Questions and Replies

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25 February 2022 - NW106

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)With reference to his department receiving an unqualified audit with findings from the Auditor-General for 2020-21, what (a) were the findings regarding the specified audit report and (b) consequence management has been put in place by his department; (2) whether there are distinct timelines factored into the consequence management system; if not, why not; if so, what are the relevant details; (3) what (a) was the nature of the transgressions and (b) departments were guilty; (4) what disciplinary actions have been taken against implicated officials who committed offences such (a) as irregular expenditure and the amounts thereof and (b) noncompliance with the law, regulations and documents, internal policies and procedures; (5) what control system has been put in place to ensure proper record keeping in order to ensure that complete, relevant and accurate information is accessible and available to support financial and performance reporting?

Reply:

(1) (a) Material misstatements of receivables, payables, immovable tangible assets, and commitments identified by the auditors in the submitted financial statement were corrected. Effective and appropriate steps were not taken to prevent irregular expenditure, as required by section 38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1. The majority of the irregular expenditure disclosed in the financial statements was caused by contravention of procurement processes. Some of the contracts were awarded to suppliers whose tax matters had not been declared by the South African Revenue Service to be in order, as required by treasury regulation 16A9.1(d). Some of the contracts were awarded to bidders who did not submit a declaration on whether they are employed by the state or connected to any person employed by the state. Some of the goods and services of a transaction value above R500 000 were procured without inviting competitive bids, or deviations were approved by the accounting officer, but it was practical to invite competitive bids.

(b) The Department has a Loss Control Committee which will investigate and determine if there are any officials accountable. Subsequently, appropriate measures in line with the labour relations prescripts will be applied.

(2) The labour relations directives and prescripts have prescribed timelines on dealing with consequence management once accountability issues have been dealt with and determined.

(3) (a) Non-compliance with the prescripts such as Public Financial Management Act no.1 of 1999, National Treasury Instruction note 3 of 2016/2017, Departmental Policy and SARS requirements;

(b) Departments that were guilty are as follows:

a) Nature of Transgression

b) Guilty Department

AGSA had indicated that the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to render emergency support services to Project Management Office (PMO) during Covid-19.

Supply Chain Management

AGSA had indicated that the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to investigate an urgent transaction on expenditure that was deemed irregular.

Supply Chain Management

AGSA had indicated that the transaction was Non-compliant with Local production and content for designated sector and noncompliance with tax requirements on foreign procurement. The services were for emergency procurement of vaccines for the country.

Affordable Medicines

AGSA had indicated that the services were rendered outside the approved period without sourcing the necessary approval from the accounting officer / delegated official / approving authority such as National Treasury.

Workforce Management

The service was for rendering of strategic communication services for NHI and emergency communication for Covid-19: Non adherence with SCM processes and National Treasury prescripts on emergency procurement.

NHI and Communication

4. (a) Other cases have been sent for assessment in terms of the Irregular Expenditure Framework as published by National Treasury, dated 16 May 2019 to determine whether the transactions are indeed irregular or not. Some of these transactions have been sent to the Office of the Accountant-General to determine if indeed the findings of AGSA are valid or not in terms of the Mechanism for Resolving Disagreement Between the Auditor (AGSA) and Auditee dated 01 June 2021, the auditee in this cases is (NDOH). Some of the officials implicated in the cases mentioned had been suspended and disciplinary hearings are underway/ in progress.

Below is the table indicating all transactions declared irregular by AGSA in terms of NDOH Final Management Letter. The table below provide details in so far as question 4(a) is concerned on the nature, the amount and the status.

Nature of the services

Amount

Status on Disciplinary Action

Non-compliance with the law, regulations and documents, internal policies and procedures

According to AGSA, the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to render emergency support services to PMO during Covid-19.

R14 671 755

Referred to NT to mediate between AGSA and NDOH to determine if transaction are irregular.

Non-compliance with NT instruction note.

According to AGSA, the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to investigate an urgent transaction on expenditure that was deemed irregular.

R592 250

Referred to NT to mediate between AGSA and NDOH to determine if transactions are irregular.

Non-compliance with NT instruction note.

Non-compliance with Local production and content for designated sector and non-compliance with tax requirements on foreign procurement. The service was for emergency procurement of vaccines for the country.

R4 350 502

Referred for assessments to determine if the transgression is non-compliance or irregular.

Non-compliance with SARS requirements

Services were rendered outside the approved period without sourcing the necessary approval from the accounting officer / delegated official /approving authority such as National Treasury.

R14 984 000

Referred for assessments to determine if the transgression is non-compliance or irregular.

Non-compliance with NT instruction note.

The service was for rendering of strategic communication services for NHI and emergency communication for Covid-19: Non adherence with SCM processed and National Treasury prescripts on emergency procurement.

R150 000 000

Disciplinary hearings are currently in emotion.

Non-compliance with NT Instruction.

(b) The status above encompasses both non-compliance and irregular expenditure.

(5) The National Department of Health developed and implemented the online National Quarterly Reporting System (NQRS) in 2017 to ensure quarterly progress on the Annual Performance Plan (APP) is tracked and on-line evidence storage. The system tracks progress towards attaining the objectives and targets set in the APP, highlighting achievements, deviations, factors enhancing or inhibiting progress, as well as corrective action when targets are not achieved. The Portfolio of Evidence for reported performance is uploaded on the online NQRS to support indicator performance reports. By Day 6 of the reporting month, the Quarterly Performance Information is captured and signed-off by Directors/Cluster Managers together with the Portfolio of Evidence which is uploaded on the online NQRS. The Quarterly Performance on APP targets is reviewed and signed off by Branch Managers. The Internal Audit Unit of the National Department of Health reviews the Performance Information and supporting evidence every quarter and reports to the Audit and Risk Committee. The primary objective is to review reported Performance Information against the Portfolio of Evidence and provide feedback to the Department to address any shortcomings identified. The NQRS system provides a single online storage for all Performance Information updated during quarterly reporting which is also used by Auditor General for auditing purposes

END.

25 February 2022 - NW70

Profile picture: Hicklin, Ms MB

Hicklin, Ms MB to ask the Minister of Health

(1) What measures are in place for healthcare workers working in State hospitals to access mental health wellness programmes; (2) what provision is there for healthcare workers suffering from COVID-19 burnout to access mental health medical leave; (3) what provision has his department made to (a) prevent hospital management from marginalising staff who admit to needing mental health leave as a result of the extreme pressures they have been subjected to as a result of COVID-19 and the loss of life they have seen in the past 20 months and (b) reduce stigma attached to mental health medical leave

Reply:

1) State hospitals have employee wellness programmes which are aimed at supporting the staff that have any workplace-related health problems including those who have mental health problems. These programmes are staffed by professionals who are trained in Employee wellness, including mental health support. Whenever there are staff members who are faced with a case that is beyond their level of expertise, they refer such cases to the relevant professionals for further management.

2) Health care workers who are suffering from Covid-19 burnout are managed on the case-by-case basis, as the situation differs from person to person. Whenever cases are reported in the health establishments, these are referred to the Employee Wellness programme manager, who makes a determination on the recommendation for leave of absence. Some of these health care workers make use of family doctors and such cases have been accepted by health establishments as genuine cases deserving leave.

(3) (a) The department has no record of any hospital management that has marginalised staff who admit to needing mental health leave as a result of the extreme pressures they have been subjected to as a result of COVID-19, and loss of life they have seen in the past 20 months. To the contrary, the department has been very appreciative of all health care workers including hospital managers who have equally been affected by the Covid-19 pandemic.

(b) The department is also not aware that there have been people that were stigmatised as a result of being in need of mental medical leave. The department is working on the sector wide productivity management and wellness services as part of post Covid-19, management for psycho-social support and reintegration.

END.

25 February 2022 - NW21

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

In terms of a media statement issued by his department on 4 February 2022, that he has appointed an Appeal Committee to adjudicate on the matter between the SA Health Products Regulatory Authority and an organisation called Free the Children - Save the Nation, over the vaccination of children between the age of 12 and 17 years old in terms of the Medicines and Related Substances Act, Act 101 of 1965, (a) what factors did he consider to convene the Appeal Committee and (b)(i) what is the process for hearing of evidence by the Appeal Committee and (ii) will such expert testimonies be publicly available?

Reply:

a) The following factors were considered to convene the Appeal Committee

Section 24A (1) of the Medicines and Related Substances Act, 1965 (Act 101 of 965) as amended ("the Act") provides that any person aggrieved by decision of the SAHPRA may appeal against such decision by notifying the Chief Executive Officer (CEO) within 30 days of becoming aware of such decision of his or her intention to appeal and setting out the full grounds of appeal. The Act also provide for a mechanism where CEO must meet with the Appellant to try to resolve the matter, especially if the appeal involves administrative matters (Section 24A (2). This process is done without the presence of the legal representative.

Section 24A (3) and (4) of the Act provides as follows:

‘‘24A. (3) Should the Chief Executive Officer and the appellant fail to resolve the matter as contemplated in subsection (2), the appellant shall within 30 days of being notified by the Chief Executive Officer of the failure to resolve the matter and upon payment of a prescribed fee, request the Minister in writing to convene an appeal committee.

(4) The appeal committee contemplated in subsection (3) shall -

(a) comprise the chairperson who shall have knowledge of the law and four other persons who shall have knowledge of the subject matter of appeal but with no financial or business interests in the affairs of the parties to the appeal, two of them nominated by the appellant and the other two by the Chief Executive Officer; and

(b) conduct the appeal hearing and make a decision within 30 days from the day when it first meets to hear the appeal.’’

Free the Children Save the Nation NPC represented by Mr John Taylor launched an appeal in terms of Section 24A (4) of the Act. The Appellant and the CEO of SAHPRA met to try and resolve the issues raised by the Appellant as provided for in the Act. However, the matter could not be resolved.

If the issues raised by the Appellant had not been resolved through the mechanism of a meeting between the CEO of SAHPRA and the Appellant, the Act compels the Minister to convene an Appeal Committee. Therefore, the Appeal Committee was convened after the processes envisaged in section 24A (1) to (3) were done but the matter remained unresolved.

b) (i) The process for hearing of evidence by the Appeal Committee

In terms of Regulation 48 (2) (a) and (b) of the General Regulations made in terms of the Act, the Appeal Committee has to determine the procedure for its hearings and may in this regard, if it deems necessary, call for oral evidence or argument.

The Appeal Committee in its meeting of 21st January 2022 agreed that it will conduct the hearings through oral submissions together with both medical and legal representation. The Parties may call their experts to lead evidence in support of their case.

(ii) The Appeal Committee in its meeting with the Parties held on 08 February 2022 had agreed that both the media and the broader public be invited and have access to the link of the hearings. Therefore, the expert testimonies will be open to the public as the hearing will be open to the general public.

END

21 December 2021 - NW2860

Profile picture: Tito, Ms LF

Tito, Ms LF to ask the Minister of Health

What (a) total number of public hospitals have declared state of readiness for the new COVID-19 variant and (b) measures have been put in place to boost the capacity of those hospitals that are not ready yet?

Reply:

 

(a). All gazetted hospitals in the country are declared ready for the Covid-19 variant. These hospitals are able to manage Covid-19 cases in the context of the hierarchy of health services per type of facility. This arrangement ensures that the patients are referred the next level of care as and when the condition of the patient changes, from mild, moderate to severe state.

(b). The department has prepared all the 336 gazetted public hospitals plus the private sector hospitals for Covid-19 variant depending of the packages of services and hierarchy of care for each level of the hospital. At the start of the pandemic in 2020, the department did the following in order to determine the state of readiness for Covid-19 admissions:

    • conducted an audit for oxygen reticulation capability;
    • identification of respiratory support devices needs;
    • determined infrastructure needs as well as Human Resource needs.

This is the information that has been used to ensure that the hospitals are ready for all various Covid-19 variants, including preparations for this current variant. Based on the Intra-Action Review that was conducted for the third wave, the department was confident to confirm during the planning for the fourth wave that all hospitals are ready for this new variant.

END.

21 December 2021 - NW2844

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What (a) number of surgeries and/or operations were (i) cancelled and (ii) postponed in each province since the start of the lockdown to curb the spread of COVID-19 and (b) is the breakdown of reasons why the surgeries and/or operations were postponed and/or cancelled considering that patients wait for months for the dates to have surgery performed and/or operations done?

Reply:

 

The Honourable Member is kindly informed that this kind of information is not readily available at the National Department of Health. This information must be sourced from hospitals in provinces, and therefore the department is busy collating the information from the hospitals through the provinces. The information will be shared with the Honourable Member and Parliament as soon as it is received from the provinces.

END.

21 December 2021 - NW2853

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

Which recommendations have been made for children under the age of five to receive vaccination, given that the Omicron virus is reported to affect children under five years the most?

Reply:

 

No COVID-19 vaccines are currently approved for use in South Africa in children under the age of 12 years.

Trials in young children have been completed for two inactivated vaccines (Sinovac-CoronaVac and BBIBP-CorV), and these products have been approved by Chinese authorities for use in children 3-17 years. However, although these vaccines have received emergency use approval from the World Health Organization (WHO) for adults, they have to date not been approved by WHO for use in children1. Several additional COVID-19 vaccines are undergoing trials in young children (including children as young as 6 months of age). Results from these trials are expected in late 2021 or early in 2022, and it is likely that the manufacturers will then apply for regulatory approval for the vaccines to be administered to children under five years of age. Decisions to vaccinate young children in South Africa will require approval by SAHPRA, and will be guided by recommendations of the Vaccine Ministerial Advisory Committee.

It should be noted that whilst initial COVID cases caused by the Omicron variant included a large proportion of children under five years of age, this pattern has changed with more cases now being seen in older (adult) age groups. The incidence and severity of disease in young children is being carefully monitored in order to understand the impact of the new variant on young children.

Caregivers should protect young children from COVID infection by ensuring that all household members and other close contacts who are eligible to be vaccinated, are fully vaccinated, and that standard COVID prevention practices are followed at all times.

END.

1 World Health Organization. Interim statement on COVID-19 vaccination for children and adolescents. 24 November 2021

21 December 2021 - NW2843

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What (a) is the total number of nursing colleges in each province in the Republic and (b)(i) number of nursing colleges have been shut down in the past two financial years and (ii) were the reasons for closing the colleges; whether he has found the nursing colleges to be effective and running smoothly; if not, why not; if so, what are the relevant details; what is the total number of graduates who have (a) graduated from the colleges and (b) been absorbed into the departments in each province over the past five years?

Reply:

 

  1. (a) There are 10 nursing colleges in the Republic. One located in each of the nine provinces and the 10th being the South African Military Health Service (SAMHS). These colleges have 45 campuses and 40 sub-campuses located in district and subdistrict level in each of the provinces to ensure access to nursing education by local communities

(b) (i) None of these colleges were shut down in the past two financial years.

(ii) Not applicable

  1. The colleges are running effectively and smoothly, phasing in new programmes whilst phasing out the legacy (old) programmes in compliance with relevant legislation guiding nursing education. While the accreditation process by the Council for Higher Education (CHE) for some programmes has been slower than expected, department is communicating with the CHE to expedite the accreditation of these programmes.
  1. (a) Table 1 overleaf reflects the number of graduates who were produced by South African Nursing Colleges in the past five-years in question:

Table 1. Number of graduates produced by South African Nursing Colleges in the past five years

Province

Name of the College of Nursing

Graduates produced per year:

   

2016

2017

2018

2019

2020

Total

Eastern Cape

Lilitha College of Nursing

358

331

426

336

322

1773

Free State

Free State School of Nursing

165

155

144

152

145

761

Gauteng

Gauteng College of Nursing

620

614

507

593

847

3181

KwaZulu Natal

KwaZulu Natal College of Nursing

316

533

393

512

164

1918

Limpopo

Limpopo College of Nursing

218

188

200

235

169

1010

Mpumalanga

Mpumalanga College of Nursing

322

76

304

243

146

1091

Northern Cape

Henrietta Stockdale Nursing College

25

44

18

46

13

146

North West

North West College of Nursing

275

130

118

200

269

992

Western Cape

Western Cape College of Nursing

243

250

77

34

6

610

SAMHS

SAMHS Nursing College

61

40

56

14

41

212

Total

11 694

(b) The following table reflects the number of eligible graduates who were absorbed into statutory posts for Professional Nursing Community Service in the past five years (The numbers below are inclusive graduates from Nursing Colleges and Universities)

Table 2.

Province

Graduates absorbed as Community Service Nurses in each year:

 

2016

2017

2018

2019

2020

Total

Eastern Cape

582

514

621

551

587

2855

Free State

217

195

211

173

164

960

Gauteng

683

781

677

655

970

3766

KwaZulu Natal

648

700

684

687

439

3158

Limpopo

171

212

276

323

279

1261

Mpumalanga

265

208

217

295

251

1236

Northern Cape

74

53

102

74

92

395

North West

390

304

394

471

268

1827

Western Cape

384

381

364

323

364

1816

SAMHS

61

40

56

14

41

212

Total

17 486

NB. After completing Community Service, Professional Nurses are not automatically absorbed into permanent posts. They need to apply and compete for advertised positions either Public Service or Private Sector. Based on the individuals performance during the selection process the favourable candidate is appointed into a post.

END.

2

21 December 2021 - NW2845

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What (a) number of officials in his department have been suspended due to the Digital Vibes scandal and (b) progress has been made with the disciplinary actions in this regard; whether any person has been charged yet for the Digital Vibes scandal; if not, why not; if so, what are the relevant details; what consequence management strategy has been put in place so that such scandals do not reoccur in future?

Reply:

 

  1. There are four officials from the National Department of Health (NDOH) that have been suspended and are currently undergoing a disciplinary hearing. Charges were served on the officials and the Disciplinary Hearing commenced on 22 November 2021, it is currently underway.
  2. Kindly refer to (1) above, charges have been served on the four implicated officials.
  3. The NDOH has resolved to minimize the use of deviations, and these will only be resorted to under extremely exceptional circumstances. In addition, the NDOH is the process of improving its contract management processes to ensure efficient and effective contract management.

END.

21 December 2021 - NW2736

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

What interventions has his department assisted with at the Robert Mangaliso Sobukwe Hospital in the Northern Cape, in view of some of the recent reports of the specified hospital having lost several medical officers in 2021; whether he has found that the administrative issues at the hospital have had any impact on the surgery backlog; if not, what is the position in this regard; if so, what are the relevant details; whether he will commit to investigating the challenges faced by the hospital; if not, why not; if so, what are the relevant details?

Reply:

 

The following interventions are made to assist the Robert Mangaliso Sobukwe Hospital:

(a) The hospital has an annual turnover of about 30 – 50 community service doctors;

(b) The hospital annually plans by commencing interviews with community service doctors who may be interested to continue working at the hospital around June – July;

(c) The hospital has completed the human resources process on time and the applicants were informed of the outcome of the interviews and the list of recommended applicants has been sent to the Head of Units;

(d) The hospital is currently filling 31 posts, following a resignation of a medical officer

​2. Yes.

(a) The hospital always had backlogs in ophthalmology, general surgery, and orthopaedics. This is due to an ongoing challenge of a shortage of nurses trained in theatre technique. The hospital does, from time to time, arrange blitz sessions to reduce the backlog;

(b) The total backlog for general surgery currently stands at 492;

(c) The long-term plan is active recruitment, coupled with training nurses in theatre technique to cover the rest of the province. This will allow the hospital to plan outreach programmes into the districts to minimise the burden on the tertiary hospital for beds.

(3) The Ministry and National Department of Health will continue to support the province as we do with us provinces in the identified area of staff shortages across all categories.

END.

 

21 December 2021 - NW2859

Profile picture: Tito, Ms LF

Tito, Ms LF to ask the Minister of Health

What specific interventions has he made to include African traditional healers in the fight against COVID-19?

Reply:

 

The outbreak of Covid–19 brought new challenges in the Traditional Health Practice, which led to the Department of Health developing Guidelines for Traditional Health Practitioners in dealing with Covid-19.

The Department supported the role played by Traditional Health Practitioners during the hard lockdown period by providing them with travel permits to allow them to continue looking after their patients and assist in the prevention and control of COVID-19. Traditional Health Practitioners have also been supported by the South African National AIDS Council (SANAC), by providing them with PPE procured through the Global Fund money.

END.

21 December 2021 - NW2806

Profile picture: Khumalo, Dr NV

Khumalo, Dr NV to ask the Minister of Health

Taking into consideration that the number of persons getting vaccinated is low, whilst there seems to be a budget increase towards efforts to encourage persons to get vaccinated, how does his department intend to ensure balance in return on investment in this regard?

Reply:

 

The department regrets to report that there has been no additional budget for demand generation. The additional resources have been provided by the private sector and voluntarily placement of advertisements and radio slots. The investments include making vaccination mean more to people (through demand creation) and making it easier to get vaccinated (through establishing more vaccination sites, using outreach and extending vaccination site times, primarily to weekends). Doses in the arms, especially of older people mean a lot fewer admissions and savings to the health system. Calculations have been done which show that vaccination of people over 65 years saves the health system around R850 per vaccination based on a cost of admission which is about R75 000 per admission. It has also been estimated that vaccinating 83 men over 65 years could prevent 1 admission, saving R903 in admission cost for this group.

The cost of vaccines and associated supplies remains the major investment. The cost of the logistics to provide the vaccinations increases exponentially as it becomes more difficult to reach people. Increasingly more effort and investment are required to drive towards critical thresholds of coverage. People who are willing to vaccinate if their personal costs or constraints are reduced cost the vaccination programme more to reach than those who have no limitation on access at their own costs.

The public investment case is that COVID-19 has had a devastating effect on both society and the economy:

  • COVID-19 has increased the number of deaths by about 30% since May 2020. There were 238,949 excess deaths in South Africa recorded between 3 May 2020 and 14 August 2021 (age-standardised excess death rate of 401 per 100,000 population).
  • Vaccination against COVID-19 will provide a return on investment of 11 to 20 times in terms of infections averted and costs to the economy.
  • COVID-19 related mortality is concentrated in older age groups: 82% of COVID-19 deaths recorded in South Africa have been among people over fifty years of age and 61% of recorded deaths among people over 60 years.
  • The net saving to the health system of vaccinating all men and women over 65 years of age is approximately R1.3 billion (R500 and R250 per person respectively), based on a mortality hazard ratio of approximately 2:1,4 an average cost per hospitalisation managed in a public general ward of R75,0005 and an unit cost of vaccination of R350.
  • The vaccination of younger people (aged 18-39 years) is crucial in securing the social and economic returns on investment in the medium-term. In the short-term, the vaccination of younger people will incur a net cost to the health sector (about R300 p.p.). However, they constitute over half (56%) of the total population and their uptake patterns will largely determine whether or not we reach critical thresholds of coverage.

END.

2

20 December 2021 - NW2688

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

Whether, with regard to the Nelson Mandela Fidel Castro Medical Collaboration Programme, he considered the South African rand to US dollar exchange rate when sending money to Cuba; if not, why not; if so, do students receive their allocated stipend, or is the charges and/or fees occurring in the specified exchange subtracted from their monthly stipend amount?

Reply:

 

In terms of the Agreement between South Africa and Cuba, the amount payable for tuition fees for students in Cuba is billed in US dollars and payable by the National Department of Health based on the exchange rate at the date of transfer. The amount payable is fixed per level of study per student. Stipend is also billed in US dollars.

All year calculations are made based on the current exchange rate which might fluctuate from time-to-time. The fluctuation is always accommodated to ensure that it does not negatively affect the budgeted amount. On a monthly basis students receive their stipend of USD 200.

There are no charges or fees subtracted on the stipend regardless of the exchange rate. END.

20 December 2021 - NW2689

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

With regard to the Digital Vibes tender, (a) what was the extent of vetting processes that were conducted by his department and (b) were the qualifications of team members and individuals in Digital Vibes vetted?

Reply:

 

The vetting conducted entailed the following:

  1. (i) Checked if Digital Vibes is fit to do business with the department by assessing its capability and capacity through functionality evaluation which was part of terms of reference.
    1. Checked if the Digital Vibes operates in the required business sector in so far as their registration with CSD.
    1. Checked the legitimacy by verifying its existence through the Central Supplier Database, how long they have existed, that they are actively trading, and their financial status.
    1. The department also checked if Digital Vibes and its directors/shareholders were not restricted to do business with the State through the National Treasury tender defaulters register.
    1. The department relied on the information certified by the bidder on the Declaration of bidder’s past supply chain management practices, standard bidding document 8 (SBD 8). Question 4.1 SBD 8 ask the bidder or any of its directors if they listed on the National Treasury Database of restricted suppliers as companies or person prohibited from doing business with the public sector. Question 4.2 of the same SBD 8 ask the bidder or its directors if they listed on the register of tender defaulters in terms of section 29 of the prevention and combating of corrupt activities Act (Act No. 12 of 2004).
    1. The department also checked if the bank account number belong to Digital Vibes and not individual through bank verification on the Central Supplier Database.
    2. The department made use of the declaration of interest, standard bidding document 4 (SBD 4) to be completed by the bidder and the bidder had to sign the declaration form certifying that the information furnished is true and correct. Paragraph 2.9 of the SBD 4 ask the bidder if “Do you, or any person connected with the bidder, have any relationship (family, friend, other) with person employed by the State and who may be involved with the evaluation and or adjudication of this bid”.
  1. The General Condition of Contract (GCC), which forms part of the standard bidding document issued to bidders’ states on paragraph 1.13 that “Fraudulent practice” means a misrepresentation of facts in order to influence a procurement process or the execution of a contract to the detriment of any bidder. In this case, qualifications of team members and individuals of Digital Vibes were not vetted. Bidders are bound by the GCC that their submission is truthful in all aspects and that any misrepresentation are dealt with in line with Preferential Procurement Regulations 2017. If after award it becomes apparent that the bidder misrepresented facts on the submission of their bidding documents the contract may cancelled which may lead to the entity being restricted from doing business with the state for a specified period.

END.

2

20 December 2021 - NW2753

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

(a) What plans are underway to ensure that communication around vaccination is not fueled by fear mongering, but that it emphasises personal care and survival and (b) how is the communication translated for different age groups, genders, races, sexuality, geographical occupation and other factors that contribute to language, discourse and understanding that is cognisant of social factors?

Reply:

 

(a)-(b) The responsibility of the Department of Health is to ensure that the public receives accurate and factual information from reliable sources in a manner that is reassuring and builds national trust. Part of that accurate information is to ensure that everyone understands the risks of not getting vaccinated and not adhering to personal protective practices like mask- wearing, handwashing, good ventilation and social distancing. It is also vital that older people and their families understand the substantially higher risk of Covid-19 related hospital admission and death, should they not get vaccinated as 58.4% of hospital admissions and 81.5% of deaths recorded by the end of the end of October 2021 were among people aged 50 and above.

The most effective reassurance which the National Department of Health can offer the general public is substantially reduced risk through vaccination and adherence to the personal practices described above. At the same time, the Department understands that the ‘messenger is as important as the message’ in persuading people to be vaccinated. For that reason, together with GCIS and other social partners, it engages extensively with national and provincial leadership of faith-based organisations, labour unions, traditional and Khoi-San leadership, community organisations and the business sector. It has also launched a Vooma Vax Champs initiative to encourage ordinary South Africans to become advocates among their friends and colleagues in an effort to tap into personal networks of trust.

The Department makes use of both regional radio stations of the SABC and over 65 Community based organisations to convey messaging in all 11 languages. It also distributes print material available in all 11 languages. Over 30 million brochures have been distributed through the Department of Health and partner retail stores. Print material is also available in Braille and large-print for the partially sighted and a video has been developed for people with hearing disability.

Every effort is to made to ensure that non-binary pronouns are used in the public communication to ensure inclusiveness with respect to gender identity. Where required, information is tailored for specific gendered audiences (e.g. dealing with concerns about male virility and clarifying that the vaccine is safe for men and for women who are pregnant).

A Risk, Community and Community Engagement Committee is responsible for synthesising the feedback from provinces to better understand and respond to regional issues.

The messages we disseminate are based on verified facts and we deliberately do not focus on giving airtime to the myths and misperceptions around the vaccine. Our current campaigns such as Zwakala, GenV Who You Doing It For? And the Vaccine Diaries are all based on positive reinforcement, demonstrating social proof that vaccines are safe and the continual encouragement of taking preventive behaviours.

We develop communication campaigns that are targeted to specific segments of our population, be they in a specific geography or age cohort. For example, the Zwakala campaign is targeted at youth and is primarily on social media and digital mediums. GenV is targeted at the 35+ year olds, and is on national radio and TV.

We also of course create communications for the mass market, but even when we do that, we create that content in multiple languages. Our new safer holiday campaign will be on community and national radio in all 11 official languages.

Finally, all of our communication is based on insights and data that we receive from our social listening and community engagement teams to ensure we are addressing real concerns people have around COVID-19 and the vaccine. We know that if we do this, our messages will resonate better.

Through regular coordination between the national level, provincial, sub-district level and the range of RCCE partners, we are confident that we are doing everything in our means to reach all South Africans in mediums and messages that are understandable and relatable.

The National Contact Centre has branches in six provinces to ensure a good spread of call centre operators fluent in all languages.

At the same time, we appreciate the limitations of nationally designed messaging and communication. Working with social partners and private foundations such as the DG Murray Trust and Tshikululu Social Investments, a network of close to 100 community- based organisations is supported, involving every district, to ensure that information can be contextualised and conveyed in a style and language suitable to all audiences. Partner organisations with the Department of Health, such as the AIDS Foundation of South Africa, NACOSA and Beyond Zero, assist in reaching hard to reach groups (including sex workers and other socially marginalised groups).

The Department has worked with NEDLAC, the business sector and trade unions to ensure that information is both targeted and specific to different occupational groups. The Mining Sector has done exceptionally well in attaining coverage levels of over 70%, while there is active mobilisation of the agricultural sector through joint engagement of agri-business and trade unions.

END.

20 December 2021 - NW2744

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Sithole, Mr KP to ask the Minister of Health

In light of the United Nations Children’s Fund’s release of the annual global HIV/Aids statistics, what has his department done to ensure that children and adolescents have access to HIV/Aids treatment during the past two financial years?

Reply:

 

The Department has always paid special attention on the children and adolescent access by monitoring the age group in the UNAIDS 90-90-90 targets on HIV and AIDS treatment.

The prevention of Mother to child HIV transmission is intended to reduce vertical transmission, the target is that all pregnant HIV positive women should give birth to HIV negative children, in that way this will decrease the burden of HIV in children. All these women are initiated on ART and viral suppression is monitored closely to remain at <50 or that they are virally suppressed so that they transmit the virus.

All children exposed to HIV are given HIV prophylaxis for the duration of breast feeding. Those babies who are vertically infected are initiated on ART immediately after diagnosis.

We have acknowledged the gap on access of HIV services within this population gap and have developed various strategies such as the following:

  1. Development and implementation across all the provinces of the Paediatric and Adolescent HIV Matrix of Interventions Plan: The key objectives of the intervention plan are to:
    • improve rates of earlier HIV diagnosis in children and adolescents and
    • increase access to quality HIV treatment and care for children and adolescents.
    • retain children and adolescent in sustainable treatment.
  1. Monthly provincial virtual calls as part of M&E for the programme and the Matrix Paediatric and Adolescent HIV Matrix of Interventions Plan. Provinces report back on progress of interventions, highlight challenges and share best practices that aim to improve indicators.
  1. Department of Health continues to ensure public health facilities provide adolescent- friendly health services.
  1. The Department of Health , in response to palatability of the paediatric ART suspensions, has since introduced Lopinavir/Ritonavir pellets for children, which is the new formulation of drugs, approved for use in SA. These pellets make adherence easy and encourages the caregivers to give treatment for viral load suppression.
  1. To date all provinces have procured the product and both nurses and doctors can prescribe LPV/r oral pellets.
  1. Department of Health with its partners continues to implement the Adolescent Girls and Young Women (AGYW) Programme and Determined, Resilient, Empowered ,AIDS-free, Mentored and Safe (DREAMS) program, which offers an age-tailored combination prevention package for adolescent girls and young women aged 15 to 25. The DREAMS partnership is an ambitious public-private partnership aimed at reducing rates of HIV among adolescent girls and young women in the highest HIV burden districts. The aim of the project is to:
    • empower adolescent girls and young women and reduce risk through youth-friendly reproductive health care and social asset building;
    • mobilize communities for change with school- and community-based HIV and violence prevention;
    • reduce risk of sex partners through PEPFAR programming, including HIV testing, treatment, and voluntary medical male circumcision; and
    • strengthen families with social protection (education subsidies, combination socio- economic approaches) and parent/caregiver programs.

The department has established Youth zones in some public health facilities, priority being to improve the accessibility of health services to young people and support for the HIV infected youth. Nationally the department has established 1027 youth zones out of 3434 public health facilities.

Youth Zone are youth friendly spaces within the health facility, meant to attract more young people to access health facilities. Youth zones, by dedicating time and environmental space and prioritise youth in service provision which is not limited to biomedical but include extramural activities and other initiatives. Youth zones encourage adolescents to have support groups and discuss health related and age appropriate topics including taking ART and remaining on ART.

The National Department of Health is in partnership with loveLife and Soul City to support implementation of youth prevention interventions including prevention of HIV , starting on ART and teenage pregnancies.

Soul City’s rise young women’s club comprises young people at community level that group themselves and meet on a monthly basis to discuss the social challenges in their communities and empower each other on health related issues and discuss support of young women on ART.

END.

2

20 December 2021 - NW2759

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Thembekwayo, Dr S to ask the Minister of Health

What is his department’s state of readiness to fight against the fourth wave of the COVID-19 pandemic?

Reply:

 

The department started planning for the fourth wave based on the experience from other countries and the advice from the scientists about the third wave. In this regard, the department worked with the provinces, the National Institute of Communicable Diseases, the World Health Organisation (WHO), the scientists and all other stakeholders to prepare for this fourth wave. The preparations resulted in the development of the fourth wave resurgence plan for both National Department and the provinces. The planning covered various areas which are provided for in the original surge planning framework. This plan includes the following:

  • The number of beds that are available for admission of CoVid-19 patients
  • The number of respiratory support devices
  • The capacity and capacity of oxygen supply and reticulation including sustainable availability in the hospitals
  • Availability of the Human Resources by encouraging that those who were at the front line be allowed to take leave to recover from the pressure of the third wave.

END.

20 December 2021 - NW2774

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Siwisa, Ms AM to ask the Minister of Health

How ready is his department with reference to hospitals and clinics to accommodate the new cases of COVID-19 that are on the rise?

Reply:

 

The department is ready to accommodate the new cases of Covid-19 that are on the rise. All hospitals and clinics have been prepared for the fourth wave as follows:

Both hospitals and clinics have been allocated adequate resources such as beds, oxygen supplies, Personal Protective Equipment (PPE), and respiratory support devices. The health care workers have also been allowed to take leave before the fourth wave.

END.

20 December 2021 - NW2756

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Mokgotho, Ms SM to ask the Minister of Health

On what date is it envisaged that the community of Ward 11 in Moses Kotane Local Municipality will be provided with a mobile clinic, as members of the community are currently forced to travel a long distance to the Mogwase Community Health Clinic and to Ward 12?

Reply:

 

The community of Ward 11 in Moses Kotane Local Municipality is receiving Health Services through Mobile clinic two times a month (bi-weekly). The next visit was scheduled on the 10 December 2021. The clinic that normally serves ward 11 is Ramokokastad clinic, which is currently closed due to the destruction that was caused during the unrests in the village. This clinic will be re-opened at the end of March 2022, and this will improve access of services in the Ward.

END.

20 December 2021 - NW2735

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Hlengwa, Ms MD to ask the Minister of Health

Whether his department has found that the series of outreaches under the banner of the Vooma Vaccination Weekend has been effective in getting persons, who would otherwise not vaccinate, to get vaccinated; if not, why not; if so, what are the relevant details?

Reply:

 

Three Vooma Weekends have been held, namely 3-5 October 2021, 12-14 November 2021 and 3-5 December 2021. Each Friday, Saturday and Sunday is regarded as a “weekend”.

The impact of Vooma weekends (in increasing vaccinations) was independently evaluated by Genesis-Analytics.

Vooma I: 3-5 October 2021: A total of 372,252 vaccinations were conducted over the three day period, and this upward trend was sustained through the following week. The weekday average in the week following of 106,393 compared to average of 84,121 for weekdays in the previous 2 weeks (excluding the Heritage Day holiday).

Overall, Vooma achieved a 25% increase in first dose vaccinations compared to trends over the previous month. Excluding Friday (which is a normal weekday), the number of vaccinations over the weekend was 141% more than expected from 2-3 Oct. First dose vaccinations were 138% higher than expected.

Vooma II: 12-14 November 2021: A total of 263,564 vaccinations were conducted over the three day period. Excluding Friday (which is a normal weekday), the number of vaccinations over the weekend was 95% more than expected from 12-14 Nov. First dose vaccinations were 79% higher than expected and second dose vaccinations were 116% higher than expected.

Vooma III: 3-5 December 2021: Evaluation of this weekend is underway, but only a total of 227,490 vaccinations were recorded. This number excludes paper records still to be captured. Unfortunately rainy weather in most parts of the country reduced attendance.

Statistical analysis of the first Vooma weekend found that the strongest driver of vaccinations was the availability of open sites, which in turn requires staffing. The availability of funding for overtime payment of staff is a constraint in a number of provinces. In addition to site availability, this analysis showed that average vaccinations at sites were 34% higher, indicating that the support by political and other leaders as well as greater publicity has the effect of increasing vaccinations.

END.

20 December 2021 - NW2737

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Hlengwa, Ms MD to ask the Minister of Health

With the looming fourth wave of the COVID-19 pandemic and the steady increase of infections, what total (a) number of (i) hospital beds and (ii) oxygen tanks have been made available in each province in anticipation of the potential increase in hospitalisations and (b) consultation has his department had with provincial departments of health following the news of the detection of the new Omicron variant in the Republic?

Reply:

 

  1. Total number of –
    1. Number of Hospital beds

The country has a total of 108 805 general beds and 5616 critical care beds all available for admission of Covid-19 patients.

    1. Oxygen tanks that have been made available in each province

The oxygen tanks are allocated per hospital and not per province. The size of the tank is based on the size of the hospital and its capability to manage patients that require oxygenation. The oxygen tanks per hospital are attached as annexure A. Over and above these tanks, Afrox has further repurposed the oxygen cylinders and increased the capacity from 9000 cylinders that were available before Covid-19 to 19 000that are available for use during the pandemic.

  1. The department held the two day workshop with the provinces, in anticipation of the fourth wave as part of the broad consultative process. This planning was irrespective of the variant, but more focused on the getting all resources ready for the pandemic knowing all variants are different but that they require proper planning. From this workshop, the provinces developed resurgence plans which are currently being implemented. Over and above these plans, the department, through the National Institute, as a partner, communicates with the provinces through the submission of the Situational Report on the variants. The departmental Incident Management Team has also allocated senior managers as provincial leads, who work directly with the provinces and they report to the National IMT every week on Thursday.

END.

20 December 2021 - NW2765

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Tito, Ms LF to ask the Minister of Health

Whether, with reference to reports that the Tembisa Hospital released its last two COVID-19 patients on 4 November 2021, his department has engaged with the management of the hospital to find out how they succeeded in treating patients with COVID-19 in order to adapt the strategy for other hospitals to implement it in their operations; if not, why not; if so, what are the further relevant details?

Reply:

 

According to the Gauteng Provincial Department of Health,

  • The current Covid-19 guidelines were used in the treatment of patients who were admitted with Covid-19;
  • This period also coincided with the end of the 3rd wave;
  • There is a possibility that the community vaccination has had a positive impact on the number of people getting infected with Covid-10 and a decrease in the number of patients who needed admission.

END.

20 December 2021 - NW2754

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Chirwa, Ms NN to ask the Minister of Health

In light of the fact that the 2020-21 report of the Auditor-General of South Africa to the National Assembly highlighted the general failure by his department and entities reporting to him to adhere to deviations and exceptions legislation, which then contributes to the high irregular expenditure and to an extent the corruption in his department, (a) how does he intend to resolve the specified crisis in (i) his department and (ii) entities reporting to him and (b) on what date it is envisaged that he will outline tangible measures and/or efforts working towards resolving this?

Reply:

 

(a) The department has a Loss Control Committee to deal with the Irregular Expenditure and do an analysis on some of the cases of disagreements related to the interpretation of irregular expenditure categorised under emergency procurement in line with the circular directive issued by National Treasury.

(i)-(ii) The department including the entities implemented processes to ensure end users are conscientise to comply with Irregular Expenditure Framework and its prescribed timelines. The department its further implementing processes and mechanism where all end users on procurements of goods and services are done through Supply Chain Management Cluster to ensure that internal policies and procedures are fully complied with.

Effective consequence management process when non-compliance on irregular Expenditure is detected, the department has a loss Control Committee to conduct a determination test or analyse particulars of the non-compliance to establish the facts and losses, if any, related to the transaction. The committee will then recommend appropriate action on each reported. The process is already implemented and underway, and Human Resource Labour Relation unit including Legal Service Cluster are currently dealing with the investigation of some of the cases which involves the officials and/ or service providers alleged to be committed irregular expenditure. Tangible measures and/or efforts will be determined at the end of the financial year during the audit process.

END.

20 December 2021 - NW2687

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Ismail, Ms H to ask the Minister of Health

Whether, with regard to the Nelson Mandela Fidel Castro Medical Collaboration Programme, there are currently any corruption charges against the specified programme; if not, what is the position in this regard; if so, what are the relevant details?

Reply:

 

There are no corruption charges that have been brought to my attention regarding the Nelson Mandela Fidela Castro Collaboration Programme.

However, when the National Department of Health conducted an internal audit and reconciliation with the Provinces on this Programme from October to December 2021, it was not conducted for the Gauteng Department of Health.

The details from the Gauteng Department of Health are that all files relating to the Nelson Mandela Fidel Castro Collaboration Programme have been taken by the Special Investigating Unit (SIU) for an investigation.

END.

10 December 2021 - NW2617

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Roos, Mr AC to ask the Minister of Health

Whether, with reference to the meeting of the Portfolio Committee on Home Affairs on 9 November 2021 at which his department was identified as one of the departments that has not yet provided the necessary input for the section 97 Presidential Proclamation to be signed to transfer the relevant border law enforcement functions to the Minister of Home Affairs, he has been informed that this lack of input is holding up the implementation of the Border Management Authority; if not, what is the position in this regard; if so, (a) what is the reason for delayed response and (b) by what date will he provide the necessary input?

Reply:

Yes.

a) The services provided by officials in the port of entry environment spans various areas, various legislation and some provided by the South African Health Products Regulatory Authority (SAHPRA). The nature of the various legislative mandates implemented in the border environment necessitated thorough assessment and engagements of the identified legislation to ensure relevant sections implemented within the border law environment are transferred to the Minister of Home Affairs. Engagements have had to be conducted with the Department of Home Affairs and the Border Management Authority office to ensure clear understanding of the intention so as to ensure BMA is adequately empowered with the correct provisions within the respective Acts. The SAHPRA has had to be engaged with respect to Acts enforced by the Entity and to receive their concurrence. Meetings between SAHPRA, Home Affairs and BMA have been facilitated by the department.

The department has been heavily involved in the Covid-19 response for the period under review, and that Port Health Service has been at the centre of the cross border monitoring and response to the pandemic in line with the Internaitonal Health Regulations. The Department has played a leading role in the response activities to mitigate against the spread of COVID-19 and strenghthening of our public health system in general. As we continue to respond to the COVID-19 pandemic, we experienced various challenges faced by ordinary South Africans and within our own work environment. It is my view that had things been normal, we would have responded much quicker to the section 97 proclamation as requested by the Minister of Home Affairs.

b) We await final response from SAHPRA, but are hopeful a response should be expected within the next month. It must be noted that SAHPRA has a Board and decisions are taken at the Board level. The meetings of the Board are scheduled on certain dates in a year. Fortunately SAHPRA is currently attending to the provisions of the Acts to be transferred to the Minister of Home Affairs.

 

END.

10 December 2021 - NW2589

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Hicklin, Ms MB to ask the Minister of Health

(1)What concrete measures has the Government taken to prioritise the (a) dissemination of information regarding the necessity to be vaccinated (details furnished) and (b) vaccination of poorer, older persons living in rural communities; (2) what number of persons living in the rural areas have received vaccines?

Reply:

1. The National Department of Health (NDoH) and the GCIS has worked together on a national information dissemination strategy, supported by a range of non-government partners. The strategy is informed through analysis of national and sub-national surveys and social listening, analysed by the Risk Communication and Community Engagement Committee of the NDoH and the multi-sectoral Demand Acceleration Task Team mandated by the NDoH. Together these structures have produced a variety of communication outputs, including:

  • Mass dissemination of over 25 million information brochures in all 11 languages (distribution with the support of the PEPKOR group)
  • Distribution of 300,000 posters in 14 languages through health facilities, retail stores and 40,000 spaza shops;
  • Production and broadcast of radio public service announcements on 11 public radio stations and talk-shows and live reads on over 60 community radio stations;
  • Production of videos for people with hearing disability and pamphlets in large print and Braille for people with visual impairment;
  • Extensive use of social media through the use of both banners and voice clips in all 11 languages.

The use of this material has been mediated through partnership with trade unions, faith-based organisations, traditional and Khoi-San leadership, the business sector and community-based organisations. This is facilitated through the National Communications Partnership convened by GCIS. In addition, a number of other social partners have facilitated large-scale public communication and social mobilisation strategies, including the ‘Roll Up Your Sleeves” campaign and UNICEF outreach vehicles.

Working with these partners, the private sector and clinical operators of outreach programmes at SASSA queues, provincial departments of health have extended services to poorer, older people living in rural communities. It is particularly gratifying that the highest vaccination first dose coverage for people aged 60 years and older is in Limpopo (77%), closely followed by the Western Cape (70%), Eastern Cape (68%), Free State (67%) and KwaZulu-Natal (61%) respectively. It is of concern to the Department that the highest number of unvaccinated older people in fact reside in Gauteng, with over half a million people aged sixty years and older still to be vaccinated. This illustrates the fact that urban informal settlements and inner city areas should equally be regarded as national priorities.

 

The National toll-free COVID hotline is promoted in all communication as an accessible channel through which the public discuss/can get answers to questions and concerns re vaccination, registration/booking, side effects etc. In addition, Govt leads specific communication and engagement campaigns to maximise key moment uptake, or focus on key groups i.e. Vooma Vaccination weekend launched in October,  and Vooma III week scheduled for 3 to 10 December, linking pop up sites with Vooma media (community radio imbizos and talkshows and on the ground activation of community networks and stakeholders for imbizos and one to one discussions, Festive Season Noku Mashaba communication campaign launching on 13 December, through multiple communication channels: commuter TV, billboards, community and national radio PSAs,  digital banners, digital videos, posters and social media.

Zwakala #takeyourshot youth focused campaign led by community youth influencers, across multiple mass media channels and rapidly extending into community activations and micro level co-ordination around vaccination drives, TheTruck community engagement campaigns in collaboration with provincial departments of health, district health services and UNICEF,  a multimedia truck broadcasting local stories in local languages has visited multiple high risk areas in all provinces, to focus attention of local communities on real stories of COVID 19, and encourage them to engage with ground support teams and services around COVID prevention and vaccination  This adds to existing community engagement and door to door work conducted by provinces.

 

The national Vax Champs programme launched in November, invites everyone living in South Africa to sign up to become an ambassador for vaccination against Covid-19by by encouraging friends, family and neighbours to vaccinate. This will grow a network of local champions to lead the way to higher vaccination rates.

Vaccination of poorer, older persons living in rural communities:

  • R200 Vooma Voucher (Checkers/Shoprite/USave) for every person over 50 who vaccinates for the first time during November/December
  • Pop up vaccination sites activated through Vooma campaigns, in December will focus on shopping malls, taxi ranks and recreational areas, in addition to existing vaccination sites.
  • NDoH campaign for youth to get older family members vaccinated.
  • Young people in communities volunteering to assisting older persons to register/access vaccination e.g. Grandkids4Gogos.
  • Involving the elderly tell their stories of vaccination in the stories broadcast on theTruck.

2. The following table reflects the details in this regard.

Province

District

Subdistrict

Total No of Individuals Vaccinated

Eastern Cape

Alfred Nzo

Matatiele LM

56117

Eastern Cape

Alfred Nzo

Umzimvubu LM

57755

Eastern Cape

Amathole

Amahlathi LM

37925

Eastern Cape

Amathole

Great Kei LM

10287

Eastern Cape

Amathole

Mnquma LM

68125

Eastern Cape

Amathole

Ngqushwa LM

19193

Eastern Cape

Amathole

Raymond Mhlaba LM

54348

Eastern Cape

Chris Hani

Emalahleni LM

35617

Eastern Cape

Chris Hani

Engcobo LM

40251

Eastern Cape

Chris Hani

Enoch Mgijima LM

80015

Eastern Cape

Chris Hani

Intsika Yethu LM

35129

Eastern Cape

Chris Hani

Inxuba Yethemba LM

21098

Eastern Cape

Chris Hani

Sakhisizwe LM

17292

Eastern Cape

Joe Gqabi

Elundini LM

36567

Eastern Cape

Joe Gqabi

Senqu LM

43327

Eastern Cape

Joe Gqabi

Walter Sisulu LM

25860

Eastern Cape

OR Tambo

Mhlontlo LM

48888

Eastern Cape

Sarah Baartman

Blue Crane Route LM

13550

Eastern Cape

Sarah Baartman

Dr B Naude LM

25911

Eastern Cape

Sarah Baartman

Kouga LM

34558

Eastern Cape

Sarah Baartman

Kou-Kamma LM

10512

Eastern Cape

Sarah Baartman

Makana LM

46295

Eastern Cape

Sarah Baartman

Ndlambe LM

16273

Eastern Cape

Sarah Baartman

Sundays River Valley LM

19808

Free State

Fezile Dabi

Mafube LM

10470

Free State

Fezile Dabi

Moqhaka LM

41052

Free State

Fezile Dabi

Ngwathe LM

28278

Free State

Lejweleputswa

Masilonyana LM

14156

Free State

Lejweleputswa

Matjhabeng LM

165221

Free State

Lejweleputswa

Nala LM

17612

Free State

Lejweleputswa

Tswelopele LM

17908

Free State

Thabo Mofutsanyana

Dihlabeng LM

98363

Free State

Thabo Mofutsanyana

Mantsopa LM

17315

Free State

Thabo Mofutsanyana

Nketoana LM

11677

Free State

Thabo Mofutsanyana

Phumelela LM

10440

Free State

Thabo Mofutsanyana

Setsoto LM

26445

Free State

Xhariep

Kopanong LM

24237

Free State

Xhariep

Letsemeng LM

9441

Free State

Xhariep

Mohokare LM

8126

Free State

Mangaung

Botshabelo SD

43328

Free State

Mangaung

Thaba N'chu SD

26697

Gauteng

Sedibeng

Lesedi LM

30662

Gauteng

Sedibeng

Midvaal LM

34739

KwaZulu-Natal

Amajuba

Dannhauser LM

15412

KwaZulu-Natal

Amajuba

Emadlangeni LM

5385

KwaZulu-Natal

Harry Gwala

Dr N Dlamini Zuma LM

31651

KwaZulu-Natal

Harry Gwala

Gr Kokstad LM

21176

KwaZulu-Natal

Harry Gwala

Ubuhlebezwe LM

28615

KwaZulu-Natal

King Cetshwayo

Mthonjaneni LM

11360

KwaZulu-Natal

King Cetshwayo

Nkandla LM

25250

KwaZulu-Natal

uMgungundlovu

Impendle LM

8758

KwaZulu-Natal

uMgungundlovu

Mkhambathini LM

13862

KwaZulu-Natal

uMgungundlovu

Mpofana LM

11545

KwaZulu-Natal

uMgungundlovu

Richmond LM

20912

KwaZulu-Natal

uMgungundlovu

uMngeni LM

37759

KwaZulu-Natal

uMgungundlovu

uMshwathi LM

19527

KwaZulu-Natal

Umkhanyakude

Big 5 Hlabisa LM

45860

KwaZulu-Natal

Umkhanyakude

Jozini LM

39606

KwaZulu-Natal

Umkhanyakude

uMhlabuyalingana LM

42313

KwaZulu-Natal

Umzinyathi

Endumeni LM

30232

KwaZulu-Natal

Umzinyathi

Msinga LM

29791

KwaZulu-Natal

Umzinyathi

Umvoti LM

25456

KwaZulu-Natal

Uthukela

Inkosi Langalibalele LM

45722

KwaZulu-Natal

Uthukela

Okhahlamba LM

22102

KwaZulu-Natal

Zululand

AbaQulusi LM

45325

KwaZulu-Natal

Zululand

eDumbe LM

15334

KwaZulu-Natal

Zululand

Ulundi LM

33722

KwaZulu-Natal

Zululand

uPhongolo LM

25392

Limpopo

Capricorn

Blouberg LM

56965

Limpopo

Capricorn

Lepelle-Nkumpi LM

67007

Limpopo

Capricorn

Molemole LM

34635

Limpopo

Mopani

Ba-Phalaborwa LM

44320

Limpopo

Mopani

Greater Giyani LM

74173

Limpopo

Mopani

Maruleng LM

44626

Limpopo

Sekhukhune

E Motsoaledi LM

82495

Limpopo

Sekhukhune

Ephraim Mogale LM

27245

Limpopo

Vhembe

Collins Chabane LM

61997

Limpopo

Vhembe

Makhado LM

139444

Limpopo

Vhembe

Musina LM

35627

Limpopo

Waterberg

Bela-Bela LM

24078

Limpopo

Waterberg

Lephalale LM

50594

Limpopo

Waterberg

Mogalakwena LM

111255

Limpopo

Waterberg

Mookgophong/Modimolle LM

42416

Limpopo

Waterberg

Thabazimbi LM

56965

Mpumalanga

Ehlanzeni

Bushbuckridge LM

150730

Mpumalanga

Ehlanzeni

Thaba Chweu LM

39159

Mpumalanga

Gert Sibande

Chief Albert Luthuli LM

39955

Mpumalanga

Gert Sibande

Dipaleseng LM

7464

Mpumalanga

Gert Sibande

Dr Pixley Ka Isaka Seme LM

12970

Mpumalanga

Gert Sibande

Lekwa LM

30997

Mpumalanga

Gert Sibande

Mkhondo LM

17138

Mpumalanga

Gert Sibande

Msukaligwa LM

46778

Mpumalanga

Nkangala

Emakhazeni LM

17010

Mpumalanga

Nkangala

Steve Tshwete LM

67574

Mpumalanga

Nkangala

Victor Khanye LM

18563

North West

Bojanala

Kgetlengrivier LM

15879

North West

Bojanala

Moses Kotane LM

64412

North West

Dr Kenneth Kaunda

JB Marks LM

80366

North West

Dr Kenneth Kaunda

Maquassi Hills LM

23957

North West

Dr Ruth Segomotsi Mompati

Greater Taung LM

36109

North West

Dr Ruth Segomotsi Mompati

Kagisano-Molopo LM

24018

North West

Dr Ruth Segomotsi Mompati

Lekwa-Teemane LM

14557

North West

Dr Ruth Segomotsi Mompati

Mamusa LM

16013

North West

Dr Ruth Segomotsi Mompati

Naledi LM

36651

North West

Ngaka Modiri Molema

Ditsobotla LM

60547

North West

Ngaka Modiri Molema

R Moiloa LM

53031

North West

Ngaka Modiri Molema

Ratlou LM

30624

North West

Ngaka Modiri Molema

Tswaing LM

26478

Northern Cape

Frances Baard

Dikgatlong LM

11806

Northern Cape

Frances Baard

Magareng LM

5917

Northern Cape

Frances Baard

Phokwane LM

19391

Northern Cape

John Taolo Gaetsewe

Gamagara LM

19338

Northern Cape

John Taolo Gaetsewe

Ga-Segonyana LM

43067

Northern Cape

John Taolo Gaetsewe

Joe Morolong LM

3410

Northern Cape

Namakwa

Hantam LM

9113

Northern Cape

Namakwa

Kamiesberg LM

3536

Northern Cape

Namakwa

Khai-Ma LM

6452

Northern Cape

Namakwa

Nama Khoi LM

19393

Northern Cape

Namakwa

Richtersveld LM

2749

Northern Cape

Pixley ka Seme

Emthanjeni LM

16908

Northern Cape

Pixley ka Seme

Renosterberg LM

350

Northern Cape

Pixley ka Seme

Siyancuma LM

7222

Northern Cape

Pixley ka Seme

Siyathemba LM

9357

Northern Cape

Pixley ka Seme

Ubuntu LM

6798

Northern Cape

Pixley ka Seme

Umsobomvu LM

9032

Northern Cape

ZF Mgcawu

!Kheis LM

221

Northern Cape

ZF Mgcawu

Dawid Kruiper LM

34303

Northern Cape

ZF Mgcawu

Kai !Garib LM

33835

Northern Cape

ZF Mgcawu

Tsantsabane LM

17278

Western Cape

Cape Winelands

Breede Valley LM

71510

Western Cape

Cape Winelands

Langeberg LM

35492

Western Cape

Cape Winelands

Witzenberg LM

48771

Western Cape

Central Karoo

Beaufort West LM

13220

Western Cape

Central Karoo

Laingsburg LM

2470

Western Cape

Central Karoo

Prince Albert LM

2950

Western Cape

Garden Route

Bitou LM

17872

Western Cape

Garden Route

George LM

72928

Western Cape

Garden Route

Hessequa LM

19894

Western Cape

Garden Route

Kannaland LM

8067

Western Cape

Garden Route

Knysna LM

31696

Western Cape

Garden Route

Mossel Bay LM

40162

Western Cape

Garden Route

Oudtshoorn LM

28566

Western Cape

Overberg

Cape Agulhas LM

13656

Western Cape

Overberg

Overstrand LM

44048

Western Cape

Overberg

Swellendam LM

13671

Western Cape

Overberg

Theewaterskloof LM

50439

Western Cape

West Coast

Bergrivier LM

23371

Western Cape

West Coast

Cederberg LM

26012

Western Cape

West Coast

Matzikama LM

20566

Western Cape

West Coast

Saldanha Bay LM

37267

Western Cape

West Coast

Swartland LM

39939

   

Total

4969800

END.

10 December 2021 - NW2661

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

With reference to his reply to question 1753 on 18 June 2021, wherein he stated that consequent management processes are still underway and his department still awaits the Special Investigating Unit report to supplement its processes, what (a) are the names of the individuals involved and (b) has his department done to date to make them account for their deeds?

Reply:

Following receipt of the SIU Report (the Report) on 29 September 2021 the investigators appointed to assist the National Department of Health reviewed the Report and supplemented their legal opinion on proposed charges against implicated officials.  Charges were subsequently issued to all affected officials who are identified in the SIU and Ngubane Report’s and based on the advice from the investigators.  The Disciplinary Hearing for the affected officials has commenced and is currently underway. 

 

END.

10 December 2021 - NW2625

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Moteka, Mr PG to ask the Minister of Health

What are the reasons that (a) the Jane Furse Memorial Hospital has been relying on water delivered by trucks from tenderpreneurs for many years despite having boreholes and the De Hoop Dam nearby, (b) water pipes have not been connected to the bore holes and/or from the De Hoop Dam and (c) his department chooses to spend millions monthly on a service provider who delivers water to the hospital instead of saving those resources for other service delivery issues?

Reply:

a) Jane Furse Memorial Hospital started to experience water shortages following the illegal connections on the main line from De Hoop Dam by the surrounding communities. The Provincial Department of Health through Water Affair Department end up contracting a service provider drilled a borehole on site. Due to challenge with water table level around Jane Furse Hospital, the borehole ran dry. The Sekhukhune District Municipality left with no choice but to fill up the hospital water storage tanks through water delivered by the contracted service provider.

b) Jane Furse Memorial Hospital had been connected to De Hoop Dam from its existence and the borehole is also connected.

c) Jane Furse Memorial Hospital is not involved in any forms of contract but Sekhukhune District Municipality. The Hospital is responsible of paying monthly bills as per the meter reading to Sekhukhune District Municipality.

END.

10 December 2021 - NW2563

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What (a) total number of provinces have reported to him that they are (i) withdrawing their support to the Nelson Mandela-Fidel Castro Medical Collaboration Programme and (ii) stopping payments towards the specified programme and (b) total amount in funds was meant to be paid by his department towards the programme for the 2021 academic year in each province; (2) whether he and/or his department requested the provinces to make an additional payment over and above the payments they were supposed to make; if not, what is the position in this regard; if so, what are the relevant details; (3) what is the (a) allocated annual stipend by his department for each student and (b) full breakdown as reported to his department of the costs for the programme in each province with regard to (i) stipends, (ii) insurance, (iii) administrative costs, (iv) wasteful expenditure and (v) any other costs; (4) whether his department is in possession of an audit report of the programme that he can provide to Ms H Ismail; if not, why not; if so; if so, what are the relevant details?

Reply:

1. (a) (i) None

 (ii) None

(b) The total cost per student to date, depending on the Rand/Dollar Exchange Rate at the time of transfer, is reflected below and based on:

(i) Scholarship Programme, jointly funded by both Governments.

  • Preparatory (one year) : $2000.00 per student
  • 1st – 5th Year (per student) : $5000.00
  • Stipend (per student per year) : $2400.00

(ii) Expanded Training Programme (ETP) is wholly funded by the South African Government is reflected in the table 1 below:

Table: 1

Level

Tuition Fees

Meals & acc.

Ave. cost Med. Ins.

Stipend

Preparatory

$6000.00

$6022

$450

$2400.00

1st – 2nd Year

$12, 500

$6022

$500

$2400.00

3rd – 4th Year

$11, 500

$6022

$500

$2400.00

5th Year

$13, 500

$6022

$600

$2400.00

(iii) Local Universities

Tuition fees at South African universities during the integration since inception until 2018 varies from one university to another. After the agreement signed with local universities, the cost of integration per student has been standardized since July 2018 and adjusted according to Consumer Price Index. Students have all to be in the clinical training platform for 18 months which translates into three (3) semesters. Additional costs included transportation of the final year students to local universities which depends on the mode of transport and distance to the university.

  • July 2018 – June 2019 : R231 325.00 (R115 662.50 per semester).
  • July 2019 – June 2020 : R241 734.63 (R120 867.31 per semester).
  • July 2020 – June 2021 : R252 612.68 (R126 306.34 per semester).
  • July 2021 – June 2022 : R260 696.28 (R130 348.14 per semester).

(2) Yes

This was a shortfall for the 2019/2020 academic period of students in Cuba. The shortfall was because the exchange rate baseline that was used in calculating tuition fees for students in Cuba was at R15 for the 2019/2020 academic period. Since the exchange rate escalated so much above the base line, this meant that the amount transferred to Cuba was lower than the amount received from Provincial Department of Health. The amount transferred to Cuba did not cover the total amount due.

(3) (a) (i)(ii)(iii) See Table 1 above

(iv) None known

(v) Additional costs include two return flight tickets per student during six years and/ or during a bereavement of next of kin.

(4) The department has just concluded an internal audit and reconciliation exercise from October 2021 to November 2021.The findings have been sent to Provinces for review and approval. Provinces have been requested to correct the findings by 17 December 2021.

 

END.

10 December 2021 - NW2590

Profile picture: Hicklin, Ms MB

Hicklin, Ms MB to ask the Minister of Health

(a) Whether he will re-introduce a requirement for the (a) SA Nursing Council and (b) training colleges registered with the National Qualifications Framework to include courses in Gerontological Nursing Science and/or Gerontology including Geriatrics in the up-coming nursing training curricula as the requirements of the National Health Act, Act 61 of 2003, indicate a clear need for the training of nursing care staff members in residential care facilities; if not, what is the position in this regard; if so, what are the relevant details?

Reply:

The South African Nursing Council (SANC) as the regulator of nurses and midwives in South Africa, takes responsibility, amongst others, for –

  • Setting and maintaining standards of education, training, and practice and
  • Providing mandatory guidance and additional advice to people designing and developing education programmes

Gerontology Nursing/ Geriatrics is currently not listed as a Post Graduate Diploma (Nursing Speciality) programme. However, the content of Gerontology nursing/ Geriatrics is covered in the curricula of the legacy professional nurse qualifications, the new higher education 4-year Bachelor degree as well as the new 3-year diploma programme under the following exit level outcome:

  • Provide nursing care throughout the lifespan in various healthcare settings of which the following criteria are evaluated:
  • Preventive, promotional, curative and rehabilitative nursing care is provided to different age groups in various health care settings,

Based on the above information, all professional nurses trained whether through the legacy professional nurse qualifications and the new qualifications at higher education level are full capacitated to holistically nurse geriatric patients throughout the levels of care. All other categories of nurses work under the direct supervision of the professional nurse who guide the nursing process. Should there be specific gerontology nursing needs that have to be developed, the establishment can provide that by way of in-service training and continuous professional development.

END.

10 December 2021 - NW2558

Profile picture: Van Staden, Mr PA

Van Staden, Mr PA to ask the Minister of Health

(1)Whether the Pelonomi Academic Hospital in Bloemfontein, Free State, is maintained in accordance with a five-year maintenance plan; if not, why not; if so, what are the relevant details of the specified plan; (2) whether his department has reviewed the plan; if not, why not; if so, (a) on what date was it reviewed and (b) what changes were implemented; (3) what are the relevant details of the current shortages of (a) beds, (b) medicine, (c) oxygen, (d) theatre beds, (e) theatre equipment and (f) general medical equipment; (4) (a) what are the names of the various suppliers contracted for the specified resources and (b) how frequently is medical waste products removed from the specified hospital (5) whether he will make a statement on the matter?

Reply:

1. It can be confirmed that Pelonomi Hospital is maintained in accordance with a 5-year maintenance plan. The objective of the departments’ maintenance plan is to address maintenance backlog, user needs, clinical standards, and statutory requirements (as per the occupational health and safety act).

2. The department is reviewing the plan on an annual basis through the User Asset Management Plan and Infrastructure Programme Implementation Plan (IPMP). This is to allow for new activities that need to be added and escalation of costs.

3. (a) The hospital is experiencing shortages in beds due to the maternity ward not yet being complete. The contractor terminated when progress was still at 40% to complete due to poor workmanship. New contractor is expected to be on site by March 2022 for 14 months.

(b) Medicine Shortages experienced as per the table below:

Medicine Name

Suppliers

Amphotericin B

Waiting for Buy-Out

Acetylcysteine Vials

Equity not paid by depot

Ganciclovir 500mg vials

Waiting for Buy-Out

Nylon 3/0

Waiting for Buy-Out

Phenylephrine drops

Waiting for Buy-Out

Prontosan cleaning solution 350 and 1000ml

Waiting for Buy-Out

Tramadol 100mg ampoules

Waiting for Buy-Out

Sodium Valproate 400mg vials

Waiting for Buy-Out

Nylon 1/0

Waiting for Buy-Out

Soda Lime

Depot cancelled order and awaiting buy-out

AMIKACIN 100 MG

Waiting stock – Medical Depot (DDV)

Cefepime 1g and 2g

Waiting stock – Medical Depot (DDV)

SALBUTAMOL RESP SOL 5MG/1ML 20

Depot out of stock

FLUMAZENIL 0.5 MG/5 ML AMP

Waiting for Buy-Out

CARBIMAZOLE 5 MG TAB

Waiting Buy-Out

CLOTHIAPINE 40 MG TAB

Waiting Buy-Out

DIGOXIN 0.25MG 28'S 1 TAB

Depot out of stock

RINGER'S LACTATE SOLUTION 200

Waiting stock – B-Braun awaiting stock

Saline 50ml, 100ml and 200ml

Waiting stock – B-Braun awaiting stock

Paracetamol syrup

Barrs not being paid

Augmentin syrups

Sandoz not being paid

Aldactone tabs

Sandoz not being paid

Hydralazine 25mg

Sandoz not being paid

Hibiscrub and Steriprep

Barrs not being paid

Tuberculin PPD

Company out of stock

Actilyse

Awaiting buy-out

Artesunate

Equity not being paid

Midazolam 5 and 15mg

Worldwide problem

(c) Oxygen Shortages

There is currently no challenge with oxygen. All vacuum and oxygen points are serviced. The medical gas plant room was upgraded to provide the following capacity:

  • Main tank = 19 500 Tons
  • Standby tank = 8 500 Tons

Tanks were also furnished with sensors that are directly linked to Afrox supply chain platform. Afrox is thus informed when levels go beyond 50% and is then actioned to refill such.

(d) Theatre Beds Shortages:

There are currently 4 theatre beds shared between surgical and maternity. This shortage dur to the maternity Ward and its theatre still being under upgrade and renovation.

(e) Theatre Equipment Shortages:

The following equipment is required:

  • Orthopaedic Drills = 6
  • Operating Light with Camera = 6
  • Anesthetic Machine = 3
  • Dermatome = 2
  • Tourniquet Machine = 4
  • Autoclave for non-heat item = 2
  • Mobile Suction Machine = 20
  • Electrical Suction Machine = 10
  • Theatre Chair = 18
  • CMAC = 2
  • Video System, Laparoscopic, General Surgery with Instruments = 1
  1. f) General Medical Equipment Shortages

The following general medical equipment shortages exists:

  • Cardiotocography (CTG) or Fetal Monitor = 15
  • Transport Incubator = 3
  • Hemodialysis Machine = 16
  • Mobile Theatre Light = 2
  • Dental Chair = 10
  • CPAP Machine = 10
  • Examination Light = 6
  • Ultrasound (Sonar) Machine = 4
  • Plaster (Cast) Cutter with Vacuum System = 6
  • Defibrillator = 15
  • AEEG Machine = 2
  • Instrument Washer = 2
  • Bronchoscope = 1
  • Electrosurgical Unit Tester = 2
  • ECG Simulator = 4
  • Examination Couch, Paediatric = 4
  • Electrical Safety Analyzer = 2
  • Digital Bucky X-Ray Machine = 4
  • Anesthetic Machine, MRI Compatible = 1
  • Contrast Warmer = 1
  • Injector Pump = 1

4. (a) Suppliers:

• Medical waste service provider is Buhle Waste.

• General waste service provider is Mangaung Metro Municipality.

• Recyclable waste: (e.g. white paper, card boxes and plastic cartons) the service is Waste Recyclers.

(b) Medical waste services are provided daily from Monday to Friday.

(5) No.

END.

10 December 2021 - NW2660

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

With reference to his reply to question 2344 on 18 November 2021, wherein he stated the total number of clinics situated in townships which offer speech and occupational therapy, what are the (a) names and (b) locations of each such clinic in (i) Gauteng and (ii) the Eastern Cape?

Reply:

The details of the names and locations of the clinics are being collated in consultation with the Gauteng and the Eastern Cape Provincial Departments of Health. These details will be furnished to the Honourable Member and to Parliament as soon as they have been received from the provinces concerned.

 

END.

10 December 2021 - NW2554

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Gela, Ms A to ask the Minister of Health

What steps will be taken by his department to intensify the COVID-19 vaccination rollout to ensure that the nation reaches herd immunity by the end of the year, especially now in the post-elections period?

Reply:

The goals of the vaccination programme are to save lives by vaccinating those at highest risk of severe disease and death, and to vaccinate as many people as possible so that society and the economy can open up and resume full capacity, thus protecting livelihoods.

Herd or population immunity refers to a situation where a high enough proportion of the population are immune (as a result of natural infection or immunisation) that the virus is unable to circulate; as a result even those who are not immune are protected from infection. Whilst it was initially thought that herd immunity for Covid-19 was achievable, scientists now consider this unlikely because of factors such as vaccine hesitancy, the emergence of new variants and the delayed approval of vaccinations for children.

The immediate target of the vaccine roll-out is to ensure that at least 70% of adults have received at least one dose of vaccine. As of 2nd December, 41% of adults had been vaccinated. Sufficient vaccines and capacity to vaccinate are now available, and the main constraint to achieving higher vaccination coverage relates to poor uptake of vaccines. In response, a comprehensive Demand Acceleration Strategy has been put in place in an effort to generate demand and increase the number of individuals accessing vaccination. Key components of this strategy include:

Raising the profile of the vaccine roll-out

  1. Vooma Vaccination weekends were held during October and November 2021. These included a national call to action led by the President, as well as other political, trade union, religious, traditional and other leaders. Events were also hosted by national, provincial and local leadership at vaccination sites.
  2. Working with a range of stakeholders at national, provincial and local levels in order to mobilise communities through a range of activities including mobilisation at events (e.g. religious gatherings), in public spaces (e.g. taxi ranks) and through door to door campaigns.
  3. Recognition of good performance at provincial and district level, and of outstanding performance by healthcare and other workers during Vooma Vaccination weekends.

Making reliable information regarding the safety and effectiveness of vaccines widely available

4. Increasing the availability of reliable information regarding vaccination through various media platforms including TV, radio and print media.

5. Improved signage at vaccination sites, and improving locally available information regarding location and opening times of local vaccination sites.

6. Monitoring and addressing misinformation circulating on social media.

7. Developing a network of local vaccination champions who volunteer to motivate those around them to vaccinate and report any problems with vaccination sites.

Providing incentives and rewards to vaccinated individuals

8. Limiting access to sports and other events to those who are vaccinated.

9. A pilot project whereby individuals 50 years and older can access a R100 (recently increased to R200) grocery voucher to offset any costs incurred through vaccination (e.g. transport costs).

10. Encouraging retail stores and other companies to provide rewards (e.g. entry to a lucky draw) for those who are vaccinated.

11. Consideration of making vaccines mandatory in some settings providing that these are implemented within the current legislative and regulatory framework.

Removing barriers to vaccination

12. Increasing the number of outreach and pop-up sites in an effort to take vaccinations as close as possible to people and communities.

13. Ensuring that as many sites as possible are open during weekends (especially but not exclusively during Vooma Vaccination weekends).

14. Pilot projects including provision of free transport to vaccination sites.

 

END.

10 December 2021 - NW2665

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether, in light of the fact that on 25 October 2021 the world commemorated World Mental Health Day and the acting Director-General of Health, Dr Nicholas Crisp, during a webinar hosted by his department described the current investment into mental health services as frightening while a very low number of persons actually receive the care they need, his department has come up with a solid plan to address the issue; if not, why not; if so, what are the full, relevant details?

Reply:

Yes. The Department has the National Mental Health Policy Framework and Strategic Plan.

The number of people with severe mental disorders who do not receive the care, treatment and rehabilitation for their mental health conditions is not only high in South Africa but across the Low and middle-Income Countries. The Department of health has developed a plan to improve access to mental health services in the country and to ensure that people living with mental health conditions receive the care they need.

The plan is derived from the provisions of the Mental Health Care Act, 2002 (Act No 17 of 2002), which among others, aims to make comprehensive and quality mental health care, treatment and rehabilitation services available to the population equitably, efficiently, integrated at all levels, and in the best interest of mental health care users, within the limits of available resources.

The National Mental Health Policy Framework and Strategic Plan ,which is being updated and reviewed, further provides a blue print for strategic interventions to improve access to mental health services for the general population.

The details of the plan includes:

  1. Mental health promotion and prevention of mental illness initiatives, which are not restricted to the Health Department, but integrated into policies and plans of relevant sectors, such as Social Development, Education, Correctional Services and other stakeholder departments.
  2. Integration of mental health into all aspects of general health care across all levels of the health system to reduce the burden of untreated mental health conditions.
  3. Ensuring that psychotropic medication as provided on the Standard Treatment Guidelines and the Essential Drug List (EDL) are available at all levels of health care.
  4. Strengthening district based mental health services through establishment of district specialist mental health teams to ensure comprehensive services and integration at primary health care.
  5. Enhancing institutional capacity and governance through establishment of Mental Health Review Boards in all provinces. These are quasi-judicial structures appointed by the Members of Executive Councils as prescribed in the Mental Health Care Act, 2002 (Act No 17 of 2002), to oversee that the human rights of mental health care users are upheld.
  6. Improving human resource capacity for mental health services and training of health professionals including ongoing routine supervision and mentoring at all levels of the health system.
  7. Strategic purchasing of services from health professionals through the NHI Conditional Grant to improve capacity for early identification, diagnosis, treatment and referral, at Primary Health Care including forensic mental health services.
  8. Improving infrastructure for mental health services in Primary health care facilities, general hospitals and specialized psychiatric hospitals.
  9. Development of community mental health day care and residential care facilities for people with severe mental illness and severe or profound intellectual disability
  10. Strengthening Inter-sectoral collaboration to address the social determinants of mental illness
  11. Ongoing surveillance and research on mental health services in the country. The Department recently conducted research on the evaluation of the health system cost on mental health services and programmes in the country; and on the mental health investment case to inform evidence based mental health plans and programmes.

END.

10 December 2021 - NW2562

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Ismail, Ms H to ask the Minister of Health

(1)With regard to the oversight measures that he implemented for the COVID-19 Vaccine Injury No-Fault Compensation Scheme, which includes the creation of the Governance Oversight Committee, what (a) are the reasons that the draft regulations state that the specified committee will be headed by a retired judge, (b) is the date on which the final members for the committee will be chosen and (c) are the relevant (i) qualifications and (ii) job descriptions for all the positions in the committee; (2) (a) through which system and/or entity will disbursements be made and (b) what are the criteria for (i) disbursements for claimants and (ii) deciding on the amounts payable; (3) whether he will provide Ms H Ismail with a list of candidates nominated for the committee; if not, why not; if so, what are the relevant details?

Reply:

1. (a) Initially the National Department of Health (NDOH) anticipated that the adjudication and appeals process of the NFC Scheme would be complicated and onerous and that a retired judge would be better placed to oversee the scheme and adjudicate the appeals.  Upon re-assessment the NDOH has realised that the processes and caseload are not as complicated and burdensome hence the requirement for a retired judge and a Governance Oversight Committee has been done away with and this will reflect in the amended Regulations and Directions that will be published soon.  All oversight powers will now vest with the DG as the Accounting Officer of the NDOH.

(b) No committee members have been appointed on the basis that the Governance Oversight Committee will no longer be required.

(c) See (a) and (b) above.

2. (a)-(b) The disbursements will be done by the NDOH.  Disbursements will be made once claimants have been able to establish a causal link between the vaccine and the injury.  This will be assessed by the National Immunisation Safety Expert Committee and the Adjudication Panel will set the quantum.

3. The NDOH is not able to provide a list of nominated candidates for the Governance Oversight Committee since the Committee was never established based on the reasons outlined above.

END.

10 December 2021 - NW2663

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

With regard to the Auditor-General’s Budgetary Review and Recommendation Report dated 10 November 2021, which was presented to the Portfolio Committee on Health, wherein it was noted under consequence management that investigations within his department are either not initiated or those initiated were not completed and, therefore, no one was held accountable for the irregular or fruitless expenditure, what (a) total number of current investigations have been launched by his department regarding irregular and fruitless expenditure in this financial year, (b) is the status of the investigations referred to in (a) and (c) total number has been completed in specific?

Reply:

(a) In the financial year 2021/22, there are no new irregular expenditure cases for the two quarters reported. 

There are 8 Irregular expenditure and 25 Fruitless and Wasteful expenditure cases registered from previous financial years. 

(b)  A total of 8 irregular expenditure cases are under investigations and 25 Fruitless and wasteful expenditure cases are pending investigation. 

(c)   None has been finalised to-date, but cases are reported to our Audit and Risk Committee on a quarterly basis to ensure regular oversight on irregular, fruitless and wasteful expenditure cases. 

Delays noted in finalizing cases are mostly due to Covid-19 and the move of the Department of Health offices from the Civitas building to Dr. AB Xuma building.  

 

END.

03 December 2021 - NW2487

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

In light of the 2021 report on mortality and causes of death by Statistics South Africa that records diabetes as the second deadliest disease in the Republic, the killer disease more people than HIV/Aids, hypertension and other forms of heart diseases combined, the major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation, as well as the highest risk factor for COVID-19 patients, what are the full relevant details of the plans that his department has put in place in order to promote (a) awareness of the dangers of diabetes and (b) access to proper health care in the Republic?

Reply:

a) The Department has put the following interventions in order to promote awareness on the dangers of diabetes:

  1. The department has developed Information, Education and Communication (IEC) materials on the signs and symptoms of diabetes, prevention measures and identification of risk factors. These materials have been shared with all provinces and are available in all the clinics. The materials are also used by the Community Health Workers as well as Health Promoters as part of the wider reach to the public. This is done as part of the routine services at all platforms, including during the commemoration of Health Events and at community campaigns. The target groups for these messages include vulnerable persons such as the youth, older persons, and persons with disabilities.
  2. The Department has developed material which is used by nurses to educate patients and promote health and wellness when patients attend routine health visits.

b) Interventions which demonstrate how access to proper care for patients with diabetes is created, among others include:

1. Additional to the interventions listed above, he department is also conducting screening for chronic diseases including for diabetes at health facilities as part of the routine services in all our clinics, at mobile health facilities and is offered at the general Health Counselling and Testing Campaigns during all public events.

2. The department has further developed policies, strategies and guidelines including Primary Care Adult, Standard Treatment Guidelines and Essential Medicine List on the prevention, and treatment of diabetes including on preventing complications.

3. The Department promotes that diabetes risks and care are integrated in the policies, strategies, and guidelines of other health programs to address amongst others: gestational diabetes and diabetes among TB patients. The integrated approach for diabetic patients with co-, and multi- morbidities is implemented through the Ideal Clinic service delivery platform.

4. The department also introduced the Centralised Chronic Medicine Dispensing and Distributing mechanism which ensures that the medicines are available and reach the eligible diabetic patients at points where they live and work.

5. There has been training of health care workers at all levels to enhance knowledge of diabetes and risk factors as well as to improve competencies when treating patients.

6. The department has also strengthened home and community-based care and support of patients with diabetes by community health workers.

END.

03 December 2021 - NW2461

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

What security contingency plans have been put in place by his department to help fight the recent spate of crimes which are occurring at various hospitals where patients and doctors are robbed at gunpoint of their valuables, including cellphones and jewellery?

Reply:

10 In 2018, Ministers of Health and of Police met to discuss safety and security challenges emanating from the incident where a Dr was shot at in Limpopo at Letaba Hospital. It was resolved that an inter departmental task team should be established comprising SAPS, PSIRA, DLE, SSA and all Provincial Security Managers to develop a safety and security strategy to address security challenges.

2. In this regard, a Task Team through National Joint Operational and Intelligence Structure (NATJOINS) developed a plan with the following deliverables:

  • Development of security infrastructure norms and standards
  • Memorandum of Agreement (MoA) between SAPS and Department of Health
  • Deployment of Reservist at identified hot spot hospitals
  • Development of a Health Security Dispensation
  • Physical assessment of hot spot hospitals
  • Normalisation of hot spot hospitals and safety of EMS practitioners

Progress to date

The following table reflects progress to date

Deliverables

Progress

Development of security infrastructure norms and standards

Done: Infrastructure Unit Support Systems (IUSS) was developed and Gazetted. This is a document developed for health facilities and provides norms and standards, which include security services.

Memorandum of Agreement between SAPS and Department of Health

Done: MOA for collaboration was developed and signed by both the Director-General of Health and the National Commissioner of South African Police Services

Deployment of Reservist at identified hot spot hospitals

Work in progress: Costing for the development of police Reservists was done, waiting for provinces to request for deployment when required

Development of a Health Security Dispensation (in-sourcing of security)

Work in progress: Dependent on inputs from provincial in-sourcing strategy and/or hybrid model, which would then be consolidated into a nation strategy. These are still outstanding.

Physical assessment of hot spot hospitals

Done: Assessments were conducted at all hot spot hospitals and recommendations were submitted to relevant HoDs for implementation.

 

3. In addition to the establishment of the task team by both Ministers (Health and SAPS), NDoH has established a team to facilitate the implementation of safety and security strategy emanating from NATJOINTS comprising South African Medical Association (SAMA), Medical Women Association of South Africa (MWASA), Provincial Security Managers and Organised Labour.

4. The National Department of Health internal team came up with the following action plan:

  • Expand membership of the Forum to incorporate other key stakeholders.
  • The Forum will be the sub-committee to the Technical NHC
  • Provinces must submit their needs for intervention and indicate hotspots hospitals for deployment of Reservists, number and period for deploying the Reservists and lastly indicate if funding is available.
  • Health Care Workers and In-house Security Officers must be trained while Private Security should be retrained every six months.
  • Provinces to provide copies of their current Service Level Agreement (SLA) to NDoH which will help the Forum to develop a universal SLA.
  • The Forum will develop standardized security services specifications.
  • Provinces to conduct and provide capacity and competency database audits and submit to NDoH.
  • Provinces must report security breaches to NDoH promptly on a continuous basis.

5. CONCLUSION

Both NATJOINTS task team led by SAPS and internal stakeholder’s security committee are meeting on continuous basis with the view to ensure that all provinces implement the strategy.

 

END.

03 December 2021 - NW2481

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

With reference to his recent media briefing held on Friday, 12 November 2021, where he informed the public that his department will ensure that there is an adequate supply of oxygen, ventilators, beds and personal protective equipment (PPE) in light of the shortage of beds and oxygen during the third wave of COVID-19 infections, what number of additional (a) beds, (b) ventilators and (c) PPEs does his department estimate will be needed nationally in order to overcome the impact of the fourth wave?

Reply:

a) Beds

The Department has no plan to increase the number of beds from the current baseline that we have. This is based on the fact that even during the third wave, which was the highest, the country never had shortage of beds and oxygen that was required for the management of Covid-19 pandemic. As an example, between the 12 and 15 July 2021, which was at the highest point of the third wave, the country had the following hospitalisation breakdown:

  • The total admissions in Non-ICU Beds was 14 319 out of total General 108 805 beds (13% bed occupancy)
  • There 2423 admissions in the ICU beds out of 5615 total ICU beds (43% bed occupancy)

This means that we have enough capacity based on the lessons learned from the third wave, and as such there is no need to increase the number of beds.

b) Additional Ventilators

Both private and public sector hospitals have received 14 292 ventilators from Solidarity Fund. These devices are in the hospitals and approximately 7000 have been used. This has left us with a strategic reserve in the event of the increase in the number of patients. The department has further received 5708 of the additional ventilators which is the reserve that is kept in the National Department of Health for further deployment in the event of further pressure that may arise.

c) Additional PPEs

PPEs are in the main consumable and as such they are dependent on the rate of use. The Department has a system for monitoring the Stock On Hand, which alerts the department to the areas of acute shortages. The department has budget which will be used whenever the PPE reach less than 70% at aby given time.

END.

03 December 2021 - NW2493

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

With reference to the guidelines stipulated in the Occupational Health and Safety Act, Act 85 of 1993, (a) what safety precautions and/or plans have been implemented nationally in hospitals to manage fires, (b) how often is fire equipment serviced and (c) what is the breakdown in each province in terms of fire equipment checks in each of the past five financial years?

Reply:

The following responses are as received from the nine provinces

a) Safety precautions and/or plans have been implemented nationally in hospitals to manage fires

  • In Eastern Cape, fire safety is managed at hospital level. Fire safety has several role-players including Infrastructure/ Facilities/ Engineering and Occupational Health and Safety units in most hospitals. Some hospitals have fire safety in their disaster plans and some have unit / ward – based action cards for response to fire and/or evacuation plans.
  • All Free State facilities are fitted with fire extinguishers and fire hydrants. The smaller facilities have fire extinguishers and the larger facilities e.g. Hospitals have fire extinguishers and fire hydrants.
  • Safety plans and emergency preparedness plans are in place but in many facilities in Gauteng there are no approved disaster management plans by the local authority for hospitals and also no occupancy certificates. Fire and evacuation drills are done sporadically or not done at all.
  • All institutions in KwaZulu-Natal have fire fighting equipment i.e. fire extinguishers (10538), fire hose reels (2756) and depending on the size of the institution fire hydrants (1152). Internal disaster management plans, which include fire evacuation plans are available and reviewed as necessary. Fire evacuation drills are conducted internally and documented. Fire departments from local municipalities are involved in major evacuation drills and also institutions acquire their inputs when reviewing fire evacuation plans. Fire safety training has been conducted for staff and some institutions have fire and alarm detection systems.
  • Limpopo has trained fire wardens in every facility with the Fire departments providing support and training. Fire drills are conducted at each facility.
  • Mpumalanga facilities have approved disaster and emergency evacuation plans. Risk assessments are being conducted inclusive of fire hazards and risks and control measures put in place. Local fire inspectors conduct fire inspections at facilities on invitation.
  • Northern Cape has no approved disaster plan but emergency plans are in place and bi-annual fire drills are conducted at facilities.
  • All hospitals in North West have floor plans and evacuation plans with trained fire wardens and fire drills performed. Inspections of hospitals were done by the Fire Departments of local authorities in 2021 and the recommendations are used to enhance the plans.
  • The Western Cape has adopted the MIMMS systems for hospital preparedness for managing Major Incidents. MIMMS (Major Incident Medical Management and Support) is an internationally accepted system to manage such incidents. Hospitals have Major Incident Plans that also include managing a fire incident. The Office for Disaster Medicine at provincial level and the facility manager signs off on the plan. The plan is reviewed annually or after a major incident at the facility.

(b) Servicing of fire equipment

  • Eastern Cape has a provincial contract for the fire safety equipment which includes the servicing of fire extinguishers and fire hydrants annually.
  • In Gauteng fire equipment are serviced once a year in line with expiry dates – however there is a dependency on the Department of Public Works and Infrastructure.
  • The fire equipment are serviced annually in Free State, KwaZulu-Natal, Limpopo, Mpumalanga, Northern Cape and North West.
  • Fire equipment at all facilities in all districts of the Western Cape are serviced through service level agreement (SLA) contracts. Each district has its own SLA contract and all fire equipment are serviced every 12 months according to applicable regulations and requirements.

(c) Breakdown in each province in terms of fire equipment checks in each of the past five financial years

  • Eastern Cape could not collate the information as it is kept at facility level.
  • It varied in different hospitals in Gauteng with 27 facilities reporting annual checks; 5 facilities were last assessed in 2020 and 4 facilities did not report.
  • Free State and Limpopo have annual checks on the fire equipment.
  • In KwaZulu-Natal, fire equipment checks form part of the monthly inspections by health and safety representatives.
  • Mpumalanga has spent on average R2m per annum on fire equipment checks and maintenance.
  • Northern Cape conducts monthly checks on fire equipment.
  • North West has monthly checks by Occupational Health and Safety (OHS) representatives with quarterly inspections by the provincial OHS forum.
  • Western Cape has spent on average R8m per annum on fire equipment checks and maintenance.

 

END.

03 December 2021 - NW2491

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(a) How will the no-fault compensation fund be (i) distributed and (ii) administered by his department, (b) which is the principal entity reporting to him that will be responsible for the management of the fund, (c) what measures will he put in place to (i) ensure that the management of the fund is transparent and (ii) prevent the fund from falling prey to theft, fraud and corruption and (d) which official in his office will be legally responsible for the management of the fund?

Reply:

a) (i) and (ii) Following extensive investigation and consultation between the National Department of Health (NDOH) and National Treasury to find a suitable model to distribute the funds, these two departments have resolved that the Fund will be administered within the NDOH. Treasury will transfer the appropriate allocation to the NDOH. The NDOH is in the process of establishing a unit that will administer the Fund, in consultation with Treasury and the Department for the Public Service and Administration (DPSA). The Director-General of Health as the Accounting Officer will oversee the governance and administration of the Fund.

b) See (1) above.

c) (i) and (ii) The prescripts of the PFMA will apply. Treasury and the Auditor General will also continue to exercise oversight over the Fund.

d) The Director-General of the National Department of Health.

END.

03 December 2021 - NW2492

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

With regard to the North West hospital near Lichtenberg, what (a) plans have been put in place by his department since 2017 to address the hospital’s (i) infrastructural problems and (ii) staff shortages, (b) are the costs of the plans to his department, (c) is the update on the progress regarding the implementation of the plans and (d) steps will he take to address the implementation of the plans?

Reply:

a) Plans to address the hospital’s

(i) Infrastructural problems

The Northwest Department of Health currently focus on statutory and day-to-day maintenance on health facilities in Lichtenburg. Statutory maintenance budget is ring-fenced to focus on Heating Ventilation Air-Conditioning and Cooling (HVAC) and maintenance of standby generators and boilers.

(ii) Staff Shortage

Due to funding constraints, the Department finds it difficult to fill vacant posts and continue to year-on-year overspend on compensation of employees. The Department continues to engage both Provincial and National Treasury in this regard.

b) Costs of the plans to the department

The estimated cost at present associated with the replacement of Lichtenburg Hospital amounts to R1.2 billion. This excludes costs associated with maintenance to maintain operability of the current facility and to where possible extend its life.

c) Update on the progress regarding the implementation of plans

The Maintenance plan, to do upkeep of the existing hospital, is an ongoing activity and funded for every financial year. The new Lichtenburg hospital will replace the old General de la Rey Hospital and the dilapidated Thusong Hospital which is too old for renovation at an estimated cost of R1,2 billion. The following tasks have been completed by the professional team since 2017:

  • Accommodation Schedule – The number of beds (wards) including the pharmacy, operating theatres, trauma unit, kitchen, laundry, mortuary, mechanical workshops etc. have been agreed to and signed off by the stakeholders. This forms part of the project brief.
  • Acquisition of land – The Ditsobotla Local Municipality has committed to making land available for the project (refer to attached letter from the municipality).
  • Environmental Impact Assessment – A record of approval from the relevant authorities have been received.
  • Traffic Impact Study – A preliminary study has been done.
  • Geotechnical Investigation – A preliminary soil investigation has been completed.
  • Land Survey – A topographical survey of the project site has been completed.
  • Hospital layout and designs – A layout of the hospital and the detailed designs are expected to be finalized by the department in 2022/23 financial year

d) What steps will he take to address implementation of the plans.

There is an emphasis on strategic alignment of the project in the Infrastructure Unit of the National Department of Health and the appraisal and prioritization of this capital project undertaken has received quite a bit of attention over the past years. A concerted effort in alignment is thus underway for this project to ensure full compliance to the National Treasury Capital Planning guidelines.

The National Department of Health via the Direct-Health Facility Revitalisation Grant will continue monitoring the progress of implementing plans associated with this new hospital.

END.

03 December 2021 - NW2465

Profile picture: Motsepe, Ms CCS

Motsepe, Ms CCS to ask the Minister of Health

What are the reasons that the elderly had not received assistance regarding vaccinations at their homes in the same manner that volunteers went house to house over the voting period?

Reply:

The health system has limited capacity to provide vaccinations in people’s homes. Factors that contribute to this include the fact that the vaccine must be administered by a health professional, that open vials of vaccine (5 doses) cannot be transported between different locations, that the vaccinee must be observed for 15 minutes (or in some cases 30 minutes) following vaccination and that emergency equipment must always be available during administration of vaccines.

Local health services are however encouraged to assist elderly and disabled persons who are unable to attend vaccination sites, including through provision of vaccination in people’s homes. Community health workers who visit households play an important role in establishing linkage between such persons and local vaccination sites.

Additional strategies used by the Vaccine Programme to reach elderly people include:

  • Vaccination of people in congregate settings especially in old-age homes.
  • Setting up outreach and pop-up sites at locations where older persons congregate such as at SASSA pay-points.
  • Encouraging younger people to assist elderly people to access sites.
  • Ensuring that all sites prioritise the elderly to avoid long waiting times.
  • Piloting the provision of R100 grocery vouchers for older persons to offset costs associated with vaccination such as costs associated with transport.

END.

03 December 2021 - NW2451

Profile picture: Van Staden, Mr PA

Van Staden, Mr PA to ask the Minister of Health

(1)What is the current number of vacancies at the Pelonomi Private Hospital in Bloemfontein, Free State, with regard to (a) nurses, (b) doctors, (c) cleaners, (d) maintenance officials, (e) administrative officials and (f) management personnel; (2) for what period has each of the specified vacancies not been filled; (3) what are the reasons that the specified vacancies have not been filled by his department; (4) whether corrective measures are being implemented by his department to ensure that the specified hospital operates with full personnel components; if not, why not; if so, what are the relevant details; (5) whether he will make a statement on the matter?

Reply:

1. The number of vacancies at the Pelonomi Hospital in Bloemfontein, Free State, as drawn from the Persal System and confirmed by the province are as follows (a) Nurses – 113, (b) Doctor – 22, (c) Cleaners – 33, (d) Maintenance officials – 5, Administrative Officials – 4 and (f) Management Personnel – 21.

2. These posts were vacated between the periods September 2009 to May 2021.

3. Due to financial constraints in the Free State Province, the priority of filling vacant posts is given to clinical posts. The Department does that to avoid unauthorised expenditure on Compensation of Employees (COE) within the budgetary allocation (VOTE), in accordance with Treasury Regulation 8.3 read with the PFMA section 76(4)(b) and Treasury Regulation 9 read with PFMA sections 38(1)g and 76(2)(e).” The Department is also busy with a process of reviewing the Organizational Structures of Hospitals including Pelonomi and the process is already at an advanced stage. It is anticipated that some of these posts might become redundant.

4. In order to ensure that the Hospital services are not compromised, as a temporary control measure, the Department has appointed a committee that focus in identify posts that are critical for filling. Based on the recommendation of the said Committee, those posts are urgently filled on a contract basis as when the need arise (i.e. While the Organizational Structural review is underway). The department also makes provision for approved overtime as one of the measures in ensuring that service delivery is not compromised.

5. The department will make a statement on the matter once the process of the Organizational Structure review is completed, defined in line with the service delivery requirements.

END.

18 November 2021 - NW2280

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What total number of laboratories in his department are currently (a) functional and (b) non-functional in each province; (2) what (a) total number of laboratory tests still need to be conducted, (b) is the current backlog and (c) is the monthly demand for laboratory tests nationally?

Reply:

(1) (a) All four (4) forensic chemistry Laboratories are functional. There is one (1) laboratory each in Cape Town, Durban, Johannesburg and Pretoria.

(b) None.

(2) (a)-(b) Total number of laboratory tests still to be conducted (including the backlog) as at 30 September 2021 refer to Table 1 below.

TABLE 1

Test to be conducted as at

Ante-mortem drunken driving

Post-mortem drunken driving

Toxicology testing

Food Testing

30 September 2021

38,111

10,648

30,669

1,745

(c) Monthly demand for laboratory tests nationally refer to Table 2 below.

TALBE 2

 

Ante-mortem drunken driving

Post-mortem drunken driving

Toxicology testing

Food Testing

Average number of test requests received per month (5-year average)

5,046

1,617

411

229

END.

18 November 2021 - NW2311

Profile picture: Powell, Ms EL

Powell, Ms EL to ask the Minister of Health

(a) What are the reasons that only girls and not boys are being vaccinated as part of the Human Papillomavirus vaccine roll-out and (b) on what scientific evidence does the approach rely?

Reply:

The Human Papillomavirus vaccination programme was implemented in South Africa in 2014 with the aim of reducing the incidence of cervical cancer. A recently published study showed that women - now in their 20s - who were vaccinated against HPV in England at age 12 or 13 years experienced an 87% reduction in cervical cancer compared to the expected rate among unvaccinated women[1].

The World Health Organization (WHO) recommends that cervical cancer, which comprises 84% of all HPV-related cancers, should remain the priority for HPV immunisation programmes. For the prevention of cervical cancer, the WHO-recommended primary target population for HPV vaccination is girls aged 9-14 years, prior to them becoming sexually active[2]. The South African HPV vaccination programme targets Grade 5 girl learners 9 years and older in public schools, and is therefore aligned with these recommendations.

Vaccination of secondary target populations (such as girls 15 years and older, and boys) is only recommended by WHO if this is feasible, affordable, cost-effective and does not divert resources from vaccinating primary target population or from effective cervical cancer screening programmes.

Global cost-effectiveness analysis informed by country-based evidence suggests that vaccinating pre-adolescent girls is usually cost-effective, particularly in resource-constrained settings where alternative cervical cancer prevention and control measures often have limited coverage. However, if the HPV vaccination coverage in girls is greater than approximately 50% (as is the case in South Africa), then gender-neutral vaccination (targeting boys and girls) is unlikely to be cost-effective. [3],[4]

END.

  1. Falcaro M, Castañon A, Ndlela B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study. The Lancet. 2021.

  2. World Health Organization. Human papillomavirus vaccines: WHO position paper, May 2017. Weekly epidemiological record. No 19, 2017, 92, 241–268

  3. Modelling estimates of the incremental effectiveness & cost-effectiveness of HPV vaccination. Available at http://www.who.int/immunization/sage/meetings/2016/october/07_Modelling_HPV_immunization_strategies.pdf?ua=1.

  4. Fesenfeld M, Hutubessy R and Jit M. Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review. Vaccine. 2013 Aug 20;31(37):3786-804.

18 November 2021 - NW2285

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)Whether his department has done any modelling forecasting regarding the date by which the Republic will achieve 40 million vaccinations; if not, why not; if so, what are the relevant details of the model, including the assumptions that were made in the forecasting processes; (2) whether he will furnish Ms H Ismail with any proof of delivery of the Oxford AstraZeneca vaccines; if not, why not; if so, what are the relevant details?

Reply:

1. The Department is working against the target of reaching 70% of adults (28 million persons) vaccinated with at least one dose by end of December 2021. The number of vaccinations is dependent on the number of persons vaccinated with Pfizer, which is a two dose vaccine. As of 16 November, the Department has vaccinated 16 million persons; however there have been 24.2 million vaccinations. The Department is confident that it will reach 70% coverage in all age bands; and in all provinces and districts. The coverage in the 60+ population is highest (just below 64%); while it is lowest (25.5%) among youth (18-34 year) population. We have a large youth population in South Africa. 17.8 million of 39.8 million adults are in this age group and therefore, our overall vaccination coverage is going to be heavily dependant on our collective ability to convince youth to be vaccinated.

The Vaccination coverage is a function of both supply and demand side factors. The forecasting done by the Department is largely from a supply side (looking at both health system capacity; and availability of vaccines). The lower coverage we’re observing currently is driven by demand side factors.

2. One million doses of the AstraZeneca vaccine (Covishield) were delivered to South Africa on 01 February 2021.

 

Attached is the vaccine arrival report detailing the receipt of the shipment in South Africa.

Furthermore, attached is the vaccine arrival report detailing the receipt of the shipment in South Africa.

END.

18 November 2021 - NW2340

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether, with regard to the recent roll-out of the electronic proof of vaccination for COVID-19 in the Republic, except for international travel purposes, the Government (a) intends to use the electronic proof of vaccination and/or any other proof thereof, to regulate who accesses services and facilities in the public sector and (b) will allow the private sector to regulate access to goods and services and employment, among others, using the proof of vaccination; if not, what is the position in this regard; if so, for what purposes and/or ends will the electronic proof of vaccination be deployed in the Republic?

Reply:

a) The Digital Vaccination Certificate is a digital version of the paper vaccination card that can be verified by a third party through the scanning of the QR code to establish the validity of the Vaccination Certificate. Government does not intend to use proof of vaccination to regulate access to public sector services and facilities.

b) Within the borders of South Africa, the primary use of the vaccine certificate could be used for third parties to allow vaccinated people to access certain rewards or incentives. This may include access to events such as sports, entertainment, and religious events, or to benefit from discounts or other rewards (such as entry into a lucky draw) offered by retailers or other private businesses.

The Department of Labour and Employment is responsible for regulating workplaces. Government's current position is that employees should be encouraged to vaccinate. However, employers may require employees performing certain functions, where not being vaccinated poses a risk to the employee, other employees, or members of the public, to be vaccinated. All existing legislation and regulations must be followed in dealing with situations where employees chose not to be vaccinated. 

END.

18 November 2021 - NW2348

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

Whether his department conducted any comprehensive investigation into the allegations of the Tembisa decuplets as reported by the Independent Media Group; if not, why not; if so, what has been the findings in relation to the existence of these babies?

Reply:

Gauteng Provincial Department of conducted the investigation about the allegations made about the Tembisa decuplets and produced a report in this regard, that confirms that Ms Gosiame Thamara Sithole was never pregnant. It is therefore not necessary for the national Department of health to conduct further investigations. The report is confidential in terms of the law.

END.

18 November 2021 - NW2344

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What total number of clinics situated in townships in (a) Gauteng and (b) the Eastern Cape offer (i) occupational therapy and (ii) speech therapy for children with speech challenges?

Reply:

a) Gauteng

(i) Occupational Therapy services

There are seventy-nine (79) clinics that are situated in the townships in Gauteng that offer occupational therapy onsite and forty-four (44) on outreach basis

(ii) Speech Therapy services for children with speech challenges

There are seventy-nine (79) clinics that are situated in the townships in Gauteng province that offer speech therapy onsite and forty-four (44) on outreach basis for children with speech challenges.

b) Eastern Cape

(i) Occupational Therapy

There are fifty-one (51) clinics that offer occupational therapy on outreach basis that are situated in the townships in Eastern Cape Province.

(ii) Speech Therapy

There are seventy-nine (79) clinics that are situated in the townships in Eastern Cape province that offer speech therapy on outreach basis for children with speech challenges.

END.

18 November 2021 - NW2398

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What is the duration of vaccine immunity of the (a) Pfizer, (b) Moderna and (c) Johnson & Johnson vaccines?

Reply:

Conclusive evidence regarding the duration of immunity following immunisation against Covid-19 is not currently available.

Vaccine effectiveness has been shown to be maintained over time for severe/critical disease, but does diminish for mild-moderate disease. The durability of a particular vaccine is dependent on the variants of concern circulating at the time, and the durability of the immune response of the primary vaccine series.

It is also currently not known whether immunity induced by one vaccine will last longer than that induced by others. The vaccine effectiveness of the Moderna, Pfizer and Johnson & Johnson vaccines has remained relatively stable over time for protection against hospitalisation and death. There have been mild declines in effectiveness over time for hospitalisation and death for older people and those who are immunosuppressed. This has led to recommendations to provide booster doses to older people and those who are immunosuppressed and health care workers.

Such recommendations are country specific. Although vaccine effectiveness has remained durable over time for severe/critical disease, vaccine effectiveness against infection declined in the USA in the period when the Delta variant became dominant as compared to the pre-Delta period. This has led to the recommendation to provide booster doses as mentioned above.

It is difficult to extrapolate evidence of vaccine effectiveness from other regions to South Africa for the following reasons:

  • their vaccine programmes started 4-6 months before the South African programme
  • different variants have dominated in South Africa
  • the high HIV prevalence in South Africa.

In South Africa, durability of effectiveness of the Johnson and Johnson vaccine against severe/critical disease during the Beta and Delta period was demonstrated in health care workers through the Sisonke study. The durability of the Pfizer vaccine during the Delta period has also been demonstrated. Ongoing monitoring is required to measure the duration of protection following immunisation with these vaccines.

END.