpretation of accounting standards, preparation of annual financial statements and disclosures to municipal officials.

Reply:

1. The bridges project mentioned in PQ 2027 belongs to Thulamela Local Municipality (TLM). The pertinent details of the project are outlined below.

The Department of Cooperative Governance (DCOG) is responsible, in terms of section 154 of the Constitution of the Republic of South Africa, Act 108 of 1996 among others, to provide support and strengthen the capacity of municipalities including TLM to manage their own affairs, to exercise their powers and to perform their functions. To that end, DCOG through the Municipal Infrastructure Support Agent (MISA) provides technical support to TLM in accordance with the District Development Model (DDM). The MISA technical support includes the following:

• Development or review of technical reports and other related documentation for project registration at project funding approval stage.
• Development and review of project planning documents, supporting with preparation of procurement documents for service providers.
• Support the municipality by giving technical advice, review reports submitted by the professional service provider appointed by TLM and conduct site inspections.

The cracks on the bridges are part of the defects that the contractor is required to fix within 21 days from the issue of the Practical Completion Certificate done on 23 May 2022. MISA conducts site visits and inspections to monitor the fixing of the defects as part of the support to TLM.

2. The contractor was instructed to fix the defects, which include the cracks, within 21 days. The days are counted from 23 May 2022 when the Practical Completion Certificate was issued as indicated in the background above.

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Reply:

The National Department of Health is working with the Provincial Departments of Health and the private health sector to source this information. As soon as the information has been received by the National Department of Health, the Minister will be able to furnish the full response to the Honourable Member and Parliament.

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(a) In an effort to determine the proportion of the excess deaths which are attributable to COVID-19 and what proportion are attributable to non-COVID factors, the SAMRC Burden of Disease Research Unit and University of Cape Town (UCT) Centre for Actuarial Research used the correlation of excess natural deaths with other measures of the COVID-19 pandemic in South Africa. Based on comparison of the time trends in excess deaths, the confirmed COVID-19 deaths (by date of occurrence), and proportions testing positive for SARS-CoV-2 in 2020 and 2021, the SAMRC/UCT collaboration estimated that 85%-95% of excess deaths were directly related to COVID-19. However, it was not possible to assess whether this differs by age groups.

(b) The remaining 5-15% of the excess deaths are considered to be attributable to non-COVID-19 factors.

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(1) (a) (i) and (ii)A person appointed as the head of the provincial disaster management centre is responsible for the exercise by the centre of its powers and the performance of its duties. Mr Sibongiseni Ngema has been appointed as the Head: KZN Provincial Disaster Management Centre in terms of the Public Service Act.

(b)The Provincial Disaster Management Centre (PDMC) was established in 2007.

(c) The budget allocation that is accessible on the financial system depicts the following allocation

No.	Year	Budget Allocated
1.	2018	R 51 017 000.00
2.	2019	R 65 218 000.00
3.	2020	R 48 229 000.00
4.	2021	R 17 083 000.00
5.	2022	R 52 583 000.00

The system could not retrieve information dating back beyond 2018 as Disaster Management did not have a separate vote. The budget was under Programme 3. 

(2) The Department of Cooperative Governance does not keep records of the provincial government. The Provincial Disaster Management Centre (PDMC) indicated that due to the changes in staff and technology, it is difficult to access the information dating back to 2007. The Provincial Disaster Management requires at least a month to locate these documents and furnish them to Ms E L Powell. This is mainly because the staff at the PDMC is still busy assisting with the coordination and supporting the stabilisation and recovery, the rehousing of people who have lost homes and restoring provision of services as a result of the flood disaster that have taken place.

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(a) The Executive Mayor, Councillor Ndikinda issued a media statement condemning the assault of the Councilor Rulashe and committed to investigate the matter further. In addition the ADM has been visited by several delegation from Minister of CoGTA and MEC to engage relevant parties affected by the incident. (b) The Executive Mayor requested protection services for Councilor Rulashe from the MEC for Safety and Liaison in the Province. Furthermore, a Threat and Risk Assessemnt report by Crime Intelligence was recieved whereby protection services were commissioned for three months to Councilor Rulashe. The Executive Mayor launched a preliminary report whose findings were reported to Council where it was resolved that an external independant legal firm be commissioned to conduct full investigation and report on its findings. Further steps taken by ADM is that the ADM official responsible for the incident was suspended, secondly a correspondence was made to the Secuirty Company to take disciplinary steps on their employees involved on the incident. 

Reply:

a) The Department of Transport is currently assisting Road Authorities through the Shamba Sonke Programme and it is a nation-wide initiative involving all Provincial Road Authorities.

Provincial Road Authorities are supported through this Provincial Road Maintenance Grant (PRMG):

• for routine, periodic, and special maintenance;
• for rehabilitation of paved roads, limited to a maximum of 25% of the value of the PRMG allocation per province;
• to ensure all roads are identified, proclaimed and reclassified as per the COTO publication TRH26 Road Classification and Access Management Manual;
• to collect road inventory data to maintain an up-to-date RAMP;
• for the repair of roads and bridges damaged by declared natural disasters;
• to improve the state / condition of the road network serving rural areas; and
• to improve road safety with a special focus on NMT safety

The PRMG is also used on the rural road networks to gather road data where District Municipalities are supported through the Rural Road Asset Management Systems Grant (RRAMSG) to:

• collect condition data (paved and unpaved) for the municipal road networks within the boundaries of the District Municipality in accordance with the COTO publication, TMH9 Manual for Visual Assessment of Road Pavements;
• collect traffic data on selected intersections of the municipal road network;
• collect data on the condition of structures (bridges and culverts) as per the COTO publication, TMH19 Manual for the Visual Assessment of Road Structures; and
• develop a Road Asset Management Plan (RAMP) in line with the COTO publication, TMH22 Road Asset Management Manual to inform maintenance and investment via the Municipal Infrastructure Grant (MIG).

The inspections in loco are performed by the technical teams to ensure quality assurance of road infrastructure delivered. Back to basic ethos are adhered to within the limited scarcity of technical resources.

b) In terms of the Division of Revenue Act (DORA), these funds has to be transferred to the Provinces and municipalities, who are the “implementing Agents”. Therefore, at this stage, the Department is reliant on the Provinces and Municipalities to insource the works as much as possible.

In most provinces, there is some form of insourcing taking place through implementation of projects using in-house teams. In the case of the Western Cape, additional insourcing is taking place through the appointment of the District Municipalities as an Implementing Agent by the province. The District Municipalities has their own staff.

The Department intends to change the Schedule of these grants to become an “Indirect Grant”, which allow the department to implement the works on behalf of the Provinces and Municipalities.

If this proposal is accepted by the Budget Council and the DORA is supported, as such, by Parliament and approved by the President, the Department plans to insource the works as much as possible within reason.

Reply:

a) (i) Warmbad Hospital has medication available and patients have been issued with medication, for scripts issued by the medical officers in the hospital, as follows:

• April 2022: 1,560 scripts dispensed with a value of R780,000.50. 30 % of these scripts had Panado as one of the medicine items, with other items, dispensed

• May 2022: 1,469 scripts dispensed with a value of R678,000.90. 27 % of these scripts had Panado as one of the medicine items, with other items, dispensed

(ii) Ambulances operate in Limpopo from 56 ambulance stations, providing a primary emergency response to communities. Bela-Bela Local Municiplaity is served by two EMS stations namely Warmbad & Pienaarsrivier.

Warmbad EMS Station has five ambulances, with three crewed ambulances per shift. Pienaarsrivier has three ambulances, with two crewed ambulances per shift. Pienaarsrivier received a new ambulanced in April 2022. The province is in the process of procuring another 28 ambulances, that would be distributed based on needs, determined by call volumes. The Ambulances are provided to the Emergency Medical Services (EMS) Stations in the districts as they are responsible for EMS and not directly to the hospital.

b) Refer to response to (a)(ii) above.

 

END.

Reply:

The below response was provided by the Mpumalanga province: 

1. The Emalahleni municipality section 106 investigation report has not yet been officially released by the provincial government.  The report is yet to be tabled before the provincial executive council and then be tabled before the municipal council for them to adopt and develop an action plan to respond to the findings. It would be premature to make any pronouncements on the contents of the report until it is tabled at both the executive council and the municipal council.

2. The report will be tabled before the municipal council after it has been tabled before the provincial executive council. 

(3) As indicated above the report has not yet been officially released by the provincial government.

(a) Not applicable.

(b) Not applicable.

(c) Not applicable.

(d) Not applicable.

(e) Not applicable.

Reply:

The question replied to in PQ 1464 dated 22 April 2022. See submitted reply below.

Reply:

a)  The Department would not be in support of such a requirement as the law as it is currently stated does not allow for the employment of undocumented foreign nationals. Section 49 (3) of the Immigration Act , 2002, states as follows:

“Anyone who knowingly employs an illegal foreigner of a foreigner in violation of this Act, shall be guilty of an offence and liable on conviction to a fine or to imprisonment not exceeding one year: Provided that such person’s second conviction of such an offence shall be punishable by imprisonment not exceeding two years or a fine, and the third or subsequent convictions of such offences by imprisonment not exceeding five years without the option of a fine.’

The department therefore takes strong action against any employer hiring undocumented foreign nationals and would not advocate that they do so even if they took their fingerprints.

(b) The department does not document individuals who are undocumented as the Immigration Act, 2002 is very specific about the processes to be followed in the employment of foreign nationals whilst those individuals who are under the Refugee Act, 1998 have specific provisions that allow them to work whilst awaiting the outcome of their refugee status determination applications.

In cases where the Minister exercises discretionary powers under section 31 of the Immigration Act, 2002, (Exemptions), where he/she grants the rights of permanent residence for a specified period this would require extensive consultation and approval at a Cabinet level. A full and detailed case for such special circumstances would be required as was done in the dispensations for Lesotho and Zimbabwean nationals that occurred during the last 12 years.

Regarding parts C, and E the department is not supportive of the recommendation as the department is guided by the legislation it is mandated to apply. With regards to D, the department conducts law enforcement inspections which provides statistics on the number of undocumented persons detected and also alerts employers of the penalties that will arise from employing undocumented persons.

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Reply:

Claims against the No Fault Compensation Fund (NFC) are only lodged after the conclusion of assessment of an Adverse Event Following Immunisation (AEFI) that has been determined by the National Immunisation Safety Expert Committee (NISEC) to be caused by the Vaccine. It is not compulsory for an affected person with a causally linked injury to claim.

a) (i) 2 appeal claims and 2 claims have been sent to the NFC. There are 68 eligible individuals (AEFI causally linked to the use of the vaccine)

(ii) No claims have been rejected

(iii) No claims have been processed.

b) No claims have been rejected, although not all claims will be eligible as the outcome of the event should be serious thus either resulting in death, permanent or temporary disability.

c) 68 AEFI linked to the use of the vaccine of which the outcomes were not all serious (Only serious outcomes will be compensated, need for compensation will be determined by the adjudication panel.)

• M (14 ) F  (54)
• 12-18y (3); 19-30y (15); 31-50y  (19); above 50y (31)

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Reply:

The national roads in the North-West totalling 2513 km under the South African National Roads Agency SOC Limited (SANRAL) have active routine maintenance contracts in place and are well maintained. In addition, a further estimated R3.8 bn will be spent over the next three years on various maintenance and improvement projects on these national roads in the North-West which will result in the addressing of identified defects on those national road sections that are at the end of their original 20-year design life.

The challenge is with the portions of the national road network which are not currently under the jurisdiction of SANRAL i.e., the N12 through the towns of Wolmaransstad, Klerksdorp and Potchefstroom. Various engagements with the North-West Province are currently underway by my Department which has resulted in SANRAL being appointed as the Implementing Agent by the Province for urgent repairs on the N12 through those towns and those works are currently in progress. As part of these engagements the remaining sections of the national roads in the North-West Province (including the N12) will also be permanently transferred to SANRAL to ensure their proper maintenance.

Reply:

(1) (a) The Ministerial Advisory Committee on COVID-19 Vaccines (VMAC) is mandated to advise the Minister regarding COVID-19 vaccines. The VMAC engaged with SAHPRA on the report from the United States of America’s Food and Drug Authority report on the Pfizer Comirnaty COVID-19 vaccine safety. This report that was released was related to the periodic safety update reports that are released by the FDA, and did not identify any new signals for safety concerns. It was also noted that this report contains more than 49 000 adverse events following immunisations (AEFIs). As such, with the lack of new safety signals in the use of Pfizer Comirnaty COVID-19 vaccine, it’s continued use is still viewed as favourable.

(b) SAPHRA released a media statement on the 11th March 2022, which noted the following: “… the safety report received from the United States of America’s Food and Drug Authority in relation to the Pfizer Comirnaty COVID-19 vaccine. SAHPRA indicated that Pfizer indicates all adverse events of special interest (AESIs) during the reporting period. However, not all AESIs included in the report are linked to the vaccine. As these vaccines are still new, their safety profiles are evolving, and investigations are ongoing; hence the need for continuous monitoring. Based on the latest periodically reported safety data reviewed by SAHPRA for Pfizer COVID-19 vaccines, the benefit-risk profile of this vaccine remains favourable and safe to be administered as per the roll-out schedule.” This media release is available on the SAHPRA website.

(2) Neither the Department nor SAHPRA have changed their stance on the use of the Pfizer Comirnaty COVID-19 vaccine, based on the factors noted above, in other words, that no new safety concerns were found in this data. Registration of medicines in the country is the role of SAHPRA, which is mandated to oversee the safety, efficacy and quality of all health products registered in the country, and this includes vaccines. All the COVID-19 vaccines authorised for use in South Africa have been evaluated for safety, quality, and efficacy, and have proven to prevent serious disease and death from COVID-19. Should new safety signals be raised, this product will be reviewed at that time.

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Reply:

The department is currently obtaining the response from the District Munucipality and we will provide response as soon as we receive it.