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24 August 2020 - NW216

Profile picture: Keetse, Mr PP

Keetse, Mr PP to ask the Minister of Finance

Did the Public Investment Corporation (PIC) invest in a company constructing student accommodation in Limpopo near the University of Venda; if so, what (a)(i) amount has the PIC invested in the company, (ii) is the name of the company and (iii) process was followed and (b) are the names of the directors of the company?

Reply:

The Public Investment Corporation did not invest in a company to construct student accommodation near the University of Venda. However, the PIC did invest in a company that has projects in Polokwane and near the University of Limpopo.

Rest of the question falls away.

24 August 2020 - NW281

Profile picture: Groenewald, Mr IM

Groenewald, Mr IM to ask the Minister of Finance

(1)Which (a) national and (b) provincial state departments have budget allocations to support local government infrastructure; (2) what is the 2020-21 budget allocation of each specified department?

Reply:

(1) The Public Investment Corporation (PIC), as an operating entity, does not have any budget allocation to support local government infrastructure.

(2) Falls away.

24 August 2020 - NW115

Profile picture: Shaik Emam, Mr AM

Shaik Emam, Mr AM to ask the Minister of Finance

What measures does he intend to put in place regarding the mass looting that takes place in the Government’s supply chain processes which results in billions that are lost annually?

Reply:

1. The review of the existing procurement regulatory framework through the Public Procurement Bill is a measure that will be put in place to prevent the mass looting that takes place in the Government’s supply chain management processes. The Draft Public Procurement Bill makes the following provisions:

  • A directive to all Accounting Officers and Accounting Authorities on what measures to put in place within their respective institutions to prevent the abuse of the supply chain management system;
  • A chapter on procurement integrity which outlines code of conduct for officials, bidders and suppliers, including measures for handling any contravention of the code of conduct; and
  • That institutions must ensure that all planned procurement is aligned to the institution’s budget and plan.

2. The National Treasury, furthermore, proposed to the DPSA, the following Key Government Focus Areas (KGFA) and Key Focus Area Activities (KFAA) to be included in the Performance Agreements of Head of Departments:

Key government focus areas: Supply Chain Management System

KGFA

KFAA[1]

Suggested Weight

Target Date

Indicator/Target

Baseline Data

Develop and implement effective and efficient supply chain management system

Elimination of wasteful and fruitless expenditure

20%

Annual

70% elimination of wasteful and fruitless expenditure from baseline 2019 [2]

2018 Baseline

 

Reduction of irregular expenditure

20%

Annual

65% reduction of irregular expenditure from baseline 2019[3]

2018 Baseline

 

Reduction of qualified audits

20%

Annual

Unqualified audit opinion with 25% fewer findings than 2019/20[4]

2018 Baseline

 

Ensure that procurement planning is managed

15%

Annual

The finalisation of tender awards within an average of 100 days

Average number of days to award tenders

 

Ensure that SCM risk management is performed

5%

Annual

Risk response plans for the top 5 SCM risks developed

Risk response mitigation plans

 

Ensure that the department pays all compliant supplier invoices within 30 days of receipt of invoice

20%

Annual

100% of compliant supplier invoices paid within 30 days of receipt of invoice

Average supplier payment days

  1. All KFAAs are compulsory

  2. This indicator should be incremental so that by 2024/2025 the target is 100% elimination

  3. This indicator should be incremental so that by 2024/2025 the target is 75% elimination

  4. This indicator should be incremental so that by 2024/2025 the target is Clean Audit

24 August 2020 - NW303

Profile picture: Lees, Mr RA

Lees, Mr RA to ask the Minister of Finance

(1)With reference to the report by the Office of the Auditor-General on 25 February 2020 to the Standing Committee on Public Accountsregarding a R1,1 billion loan from the Public Investment Corporation (PIC) to the Madibeng Local Municipality in the North West, what (a) are the details of the due diligence measures that the PIC took when considering the application to grant the loan, (b) was the purpose of the loan, (c) is the interest rate that will be paid on the loan and (d) are the loan repayment (i) dates and (ii) amounts, (2) whether the municipality will be able to meet all interest and capital repayments; (3) what are the details of all conditions attached to the loan; (4) what are the reasons given by the Madibeng Local Municipality for not repaying the loan and interest; (5) what are the details of the (a) court orders obtained by the PIC to force the specified municipality to pay the interest and capital amounts due to the PIC and (b) action taken by the National Treasury to ensure that the interest payments and capital repayment obligations are adhered to by the specified municipality?

Reply:

(1)(a) There are no details available of the due diligence measures that were taken at the time of the transaction. The transaction was concluded on 11 January 1994 by the then Public Investment Commissioners.

(1)(b) The purpose of the loan was to assist Madibeng Local Municipality (Madibeng) with the repayment of a number of short-term loans.

(1)(c) The current matter relates to the remaining three Coupon Certificates (others were settled), and their respective numbers are BR20, BR25 and BR26. The interest rate on BR20 was 13.29%; BR25 was 12.47% and BR26 was 12.47%. The PIC waived the respective interest rates and charged a flat interest rate of 10% in respect of each certificate.

(1)(d) The loan repayment dates and amounts are as follows:

  • BR20 – 30 November 2003 – R37 million
  • BR25 – 30 June 2003 – R83 million
  • BR26 – 30 November 2003 – R87 million

(2) Madibeng will be in a better position to reply to this question, however, they have and continue to make provision for this debt in their financial staments and have not pleaded that they will not be able to repay the PIC. The PIC also made an offer to the Municipality to effect the payment over a period of time, which they declined.

(3) Yield to maturity; final yield on redemption dates; repayment to be effected at par on the redemption date on each certificate.

(4) The reasons are all of a technical nature. Madibeng admitted that they have received the loan amounts and that they owe the money to the PIC. However, they first raised a technical point that they were not authorised to raise the loan and issue the certificates. When they lost on this point, they appealed to the Supreme Court of Appeal (SCA) where they lost the appeal as well. The matter was remitted to the Court of First Instance for hearing on the merits and the quantum. Madibeng raised another technical point that the debt has prescribed. They lost again and have once more appealed to the SCA . PIC is currently awaiting for a hearing date from the SCA.

(5)(a) The current Court Order, which Madibeng is appealing, is for payment of the sum of R162,639,962,00 plus interest at the reduced rate of 10% per annum. This is after taking into consideration the payments that Madibeng effected after summons was issued.

(5)(b) National Treasury will be in a better position to reply to this question.

24 August 2020 - NW72

Profile picture: Hill-Lewis, Mr GG

Hill-Lewis, Mr GG to ask the Minister of Finance

What is the position of the Board of Trustees of the Government Employees Pension Fund on the proposals by the Congress of South African Trade Unions, which are alleged to be supported by the Minister of Public Enterprises, to commandeer R254 billion in funds from the Government Employees Pension Fund for the purposes of writing down Eskom’s debt?

Reply:

The GEPF has not received the proposal by the Congress of South African Trade Unionsfor consideration to write down Eskom debt.

21 August 2020 - NW1777

Profile picture: Steenhuisen, Mr JH

Steenhuisen, Mr JH to ask the Minister of Health

(a) To which location in the Republic was each of the Cuban medical personnel deployed who arrived in the Republic around 27 April 2020 to assist in the fight against Covid-19 and (b) how have the specified medical personnel contributed to the Republic’s fight against Covid-19 in each of the locations?

Reply:

Provinces provided the following update on the Cuban Medical Brigade brigade :

a) Allocation per Province:

Eastern Cape

 

Family Physicians

Biomedical Engineers

Epidemiologists

Biostatisticians

BCM

3

1

1

1

NMBD

3

1

1

1

Chris Hani

1

1

-

-

OR Tambo

1

1

-

-

Free State

 

Family Physicians

Biomedical Engineers

Epidemiologists

Biostatisticians

Botshabelo

2

-

1

-

Mangaung

3

-

-

1

Thabanchu

1

-

-

-

MUCPP

1

-

-

-

  1. Nzula

4

-

-

1

Pelonomi

-

3

-

-

Gauteng

District

Facility

Family Physicians

Clinical Engineer

Johannesburg

Nasrec isolation Centre

5

-

Sedibeng

Sebokeng Hospital

-

1

West Rand

GPG facilities

2

-

Ekurhuleni

Essellen Park

5

-

Tshwane

Pretoria West Hospital

3

-

KwaZulu Natal

 

INSTITUTION

Family Physician

Health Technology

Information Management (Biostatistics)

Epidemiology Technologist

           

Amajuba

Dannhauser CHC

1

-

-

-

EThekwini

St. Mary's Marianhill

2

-

-

-

Harry Gwala

Christ the King Hospital

2

-

-

-

ILembe

Ntunjambili Hospital

2

-

-

-

King Cetshwayo

St. Mary's KwaMagwaza

2

-

-

-

UGu

GJ Crookes Hospital

1

-

-

-

uMgungundlovu

Edendale Hospital

1

-

-

-

UMgungundlovu

Pietermaritzburg

1

-

-

-

Umkhanyakude

Hlabisa Hospital

2

-

-

-

UMzinyathi

Dundee hospital

1

-

-

-

Uthukela

Ladysmith hospital

1

-

-

-

Zululand

Itshelejuba Hospital

2

-

-

-

King Cetshwayo

Ngwelezana hospital

 -

2

-

-

uMgungundlovu

Greys Hospital

-

1

-

-

Wentworth

eThekwini

-

1

-

-

ILembe

Stanger Hospital

-

-

1

-

Uthukela

Ladysmith hospital

-

-

1

-

Amajuba

Madadeni Hospital

-

-

-

1

ILembe

Stanger Hospital

-

-

-

1

Uthukela

Ladysmith hospital

-

-

-

1

Limpopo

DISTRICT

INSTITUTION

Medical Officers

Clinical Engineering

Technologist

Hygienist

Biostatisticians

Capricorn

Rethabile CHC

2

-

-

-

Sekhukhune

Dilokong Hospital

2

-

-

-

Waterberg

FH Odendaal/MDR-TB

2

-

-

-

Mopani

Kgapane Hospital

2

-

-

-

Capricorn

Head Office

-

3

1

1

Mpumalanga

District

Institution

Family Physician

Clinical Engineering

Epidemiology

Ehlanzeni

Rob Ferreira Hospital

-

1

-

GertSibande

Ermelo Hospital Clinical

-

1

-

Nkangala

Witbank Beatty Clinic

-

1

-

Ehlanzeni

Tonga District Hospital

1

-

-

Ehlanzeni

Shongwe District Hospital

1

-

-

Ehlanzeni

Tintswalo District Hospital

1

-

-

Ehlanzeni

Lydenburg District Hospital

1

-

-

Nkangala

Witbank/Impungwe District Hospital

1

-

-

Provincial Office

Provincial Office - CDC

 

-

-

Nkangala

Kwa-Mhlanga District Hospital

1

-

-

GertSibande

Piet Retief District Hospital

1

-

-

GertSibande

Evander District Hospital

1

-

-

Provincial Office

Provincial Office - Integrated Health Planning Unit

-

-

-

Northern Cape

 

MEDICAL OFFICERS

DEPUTY DIRECTOR ADMI

ASS. DIR. ADMIN

JT Gaetsewe

2

-

-

Namakwa

1

-

-

Frances Baard

2

-

-

PixleyKaSeme

1

-

-

ZF Mgcawu

1

-

-

Provincial Office

-

2

2

North West

DISTRICT

INSTITUTION

Family Physician

Health Technology

       

Provincial Office

Mahikeng

-

-

NgakaModiriMolema District

Mahikeng (Lehurutshe/Zee rust Hosp)

2

-

Dr Ruth SegomotsiMompati District

Greater Taung Sub-district

1

-

Bojanala District

Rustenburg

2

2

Bojanala District

Madibeng

3

-

Dr Kenneth Kaunda District

Potchefstroom

1

-

Dr Kenneth Kaunda District

Matlosana

1

1

Western Cape

 

MEDICAL OFFICERS

Health Technologists

Epidemiologists

Biostatisticians

CTICC

18

4

-

-

Directorate: Facilities Management

-

-

3

-

Directorate: Information

-

-

-

3

b) The Cuban Medical Brigade’s contribution to the Republic’s fight against Covid-19 in each of the locations includes but not limited to -

  • Their deployment made a significant impact because the institutions are able to address issues of workload pressure because of Covid-19 pandemic.
  • The Cuban Medical Brigade have been resourceful in the Primary Health Care as this is their specialty.
  • Data analysis and information management team were tremendously instrumental in assessing the impact of the intervention.
  • The Epidemiologic predictions of the peak of the pandemic are critical to District readiness.
  • Hygienists and Epidemiologists are playing a key role in the research of the trends the pandemic is following and are providing advice on the projections.
  • The Biomedical Engineers have been critical in the design, installation, adjusting, repairing or provision of technical support for biomedical equipment.
  • The Cuban Medical Brigade are also involved in contact tracing and testing programme of the COVID-19 response.
  • Other Brigades are deployed to Isolation and Quarantine sites
  • They are also assisting with the implementation of the District SOP in the management of confirmed and suspected contacts (PUIs) in the District
  • They are part of ward-based programme and Health Facility decongestion program

END.

21 August 2020 - NW1671

Profile picture: Abrahams, Ms ALA

Abrahams, Ms ALA to ask the Minister of Trade, Industry and Competition

Whether a certain company (name furnished) that was launched on 6 June 2018 by his department is still being funded through the Black Industrialists Scheme; if so, what is the (a) funding transfer agreement, (b) contract thereof and (c) total amount of funding awarded to the specified company to date?

Reply:

I am advised by the Department that the company referred to in the question has been approved for a R8 million grant funding for machinery and equipment, commercial vehicles and business development services, under the Black Industrialist Scheme in the 2016/2017 financial year. To date an amount of R4,89 million has been disbursed towards machinery and equipment. The project is still active with the balance of R3,1 million available.

-END-

21 August 2020 - NW1610

Profile picture: De Freitas, Mr MS

De Freitas, Mr MS to ask the Minister of Health

(1)With reference to his reply to question 1685 on 18 December 2019, what (a) was the absentee record (ii) in each month in the past three financial years and (ii) since 1 April 2020, (b) processes, procedures and mechanisms are in place to ensure that staff is always present during all required working hours; (2) what (a) is the current number of vacant positions, (b) measures have been put in place to fill the positions, (c) are the timeframes and deadlines for filling each vacancy respectively and (d) functions will be fulfilled by the vacant posts once they are filled?

Reply:

1. (a)-(ii)(iii) The table below reflect the absentee record (ii) in each month in the past three financial years in South Rand Hospital:

Month

Number of planned leave

Number of unplanned leave

Jul-18

64

94

Aug-18

64

120

Sep-18

49

99

Oct-18

70

110

Nov-18

58

161

Dec-18

43

226

Jan-19

30

181

Feb-19

112

43

Mar-19

171

55

Apr-19

124

45

May-19

171

55

Jun-19

120

45

Jul-19

135

39

Aug-19

271

39

Sep-19

313

60

Oct-19

131

44

Nov-19

160

18

Dec-19

99

33

Jan-20

132

59

Feb-20

141

50

Mar-20

159

81

Apr-20

67

20

May-20

135

38

Jun-20

151

48

(b) After the implementation of unplanned leave control measure, all annual leave that are applied for in advance, irrespective of how many leave days is regarded as planned leave.

  • The unplanned leave control measures were effective from the 18th June 2018 and this is what HR is currently doing:
  • HR is categorising all leave forms submitted to the office per directorate
  • This is to allow identification and areas of the high number of unplanned leave per directorate
  • A specific member with high number of unplanned leave will be identified
  • Relevant supervisor will be informed with the request to investigate reason and provide measures to be instituted.
  • HR has already developed a recording book, to record all received unplanned leave per name and department in order to identify the trends

2. (a) Currently there are 20 permanent vacant posts in South Rand Hospital.

(b) All 20 vacant posts have been advertised in May and June 2020.

(c) Shortlisting and interviews were done during the month of May, June & July 2020. The timeframe to fill the posts after posts became vacant is 4 months.

(d) Current staff do overtime to cover the staff shortage until the post is filled.

END.

21 August 2020 - NW1564

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What research has his department conducted in the efforts to study and observe immunity in the South African context as research conducted in Spain on immunity has shown that recovering from Covid-19 does not necessarily result in immunity against the virus?

Reply:

The concept of herd immunity is the indirect protection from a contagious infectious disease such as SARS-CoV-2 (Covid-19) and related corona viruses and the threshold is crossed when enough people are immune and the number of new cases is are declining. The effectiveness of herd immunity is dependent on several epidemiological principles which include the following:

  • The disease must carry a substantial health risk.
  • The risk of contracting the disease must be high.
  • The vaccine must be effective.
  • The vaccine must be safe.

The COVID-19 virus fits all the above principles, but there is currently no clinically proven vaccine against the virus. The immune response to Covid-19 is currently not yet fully understood and definitive data on post-infection immunity is also lacking.

South Africa has not published results of any immunological studies in response to the SARS-CoV-2 (Covid-19) threat. Such a research is normally conducted by research institutes such as through the Department of Science and Innovation’s research institutions and Councils including entities such as the South African Medical Research Council (SAMRC)and the Council for Scientific and Industrial Research (CSIR).

There are several studies initiated by the National Department of Health (NDoH), the National Institute for Communicable Diseases (NICD), the National Health Laboratory Service (NHLS), universities and institutes, including the South African National Blood Service (SANBS), that are currently under consideration to assist the country in understanding the immunological response to the COVID-19 disease and the level of antibody response at an individual level and on a population level. This work is ongoing, and results will be released as they become available.

END.

21 August 2020 - NW1527

Profile picture: Cuthbert, Mr MJ

Cuthbert, Mr MJ to ask the Minister of Trade, Industry and Competition

(1)What are the details of the events that led to Moody’s downgrading, from Ba1 to Ba 2, of the credit rating of the Industrial Development Corporation (IDC); (2) What are the details of the action steps that his department intends to implement to restore the IDC’s credit rating by Moody’s to Ba1; (3) What are the implications of the credit rating downgrade for COVID-19 relief funding which according to his departmentis to be disbursed by the IDC?

Reply:

The Moody’s downgrade of the Industrial Development Corporation (IDC) to Ba2 from Ba1 appear to be based principally on concerns about the preparedness of Government to support public entities, and the timeliness of any decision to offer such support. This follows challenges with timely provision of funding for the Land and Agricultural Development Bank to make payments of maturing credit facilities and payments relating to SAA.

Moody’s recognised that the IDC “is still one of the stronger credits in the country, primarily reflecting the company's high capital buffers.”Moody’s further highlighted that the “IDC has strong capitalisation, with an equity-to-total assets ratio of 66% as of March 2019, which provides significant buffers to absorbunexpected losses and grow the business further.”

Moody’s assessment of the assumption of government support has been reduced from high to strong, and as a result the rating for the IDC to be downgraded. A similar rerating of the Development Bank of SouthernAfrica has been effected, for similar reasons.

As the principal factors relate to Moody’s assumptions on the sovereign, the IDC Board and Management will reinforce the point about the IDC’s capital buffers in engagement with Moody’s.

The IDC’s commitment to the COVID-19 relief funding remains i.e. the COVID-19 relief funding has not been affected by the credit downgradebecause IDC is managing prudently within its Liquidity Framework. The IDC continues to receive funding applications in this regard and perform the necessary credit assessments.

-END-

21 August 2020 - NW1708

Profile picture: Cuthbert, Mr MJ

Cuthbert, Mr MJ to ask the Minister of Trade, Industry and Competition

(1)On what date will the preliminary report of the investigation into the National Lotteries Commission (NLC) be tabled to the Portfolio Committee on Trade, Industry and Competition; (2) with reference to his letter to the chairperson of the Portfolio Committee on Trade, Industry and Competition dated 15 June 2020, in which he mentioned that his department was investigating four projects related to the NLC yet his response regarding the preliminary report only refers to one project, (a) why is that the case and (b) what are the relevant details thereof? NW2098E

Reply:

In the letter addressed to the Chairperson of the Portfolio Committee on Trade and Industry on 15 June 2020, I advised that I have received various allegations of maladministration at the National Lotteries Commission, particularly relating to irregularities in respect of pro-Active Funding. When these allegations were brought to my attention, I requested an independent investigation on the matters. The ad-hoc release of information flowing from the current process may compromise the investigation and I will accordingly provide the additional information as soon as the processes warrant and permit it. I can confirm that the investigation commissioned is currently considering four projects.

-END-

21 August 2020 - NW1555

Profile picture: Madlingozi, Mr BS

Madlingozi, Mr BS to ask the Minister of Health

What (a) total number of Covid-19 vaccine trials are taking place in the Republic at the moment, (b) are the names of the companies conducting the specified vaccine trials and (c) safety measures are in place to ensure that the persons who are participating in the vaccine trials are protected?

Reply:

(a) There are currently two (2) ongoing COVID-19 vaccine trials in South Africa;

(b) The vaccine trials are conducted by the Respiratory and Meningeal Pathogens Research Unit, Wits Health Consortium (ChAdOx1 SARS-CoV-2 Trial) and TASK Applied Science (TASK-008 BCG- CORONA Trial); and

(c) In general, Regulation 30 of the Medicines Act (Act 101 of 1965, as amended) mandates the South African Health Products Regulatory Authority (SAHPRA) to regulate the conduct of all clinical trials in the Republic of South Africa. In carrying out this legislative mandate, SAHPRA is guided by relevant sections of the current South African Good Clinical Practice (SAGCP) Guidelines.

Specifically, sub-regulations 30(10)(b) and (c) empower SAHPRA to inspect clinical trial sites and/or withdraw authorization to conduct clinical trials, respectively. Withdrawal can be for reasons of compromised safety of trial participants, or changes in the original science behind the trial, or where the integrity of the data being generated becomes compromised. In addition, SAHPRA, in line with current SAGCP Guidelines, ensures that all protocols have had adequate oversight by registered ethics committees as part of its clinical trial protocol approval process.

All these regulatory measures taken by SAHPRA during protocol approval, and subsequent trial monitoring by both site inspections and safety monitoring reports, serve to ensure that persons participating in all clinical trials conducted in South Africa are protected from harmful and unethical medical conduct.

END.

21 August 2020 - NW1646

Profile picture: Tafeni, Ms N

Tafeni, Ms N to ask the Minister of Justice and Correctional Services

What legal steps has been taken to hold persons accountable, after a proclamation in 2017 by the President, Mr M C Ramaphosa, resulting in an investigation by the Special Investigating Unit into corruption of water supply tenders at the Alfred Nzo District Municipality found R300 million looted from the specified municipality?

Reply:

1. The table below provides details of the steps taken by the Special Investigating Unit (SIU) for each proclamation made by the President in 2017:

Details of the Proclamation

Actions Taken

Civil Litigation

Disciplinary

1. Proclamation R19 of 2017

a) The SIU concluded all investigations and submitted a report to the Honourable President.

b) Criminal matters were referred to the National Prosecuting Authority (NPA)

c) Evidence obtained by the SIU resulted in the Hawks arresting eight (8) Municipal officials and one (1) private individual.

The SIU recommended that the Municipality cancel a contract of R2.5 million.

Evidence relating to misconduct against the Acting Municipal Manager, Head of Supply Chain Management and Chief Financial Officer was referred to the Honourable Mayor of Alfred Nzo District Municipality. The said officials resigned and no further action could be taken.

2. Proclamation R36 of 2017

a) The SIU concluded all investigations and submitted a report to the Honourable President.

b) Criminal matters were referred to the NPA

c) Seven (7) cases of Fraud

d) One (1) case in terms of Section 173 of the Municipal Finance Management Act (MFMA)

e) These matters are currently being investigated by the Hawks in the Eastern Cape.

Evidence relating to an undue benefit by the service provider amounting to R60.7 million was referred for purposes of civil litigation. Combined summonses were issued by the Special Tribunal. Pleadings not yet closed and a court date yet to be determined.

Evidence relating to misconduct against the Acting Municipal Manager was referred to the Honourable Mayor of Alfred Nzo District Municipality. The Acting Municipal Manager resigned and no further action could be taken.

2. The National Prosecuting Authority (NPA) has taken the following legal steps:

a) Upon receipt of the SIU’s referral of matters relating to the corruption of water supply tenders at the Alfred Nzo District Municipality to the NPA, case dockets were registered, and prosecutors as well as investigating officers were assigned by the NPA and the Directorate for Priority Crime Investigation (DPCI) respectively.

b) Case planning was done by the investigating team and prosecutors, whereby two (2) legs of investigations on the matters were undertaken.

c) Police investigations in respect of one (1) of the dockets have been finalised and the charge sheet has been drafted. The case is ready for enrolment and will be placed on the court roll by end August 2020, upon which the accused, who is the service provider to the Municipality, will face charges of fraud.

d) It is anticipated that the investigations, in respect of the other leg, will be finalised in the next two (2) months or so, after which the prosecutor will start to draft the charge sheet so that the case can be placed on the court roll.

21 August 2020 - NW1663

Profile picture: Ndlozi, Dr MQ

Ndlozi, Dr MQ to ask the Minister of Health

Whether, in responding to the Covid-19 pandemic and making decisions on the lockdown to curb the spread of the coronavirus, he used any statistical data on the number of persons who stay in the (a) rural areas and (b) townships; if not, why not; if so, what statistical data did he use to source statistics on the number of persons living in the rural areas and townships?

Reply:

a) The key statistic that we have been monitoring is the rate of spread of new infections i.e. the 7 day rate of change in COVID-19 cases. While the total number of infections are useful, the key statistic is the number of active cases particularly the rate of change of these active cases and the location of new cases.

b) The spread of the infection in South Africa has not been specific to rural areas or townships. The spread of the infection has been driven largely by movement and interaction by persons that are infected. The infection is droplet spread which would spread much easier in densely populated areas. The areas that have been most severely affected are the large Metros such as City of Cape Town, City of Johannesburg, Buffalo City, Nelson Mandela Bay and eThekwini. The more rural areas have been spared to a large extent from widespread infection due to our restriction on movement during level 5 and level 4. You would note to date that the more rural provinces have had much lower rates of infection – Mpumalanga, Limpopo, Northern Cape and Free State. The infection in the Eastern Cape and Kwa-Zulu is concentrated in the urban centres not rural areas.

c) The infection spread within urban areas has affected both the suburbs and the townships. There viral infection has not spared any community in terms of its transmission.

 

The increase in cases from the 5thto the 18th March was 1088% (5 to 58 cases). On the 25 March 2020 when the 21 day lockdown was announced the rate of change for COVID-19 cases decreased to 526% (58 to 362) then to 24% (362 to 1232) then to 33% (1232 to 1641 cases)-coinciding with the 14 day lockdown extension. The relatively slow rate of increase averaged about 47% until lock down level 4. It then gradually started to increase. This data proved that the lockdown achieved the objective of slowing down the rate of increase of cases, thereby giving health care authorities an opportunity to prepare the health system for the anticipated COVID-19 peaks.

END.

21 August 2020 - NW1609

Profile picture: De Freitas, Mr MS

De Freitas, Mr MS to ask the Minister of Health

With reference to his reply to question 1685 on 18 December 2019, what (a) total number of complaints have been received from patients (i) in each month in the past three financial years and (ii) since 1 April 2020 and (b)(i) measures and/or processes are in place to ensure that complaints are addressed and resolved and (ii)(aa) timeframes and (bb) deadlines have been put in place in this regard?

Reply:

a) (i) Total number of complaints for 2018/19 and 2019/20

The National Department of Health (NDoH) has developed a web-based application to assist public health facilities to comply with the National Guideline to Manage Complaints, Compliments and Suggestions in the Public Health Sector. The number of complaints as set out in the tables below are according to the web-based application which came into effect on 1 April 2018. It is important to note that not all health facilities are reporting on the system yet, therefore the number of complaints reflect those health facilities that are reporting complaints on the web-based application.

Month

# Complaints received 2018/19

# Complaints received 2019/20

April

1934

2409

May

2065

2664

June

1720

2129

July

1859

2373

August

1973

2396

September

1875

2116

October

2053

2345

November

1961

1889

December

1219

1330

January

2058

2033

February

2164

2098

March

2118

1740

TOTAL

22999

25522

(ii) Total number of complaints from 1 April to 31 July 2020

 Month

# Complaints received 1 April 2020 to 31 July 2020

April

960

May

1021

June

936

July

736

TOTAL

3653

b) (i) Measures and/or processes are in place to ensure complaints are addressed

The National Health Act (Act 61 of 2003) stipulates in Section 18 that, (i) any person may lay a complaint about the manner in which he or she was treated at a health establishment and have the complaint investigated. To this effect the National Department of Health (NDoH) published the National Guideline to Manage Complaints, Compliments and Suggestions in the Public Health Sector which came into effect on 1 April 2018. Provincial workshops were held in November and December 2017 to train staff on the implementation of the Guideline. According to the Guideline a complaint is defined as the dissatisfaction, displeasure, disapproval or discontent expressed verbally or in writing by any person about the specific health services being rendered and or care being provided within the health sector.

The National Health Act, 2003 was amended in 2013 to make provision for the establishment of the Office of Health Standards Compliance (OHSC). The objects of the Office are to protect and promote the health and safety of users of health services by:

  • monitoring and enforcing compliance with prescribed norms and standards
  • ensuring effective management of complaints relating to non-compliance with norms and standards through a Health Ombud.

The first Health Ombud, Professor Malegapuru William Makgoba, was appointed on 1 June 2016.

(ii) Time frames and deadline that have been put in place.

According to the National Guideline to Manage Complaints, Compliments and Suggestions in the Public Health Sector, complaints must be resolved within 25 working days.

The National Guideline stipulates that complaints should be lodged at the point of care, i.e. the public health facility where the incident took place. Should the complainant feel that the facility has not addressed his/her concern to their satisfaction, he/she may escalate the complaint in writing to the relevant District Office or the Provincial Health Department. As a last resort when complainants are still aggrieved with the outcome of the District Office or Provincial Health Department’s investigation, they can lodge their complaint with the Health Ombud within the OHSC.

END.

21 August 2020 - NW522

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Lees, Mr RA to ask the Minister of Public Enterprises

Whether all of the SA Airways Group Companies including (a) SA Airways SOC (Limited), (b) Mango Airlines SOC (Limited), (c) Air Chefs SOC (Limited), (d) SAA Technical SOC (Limited) and (e) SA Airways City Centre SOC (Limited), but not exclusively, are under business rescue; if not, why not?

Reply:

The only company in business rescue is South African Airways SOC Limited (SAA).

SA Airways City Centre SOC (Limited) has been placed in voluntary liquidation before the business rescue proceedings.

None of the other companies in the group are in business rescue as the boards have not placed the companies under voluntary business rescue, nor has any other process in terms of the Companies Act been given effect to.

21 August 2020 - NW1604

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Ismail, Ms H to ask the Minister of Health

(1)What is the (a) total breakdown of the type of Covid-19 tests that each private laboratory has conducted since 5 March 2020 and (b) total number of (i) positive and (ii) negative test results that have been reported to date; (2) what is the total (a) breakdown of the type of Covid-19 tests that the public healthcare sector has conducted since 5 March 2020 and (b) number of (i) positive and (ii) negative test results that have been reported to date?

Reply:

The Honourable Member is kindly informed that the information being requested by this question is still being collated to enable the Minister to respond to the Question.

The full answer will be furnished to Parliament as soon as all the information has been received from all the relevant sources.

END.

21 August 2020 - NW1603

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Ismail, Ms H to ask the Minister of Health

(a) What total number of ventilators will be provided by his department to each hospital that has a shortage of ventilators to assist with the Covid-19 spread and needs and (b) which hospitals will be receiving ventilators?

Reply:

a) The Department of Health will provide ventilators to hospitals that have shortage of ventilators to assist with the COVID-19 spread and needs. The Department has collaborated with the Department of Trade and Industry (DTI) and Council for Scientific and Industrial Research (CSIR), to manufacture 10,000 ventilators. These ventilators will be allocated to hospitals that do not have enough ventilators. The table here below shows the production timelines for the ventilators.

Activity

Quantity

Date

1st Batch

250

31 Jul 2020

2nd batch

600

7 Aug 2020

3rd batch

600

14 Aug 2020

4th batch

1,500

19 Aug 2020

5th batch

1,500

21 Aug 2020

6th batch

1,500

24 Aug 2020

7th batch

1,500

26 Aug 2020

8th batch

1,500

28 Aug 2020

9th batch

1,150

31 Aug 2020

Total

10,000

 

b) The list of hospitals that will receive the ventilators is attached as Annexure A.

END.

21 August 2020 - NW1702

Profile picture: Wilson, Ms ER

Wilson, Ms ER to ask the Minister of Health

(1)What was the (a) original quote his department received for the new hospital at Bethal, Mpumalanga and (b) final cost of the new hospital; (2) why was there a discrepancy between the original quote for the hospital and the final cost; (3) to whom did his department award the contract to (a) build and (b) equip the hospital in each case; (4) on what date was the new hospital originally due to be (a) completed and (b) opened; (5) on what date was the new hospital actually opened?

Reply:

1. (a) The estimated costs for Bethal Hospital in Mpumalanga was estimated to be R629,901,000. That consisted of Professional Service Provider fees to the value of R60,901,000 and then Construction costs for phases 01 to 03 to the value of R569,000,000.00.

(b) The estimated final costs of the project is valued at R659,901,000.00

2. The discrepancy between the planned and actuals can be attributed to an approved variation order for procurement of medical equipment and furniture for the amount of R30,000,000.00.

3. The contract was awarded to Clear Choice Builders.

4. (a) The estimated completion of the project was the 30th of October 2020.

(b) Given an actual start date of the 10th of October 2016, Phase 1 and 2 of the project was completed in May 2020.

5. A sectional hand over was achieved for Phase 1 and 2 of the project. The project however is still in Phase 3 and not yet complete.

END.

21 August 2020 - NW1706

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Cuthbert, Mr MJ to ask the Minister of Health

(1)With regard to the response by the City of Ekurhuleni during the Covid-19 pandemic, (a) what number of test kits have been procured, (b) from whom were the test kits procured and (c) what was the cost per unit; (2) what (a) is the overall backlog in testing results in each clinic in the City of Ekurhuleni and (b) is being done to reduce these backlogs; (3) what (a) is the overall backlog on tracing Covid-19 cases, (b) are the full relevant details of the communities that are yet to be visited and (c) is being done to improve tracing capabilities in the city; (4) what process did his department put in place to ensure that clinics adhere to safety measures put in place for Covid-19 with regard to social distancing, sanitising of hands and the wearing of masks?

Reply:

1. (a) A total of 77 645 test kits were supplied to Ekurhuleni District and this covered all hospitals and clinics.

b) The test kits were procured by the National Health Laboratory Service (NHLS), and supplied to the District.

c) Cost per test kit including forms, testing and courier services is R399.00.

2. (a) Backlog in all six NHLS testing laboratories as of 28 July 2020 was 891 with registered samples

(b) The two main hospitals that are supporting Ekurhuleni are Tambo Memorial and Charlotte Maxeke. Tambo Memorial is doing the tests for all in-hospital patients while Charlotte Maxeke does all clinic work.

3. (a) The district has a tracing backlog of nearly 23 481 contacts as at 25 July 2020.

(b) The district does not conduct visits to the communities for tracing because they are currently implementing telephonic and COVID-19 Connect tracing initiatives which make use of the telephone and messaging system.

(c) The District is implementing telephonic and COVID-19 Connect for tracking and tracing of contacts. A total of 164 Clinical Officials are currently deployed across the district to strengthen telephonic tracing initiatives.

4. All members of staff in clinics have been trained on COVID-19 safety measures. COVID-19 steering committees have been setup in facilities and they ensure adherence to measures such as social distancing, appropriate use of PPE and frequent hand-washing and sanitization of hands in all the clinics. Senior and Middle Managers undertake unannounced visits to facilities in order to observe and ensure adherence to COVID-19 safety measures.

END.

21 August 2020 - NW1509

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Van Der Walt, Ms D to ask the Minister of Basic Education to ask the Minister of Basic Education

(1)       What measures has her department put in place to attend to the dire need for professional staff such as nurses, psychologists and therapists in (a) ordinary schools and (b) schools for learners with special educational needs; (2) whether she intends to make use of students performing their community service year to assist the specified schools; if not, why not; if so, what are the further relevant details?

Reply:

(1) (a) (b) The Department of Basic Education (DBE)  has developed the National draft Guidelines for Resourcing and Inclusive Education system. The proposed guidelines deal with resourcing as it relates to the inclusive education system as a whole. This system comprises Special Schools, Special Schools/Resource Centres, Full-service Schools, Ordinary Public Schools, and District-based Support Teams. It addresses barriers in two focal areas: 1) teaching and learning and 2) psycho-social and health support.

The document motivates for the development of an integrated and holistic approach which does not separate support provisioning of special and ordinary schools from that of districts and aims at strengthening support to all learners who experience barriers to learning in the system on a continuum from low to high intensity support.

The Guidelines must be seen as a key procedure to ensure the transformation of the education system towards an inclusive education system in line with the prescripts of Education White Paper 6 on Special Needs Education: Building an Inclusive Education and Training System (2001). Furthermore it calls for the appointment of healthcare professionals within the education system, in all educational institutions and offices so that learners are provided with a holistic intervention approach. The guidelines are being costed by provincial Education Departments PEDs), and a phased in strategy will be used to ensure that critical healthcare professional posts needed by provinces are filled.

(2) Community service students are required by government to complete their community service year in a clinical institution. This allows them to put into practice their clinical knowledge, so as to gain clinical experience. If the clinical institution (hospital/clinic) provides an outreach community programme, where the student can provide services to a an educational institution, the Department of Basic Education would by all means accept the services to be rendered by the community service individual. The department also encourages Higher Education Institutions (HEIs) to allow students still obtaining their degree/diploma to do their clinical practicals in different education institutions so that the student has an all rounded experience and gains insight of the education system. An example of such an initiative will be the expose of student social workers who perform their practicals at schools and also have been appointed to provide services to schools in the community in which they are based in.

21 August 2020 - NW1681

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Brink, Mr C to ask the Minister of Public Enterprises

What: (a) are the details of the current age analysis of the total debt owed by each municipality to Eskom and (b) amount of the debt is made up of (i) principal debt, (ii) interest and (iii) penalties ineach case?

Reply:

According to the information received from Eskom

a) The total debt owed by municipalities as at June 2020 is R43.9 billion, of which R30.9 billion is overdue debt. The details of the age analysis of the total debt owed by each municipality to Eskom, as at June 2020 are set out in Annexure A.

b) (i) and (ii) The total debt of R43.9 billion, is made up of the capital amounts of R32.4 billion, interest of R6.7 billion and VAT of R4.8 billion. The makeup of total debt in terms of capital and interest for each municipality, as at June 2020 is set out in Annexure A.

c) (iii) The total Notified Maximum Demand (NMD) exceedance charge for June 2020 is R46.9 million and R104 million for the financial year to date. This is a penalty for NMD exceedance raised in terms of the NMD Rules approved by the National Energy Regulator of South Africa (NERSA) to discourage future exceedances and is included in the capital amount. The NMD exceedance charge, for each municipality as at June 2020 is set out in Annexure B.

21 August 2020 - NW1627

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Hill-Lewis, Mr GG to ask the Minister of Health

What (a) are the relevant details and (b) is the total (i) number and (ii) total amount of all disbursements made available to each province by his department in response to Covid-19 pandemic?

Reply:

(a)-(b) (i)-(ii) The department did not transact any disbursements to each province in response to COVID-19 pandemic. However, National Treasury (NT) did transfer the total amount of R466,392,000 to Provinces through the Provincial Disaster Relief Grant for immediate response to COVID-19 from Cooperative Governance and Traditional Affairs: National Disaster management Centre. The details of the funds are indicated on the attached approval from NT as Annexure A.

The total allocation in response to COVID-19 for the 2020/21 financial year amounts to R3,450,537,000 (Three billion four hundred and fifty million five hundred and thirty-seven rand) scheduled to be disbursed with effect from August 2020 until March 2021 to all Provincial Departments of Health as per attached Annexure B and Annexure C.

END.

21 August 2020 - NW1651

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Komane, Ms RN to ask the Minister of Health

(1)What (a) total number of (i) vacant posts were available across the Republic for nurses, doctors and other healthcare workers in February 2020 and (ii) the specified vacancies have since been filled and (b) is the number of doctors and nurses that is now needed to deal with the Covid-19 pandemic; (2) whether there is a required number of professionals in the Republic; if not, what measures will he put in place to ensure that there is no shortage of healthcare workers; if so, what are the further relevant details?

Reply:

1. (a) (i) The total number of vacant posts that were available across the Republic for nurses, doctors and other healthcare workers in February 2020 was 33 398.

(ii) A total number of 17150 health professionals (i.e. nurses, doctor and other related health care professions) have since been appointed from February to June 2020. This accounts for 34%of the 33 398 vacancies listed above.

(b) The National Department of Health used the Model of Demand based on the projected number of infections per district to determine the Surge Capacity demand during the Covid-19 Pandemic. The Model is applied to the population and Covid-19 caseloads using 85% of Public hospital general beds and 100% of ICU and High Care beds for Covid-19 care. The Model, estimates that the Public Health Sector will require an additional 1 200 Doctors and 18 000 Nurses of various categories.

(2) A total of 7 416 health professionals were already contractedacross the provinces to fill the gap in the HR requirements. A database for workforce candidates containing 942 doctors and 1 261 as well as 144 other categories of staff is accessible to provinces to recruit staff from and some provinces also have databases with potential candidates available. Recruitment is continuing.

Based on the directions issued by the Minister of Health in April, the recruitment process should be shortened by advertising a post and effecting appointments within a period of a week

Budget motivations are submitted to Provincial Treasuries and to NDoH for consideration.

Other sources for healthcare workers include the following:

  • Health Professionals working in the private sector can be appointed on sessional basis
  • 176 health professionals from Cuba is assisting South Africa in the response to COVID-19. The necessary registrations have been completed and they have been deployed across all provinces. They are authorised to work in any province. Since the projected peaks differ between provinces, this cadre could be deployed to areas with the highest need
  • Volunteers: Provinces placed advertisements for volunteers to assist in the response to the COVID-19 pandemic.
  • Foreign nationals: The Foreign Workforce Management Unit (FWM) of the National Department of Health is facilitating the recruitment and placement of all “Foreign Health Workers” who present themselves for employment and study opportunities in South Africa. Policy guidelines for registration and employment of foreign qualified health professionals in South Africa are in place.
  • Final year students: NDoH engaged with Deans of Health Sciences Faculties and Principals of Nursing Colleges to facilitate deployment of final year students to assist with care of COVID-19 patients e.g. in field hospitals. Postgraduate nursing students returned to workplaces to support the COVID-19 response. Final year nursing students will write examinations by the end of August and will thereafter available for the surge capacity.
  • Interns and Com Serve: There is an existing ICSP database. Health professionals in this category that are not currently employed or due to complete their terms, can be contracted to supplement the surge capacity
  • Retired health professionals: Based on the directions issued by the Minister of Health in April, all retired personnel may be requested to fill in positions on a temporary basis to assist in responding to the pandemic. Retired employees can be deployed to low risk areas to relief staff to attend to COVID-19 patients.

The following additional areas are pursued to expand the resource base:

  • Non-Governmental Organisations and Community based organisations: The directions issued by the Minister of Health in April also makes provision for community service personnel, extended public works programme workers, CBOs and NGOs to fill in positions on a temporary basis to assist in responding to the pandemic. Provinces can engage with these sectors to identify possible capacity. Possible down referral of patients to suitable sectors should be considered as well as increasing the capabilities of homebased caregivers and Community Health workers to strengthen home care.
  • South African Military Health Services (SAMHS): SAMHS can support Provinces in the response to COVID-19 in terms of the role of the South African Defence Force (SANDF) in Disaster Management. Provinces should liaise with SAMHS in the province.

The following measures are implemented to reduce the demand on human resources during the pandemic:

  • Provincial Health Departments are reprioritising health care services. This can include the identification of routine and elective services that can immediately be deferred or moved to other settings or non-affected areas or identification of alternative service providers e.g. from hospitals to PHC settings, private sector or NGOs.
  • Co-ordination with the private sector is done to optimise all the resources available in the province. Discussions at National level resolved to contract the private sector on a global fee inclusive of beds, hospital staff, equipment and consumables where additional capacity is needed, especially for critical care beds. A Service Level Agreement (SLA) template is available.
  • In provinces with metros, metros are engaged to identify services that can be redirected from provincial facilities to municipal clinics and health centres to free up provincial staff for the COVID-19 response. Alternatively, metro staff can be seconded to the field hospitals or other COVID-19 settings.
  • Alternative service delivery mechanisms are to be considered, e.g. allowing pharmacists to extend ordinary prescriptions for people with chronic conditions provided they are controlled on treatment.

END.

21 August 2020 - NW1818

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Chirwa, Ms NN to ask the Minister of Health

Whether the support team led by Dr SibongileZungu, including Professor Ian Sanne, Theo Lighthelm, Albert Jansen, Dr Dorman Chimhamhiwa and Wendy Ovens that was deployed by Minister ZweliMkhize in the debilitated Eastern Cape Department of Health has submitted any report with recommendations regarding what needs to be done in the specified province; if not, what is the position in this regard, if so, (a) what were the recommendations and (b) how far has each recommendation been implemented?

Reply:

The intervention team has submitted a report to the Eastern Cape Department of Health, the Office of the Premier, and the Office of the Minister of Health.

The report submitted covered the analysis and the state of the COVID-19 response in the Eastern Cape for the period, 29th June 2020 until 10th July 2020. The report recommended nine areas of intervention. The recommendation made by the Strategy Team is following the key strategic areas as outlined by the WHO-COVID-19 response guideline as tailored to the provincial needs.

(a) The recommended interventions

1.1 Coordination between Tertiary, Regional and District hospitals is inadequate and should be addressed through the revised command and control structure.

1.2 Given the busy schedule of the SG, it would benefit the Province to have a Project Manager for COVID19 with the necessary authority to fast track actions.

1.3 While the metros have mobilised reasonable infrastructure to meet the surge, the Eastern Cape Department of Health (the Department) needs to give attention to the scaling-up of service delivery requirements such as the adequate provision of oxygen, equipment, human resources, and medicines necessary for the management of the Pandemic.

1.4 Certain hospitals are currently overwhelmed (Doran Nginza in NMB in particular) by the patient demand, and lack of infrastructure, equipment and human resources to meet the clinical care demand which the Department needs to address.

1.5 Labour relations is a matter that requires a dedicated action plan to normalise service delivery.

1.6 Historic arrangements for drainage areas, resource allocation, and referral routing are not addressing the significant surge in patient numbers, particularly in underserved, vulnerable populations.

1.7 Emergency Medical Services and patient transport services require intervention to ensure continued function.

1.8 Within the Province, the oxygen separation plants are located in the Nelson Mandela Bay Metro. The distribution of the oxygen is, therefore, a challenge for areas furthest from the Metro.

1.9 Implementation of a comprehensive data system to capture the parameters of the COVID-19 response.

(b) How far each of the recommendations has been implemented

1. Coordination between Tertiary, Regional and District hospitals is inadequate and should be addressed through the revised command and control structure.

The Intervention Team assisted the Department to establish its Command and Control structure which was adjusted from the Department’s strategic documents.

The structure is divided into three layers, Provincial, district and facility specific. Each structure has adopted an incident management approach (WHO-COVID-19 Guidance) with daily command and control meetings covering the following areas:

  • Epidemiology and Surveillance
  • Community engagement for prevention, contact tracing and testing
  • Laboratory support and result reporting
  • Treatment and Care including facility surge capacity
  • Infrastructure and equipment
  • Logistic support - pharmacy, consumables and personal protective equipment
  • Emergency Services
  • Psycho-social support to health workers
  • Port Health

The strategic area of Port Health is not given a daily focus as Port Health is a national competence. The PMU is vigilant around Port Health issues and receives reports relevant to the Province from the National Department of Health.

2. Given the busy schedule of the SG, it would benefit the Province to have a Project Manager for COVID-19 with the necessary authority to fast track actions.

The Premier of the Province Hon. Mr. Oscar Mabuyane announced the establishment of the Project Management Unit for a comprehensive response to COVID-19. The Project Management Unit(PMU) has established the following structure (Fig. 1 below).

Dr Zungu leads the PMU. She works with Dr Monde Tom, a financial management expert with vast experience in both the public and private sector, leads the Business Continuity Workstream and Mr LauwrenceVanZuydam an experienced HR executive seconded from the Office of the Premier.

The project leader is responsible for directing all COVID-19 activities and for fasting track actions. The PMU has been integrated into the overall Eastern Cape Department of Health’s Covid-19 response and supports the HOD as the accounting officer.

The structure of the PMU and the related workstreams is depicted below.

4. Certain hospitals are currently overwhelmed (Doran Nginza in NMB in particular) by the patient demand, and lack of infrastructure, equipment and human resources to meet the clinical care demand which the Department needs to address.

This recommendation is specific to DorahNginza and Livingstone hospitals as there had been persistent negative media reports about the two facilities.

Dora Nginza Hospital

Maternity Services

The Department resolved the congestion of the maternity wards at DorahNginza by strengthening the peripheral clinics to operate their midwife services. They have also addressed the shortage of staff by fast-tracking the recruitment of doctors and nurses.

Upgrade of Dora Nginza Hospital- 100-bed wing

The Department upgraded a dilapidated wing of the hospital to provide a 100-bed wing to support the COVID19 peak. The project was part of the Province’s “Accelerated Construction Program” which meant that a project that would typically take four months, the constructors completed in two months. The Department handed over the site to DorahNginza Hospital on the 6th July 2020.

Oxygen Reticulation

The National Oxygen Team undertook an audit of the whole oxygen reticulation system of the Dora Nginza hospital. It found that the hospital has four Oxygen Manifolds with only one partially functional. Repairs to the system commenced on the 28th July. The local car manufacturing company has committed to the replacement of two manifolds, and the Department has ordered a further one. The full functionality of all the manifolds will ensure a continuous supply of oxygen at the correct pressure and volume.

Livingstone Hospital

Infrastructure

The Department undertook a project to upgrade the basement to provide an additional 68 Beds with Oxygen. The initiative is also part of the “Accelerated Construction Program”.

Leadership

The Department appointed an Acting CEO for the Livingstone hospital on 22nd July. Also, they have advertised the post of Nursing Service Manager and CEO. The processes will be fast-tracked.

Facilities Management

The hospital management set-up a short-term 6-month cleaning contract. The intention is to ensure that the staff at Livingstone hospital are reoriented into a deep cleaning routine and protocols. The washing machine has been repaired, resulting in improvement with the laundry services.

3. While the metros have mobilised reasonable infrastructure to meet the surge, the Eastern Cape Department of Health (the Department) needs to give attention to the scaling-up of service delivery requirements such as the adequate provision of oxygen, equipment, human resources, and medicines necessary for the management of the Pandemic.

6. Historic arrangements for drainage areas, resource allocation, and referral routing are not addressing the significant surge in patient numbers, particularly in underserved, vulnerable populations.

7. Emergency Medical Services and patient transport services require intervention to ensure continued function.

8. Within the Province, the oxygen separation plants are located in the Nelson Mandela Bay Metro. The distribution of the oxygen is, therefore, a challenge for areas furthest from the Metro.

We have addressed the recommendations 3, 6, 7, and 8 above through adoption of a service delivery model that rearranges the structure and resource distribution within the Eastern Cape health system to optimise service delivery.

Currently, the major urban areas contain all the critical care capacity, that is Nelson Mandela Bay and Buffalo City metros, Mthatha, and to a limited extent, Queenstown. The outer reaches of the western, central and eastern areas are more than three-hour drive time from existing critical care beds. In collaboration with the Provincial Department of Health, the PMU developed a Hub and Spoke approach to address the shortfalls. The purpose of the Hub and Spoke strategy is then to identify the hospital drainage (referral pathway) to existing and or expanded Critical Care capacity coupled with the estimated distance and travel times to reach a bed safely at the peak of the COVID19 Pandemic. The PMU has also determined the high-risk areas based on at least one of the following factors:

  • Travel times between facilities
  • Travel distance between facilities
  • Quality of the road infrastructure
  • Quality of hospital infrastructure between the referring hospital and the receiving hospitalCritical care bed saturation

The District team are in the process of confirming satellite hubs for the expanded distribution of COVID19 critical care beds to address the potential shortfall. The PMU will support the Province to optimise existing district hospitals based on minimal input but with a maximum return.

The Department of Health supported by the PMU has made the following progress:

Infrastructure: The following infrastructure projects are underway in the Province, to yield a significant increase in the general ward beds (n=2,022) and critical care beds (n=311). The addition of the infrastructure development from the baseline will address the NEC long-term projected peak demand for COVID-19 admission in the districts and Province. The Rev Dr Elizabeth MamisaChabula Hospital facility will receive an additional upgrade of the current Phase I priority three beds to include additional oxygen supply. The intervention will add 312 oxygen beds to meet the demand in the Nelson Mandela Bay Metro and surrounding districts.

Figure : Estimated General Ward Beds required to meet the demand for COVID-19, current and projects under construction.