Questions and Replies
21 December 2021 - NW2853
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 - NW2736
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 - NW2845
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:
- 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.
- Kindly refer to (1) above, charges have been served on the four implicated officials.
- 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 - NW2844
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 - NW2843
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:
- (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
- 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.
- (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 - NW2806
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
21 December 2021 - NW2860
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.
20 December 2021 - NW2753
Chirwa-Mpungose, 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
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:
- 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.
- 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.
- Department of Health continues to ensure public health facilities provide adolescent- friendly health services.
- 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.
- To date all provinces have procured the product and both nurses and doctors can prescribe LPV/r oral pellets.
- 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 - NW2737
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:
- Total number of –
-
- 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.
-
- 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.
- 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 - NW2735
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 - NW2689
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:
- (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.
-
- Checked if the Digital Vibes operates in the required business sector in so far as their registration with CSD.
-
- 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.
-
- 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.
-
- 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).
-
- The department also checked if the bank account number belong to Digital Vibes and not individual through bank verification on the Central Supplier Database.
- 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”.
- 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 - NW2688
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 - NW2687
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.
20 December 2021 - NW2774
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 - NW2765
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 - NW2759
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 - NW2756
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 - NW2754
Chirwa-Mpungose, 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.
10 December 2021 - NW2660
Chirwa-Mpungose, 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 - NW2563
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 - NW2558
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
- 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 - NW2589
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 - NW2590
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 - NW2617
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 - NW2625
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 - NW2661
Chirwa-Mpungose, 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 - NW2663
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.
10 December 2021 - NW2665
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:
- 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.
- 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.
- 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.
- Strengthening district based mental health services through establishment of district specialist mental health teams to ensure comprehensive services and integration at primary health care.
- 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.
- 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.
- 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.
- Improving infrastructure for mental health services in Primary health care facilities, general hospitals and specialized psychiatric hospitals.
- Development of community mental health day care and residential care facilities for people with severe mental illness and severe or profound intellectual disability
- Strengthening Inter-sectoral collaboration to address the social determinants of mental illness
- 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
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 - NW2554
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
- 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.
- 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.
- 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.
03 December 2021 - NW2487
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:
- 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.
- 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 - NW2481
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 - NW2465
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 - NW2461
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 - NW2451
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.
03 December 2021 - NW2493
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 - NW2492
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 - NW2491
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.
18 November 2021 - NW2398
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.
18 November 2021 - NW2397
Ismail, Ms H to ask the Minister of Health
(1)What are the minimum requirements and/or competencies for senior management positions in public hospitals; (2) with reference to senior managers employed at each Gauteng public hospital, what (a) are their (i) names and (ii) current qualifications, (b) is the total number of managers who are currently not meeting the minimum requirements and (c) is being done to address the requirement mismatch?
Reply:
(1) The minimum requirements/competencies for senior management in the Public Hospital are as prescribed by the DPSA directive on minimum entry requirements for Senior Management Service (SMS).
Minimum Qualifications for entry into SMS positions
For a Director and Chief Director - an undergraduate qualification (NQF Level 7) as recognized by South African Qualifications Authority (SAQA) in Public Health/Management.
For Deputy Director-General and Head of Department – an undergraduate qualification and a post graduate qualification (NQF Level 8) as recognized by SAQA.
Minimum Years of Experience as an Entry Requirement into the SMS
SMS Level |
Relevant Experience (wef 01 April 2015) |
Entry (Level 13) |
5 years of experience at a middle/senior management level |
Level 14 |
5 years of experience at a senior management level |
Level 15 |
8-10 years of experience at a senior management level |
Level 16 |
8-10 years of experience at senior management level (at least 3 years of which must be with any organ of State as defined in the Constitution, Act 108 of 1996) |
Pre-Entry Certificate into the SMS
A further requirement for appointment at SMS level is a successful completion of the Senior Management Pre-Entry Programme as endorsed by the National School of Government.
Competencies
Strategic Capability and Leadership; People Management and Empowerment; Programme and Project Management; Financial Management; Change Management; Knowledge Management; Service Delivery Innovation; Problem Solving and Analysis; Client Orientation and Customer Care; Communication; Sound Knowledge of the Relevant Legislation such as National Health Act, Public Finance Management Act (PFMA), Public Service Act.
(2) (a) (i) See the attached list (Annexure A)
(ii) Kindly see the attached list (Annexure A)
(b) None
(c) Not Applicable
END.
18 November 2021 - NW2372
Motsepe, Ms CCS to ask the Minister of Health
What are the reasons that his department continues to prohibit hospital visits by families of those who are admitted to hospitals, noting that the Republic is now on Alert Level 1 lockdown?
Reply:
The Department of Health is taking serious precautionary measures by prohibiting hospital visits by the families of the patients that are admitted within the facilities because the threat of Covid-19 virus is still real. While the country in alert level 1, we remain concerned about the possible increase in infections especially because there are still a number of cases on infections that are reported through our laboratories, although very low.
END.
18 November 2021 - NW2378
Siwisa, Ms AM to ask the Minister of Health
What are the reasons that the Bloemanda Clinic in Kimberly is without immunisation for children, which forces parents to seek immunisation from private healthcare providers?
Reply:
According to the report from the Northern Cape Provincial department of health, the clinic that is referred to as Bloemanda is Masakane Clinic. Masakhane Clinic has been without immunisations for children. This clinic does immunisations daily and this has been verified through stock visibility system which has not shown any stock outs for vaccines.
END.
18 November 2021 - NW2285
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 - NW2286
Ismail, Ms H to ask the Minister of Health
What has been the vacancy rates for medical doctors in (a) clinics and (b) hospitals in each province in the past three years?
Reply:
a) The tables below indicate the vacancy rate percentages per province and for the last 3 years in Clinic’s (Reports as of September of each year)
Clinics - Medical Officer / Specialist Vacancy rate as at September 2019 |
||||||||||
Row Labels |
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North - West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
57 |
74 |
25 |
25 |
206 |
5 |
60 |
50 |
274 |
565 |
Vacant |
0.0 |
1.0 |
0.0 |
0.0 |
1.0 |
0.0 |
1.0 |
0.0 |
1.0 |
3.0 |
% Vacancy rate |
0.00 |
1.33 |
0.00 |
0.00 |
0.48 |
0.00 |
1.64 |
0.00 |
0.36 |
0.53 |
Clinics - Medical Officer / Specialist Vacancy rate as at September 2020 |
||||||||||
Row Labels |
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North - West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
57 |
38 |
24 |
22 |
193 |
5 |
58 |
46 |
225 |
668 |
Vacant |
0 |
1 |
0 |
0 |
1 |
0 |
1 |
0 |
1 |
4 |
Vacant |
0.00 |
2.56 |
0.00 |
0.00 |
0.52 |
0.00 |
1.69 |
0.00 |
0.44 |
0.60 |
Clinics - Medical Officer / Specialist Vacancy rate as at September 2021 |
||||||||||
|
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North - West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
60 |
45 |
30 |
25 |
184 |
5 |
60 |
50 |
277 |
736 |
Vacant |
13 |
13 |
12 |
10 |
79 |
6 |
18 |
11 |
18 |
180 |
% Vacancy rate |
17.81 |
22.41 |
28.57 |
28.57 |
30.04 |
54.55 |
23.08 |
18.03 |
6.10 |
19.65 |
b) The tables below indicate the vacancy rate percentage per province and for the last 3 years in Hospital’s (Reports as of September of each year)
Hospitals - Medical Officer / Specialist Vacancy rate as at September 2019 |
||||||||||
Row Labels |
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North - West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
172 |
529 |
383 |
2855 |
1288 |
957 |
443 |
70 |
1447 |
8144 |
Vacant |
5 |
4 |
3 |
10 |
7 |
7 |
2 |
0 |
11 |
49 |
% Vacancy rate |
2.82 |
0.75 |
0.78 |
0.35 |
0.54 |
0.73 |
0.45 |
0.00 |
0.75 |
0.60 |
Hospitals - Medical Officer / Specialist Vacancy rate as at September 2020 |
||||||||||
|
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North - West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
167 |
448 |
350 |
2567 |
1222 |
911 |
408 |
69 |
1029 |
7171 |
Vacant |
5 |
4 |
3 |
10 |
6 |
7 |
2 |
|
6 |
43 |
% Vacancy rate |
2.91 |
0.88 |
0.85 |
0.39 |
0.49 |
0.76 |
0.49 |
0.00 |
0.58 |
7.35 |
Hospitals - Medical Officer / Specialist Vacancy rate as at September 2021 |
||||||||||
|
Eastern Cape |
Free State |
Gauteng |
KwaZulu Natal |
Limpopo Province |
Mpumalanga |
North -West |
Northern Cape |
Western Cape |
Grand Total |
Filled |
167 |
470 |
445 |
2935 |
1325 |
1089 |
503 |
72 |
1166 |
8172 |
Vacant |
29 |
121 |
32 |
296 |
523 |
166 |
65 |
16 |
48 |
1296 |
% Vacancy rate |
14.80 |
20.47 |
6.71 |
9.16 |
28.30 |
13.23 |
11.44 |
18.18 |
3.95 |
13.69 |
END.
18 November 2021 - NW2311
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.
-
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. ↑
-
World Health Organization. Human papillomavirus vaccines: WHO position paper, May 2017. Weekly epidemiological record. No 19, 2017, 92, 241–268 ↑
-
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. ↑
-
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 - NW2340
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
Chirwa-Mpungose, 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 - NW2396
Ismail, Ms H to ask the Minister of Health
What is the total breakdown for lawsuits against his department for medical negligence in public hospitals (a) nationally and (b) in each province?
Reply:
The information provided is for the 2020/21 and 2021/22 Financial Years. The 2020/21 Financial Year is an update of the information that was submitted in March 2021. The information submitted in March 2021 was for Five Financial Years from 2015/16 Financial Year to 2020/21 Financial Year. The Information on 2020/21 Financial Year is now updated as when the information that was submitted in March was before the end of the Financial Year hence the submission of the updated information of the 2020/21
2020/21 FINANCIAL YEAR
PROVINCE |
NUMBER OF NEW CASES RECEIVED |
AMOUNT CLAIMED BY THE PLAINTIFFS[1] |
Eastern Cape |
Outstanding |
Outstanding |
Free State[2] |
47 Cases |
R 512 674 171.29 |
Gauteng[3] |
77 Cases |
R 873 785 433-55 |
KwaZulu Natal |
329 Cases |
R 727 706 522.00 |
Limpopo |
215 Cases |
R 1 764 652 099.00 |
Mpumalanga |
132 Cases |
R 1 058 442 000.00 |
North West |
66 Cases |
R 469 960 350.00 |
Northern Cape |
15 Cases |
R 531 716 811.04 |
Western Cape |
65 Cases |
R 529 995 591.10 |
TOTAL |
2021/22 FINANCIAL YEAR
PROVINCE |
NUMBER OF NEW CASES |
AMOUNT CLAIMED BY THE PLAINTIFFS |
Eastern Cape |
Outstanding |
Outstanding |
Free State |
21 Cases |
R 246 850 920.00 |
Gauteng |
53 Cases |
R 560 370 586-90 |
KwaZulu Natal |
205 Cases |
R 1 578 054 150.00 |
Limpopo |
167 Cases |
R1 498 238 059.00 |
Mpumalanga |
69 Cases |
R 472 379 000 |
North West |
31 Cases |
R 215 496 610. 00 |
Northern Cape |
11 Cases |
R 169 616 789.42 |
Western Cape |
39 Cases |
R 319 202 451.00 |
TOTAL |
END.
iThese are the amounts that the Plaintiffs think they are entitled to and they are not the amounts awarded by the Courts. Most of these cases are defended by the Provinces and the final payment or award if any will differ from the claimed amount. ↑
iiThe information from Free State has been revised from 2015/16 Financial Years after data cleansing as follows: 26 cases for 2015/16, 34 Cases for 2016/17, 42 Cases for 2017/18, 42 Cases for 2018/19, 44 Cases for 2019/20 and 47 Cases for 2020/21. ↑
iii.The information for Gauteng has been revised to 77 cases. ↑
18 November 2021 - NW2371
Pambo, Mr V to ask the Minister of Health
In light of the worst global pandemic, in which we have seen public health overstretched and demands on private health going beyond this sector’s capacity, what (a) has he found will be the consequences of the decisions by the Council for Medical Schemes which are outlined by Circulars 80 and 82 of December 2019 and Circular 56 of 2015 and (b) impact will this have on the ability of low-earning households to have access to quality medical care?
Reply:
a) The Council for Medical Schemes (CMS) issued circulars 80 and 82 in December 2019 based on two sets of research results at its disposal. The main message contained in these circulars was directed at the industry indicating that the exemption that had been granted to the primary insurance products that had applied to the CMS previously may not be granted again at the end of March 2021 if there were no significant improvement and changes made to primary insurance products and low-cost benefit options (LCBO). This was based on research conducted by a group of economists on behalf of Council, indicating the undesirability of these primary insurance products and the Low-Cost Benefit Option in the medical schemes industry. These research results indicated that:
- These products are targeting individuals that are already tax-exempt based on their low income. Expecting these individuals to spend more of their remaining disposable income contributing to health products with thin benefits did not make sense
- The introduction of the Low-Cost Benefit Option and related products will be adding yet another set of benefit options in an industry with too many options that are already making rational purchasing choices difficult for the consumer. This goes against the Health Market Inquiry recommendations
- The Low-cost Benefit option will also require some tax subsidies and credits and further burden the fiscus during a period of economic constraints
- There is no evidence that these options will ensure that relief is provided to the over-burdened public health system, given the fact that their beneficiaries still primarily rely on the state for the provision of the greater part of their health benefits.
- The burden of disease in the lower income groups is often higher than your high income earners, and providing a low benefit option is counter-intuitive
The second set of research results indicated that the primary health insurance products that were subjected to analysis had serious structural shortfalls in the following areas:
- The greater part of the contribution made by policyholders was spent on broker fees and administration instead of the relevant health benefits
- The marketing of these primary insurance products was misleading, promising unlimited GP consultations when in fact, the entitlements are no more than 3 per annum
- These products were experienced a significantly low claims ratio due to members were not aware of the extent of cover or benefit entitlements
- These primary insurance products are also unlikely to reduce the over-burdened public health system on the basis of lack of comprehensive cover
b) The impact of circulars 80 and 82 on the primary insurance products in the market has been minimal as no product has been discontinued as a result of these circulars:
- The CMS undertook an extensive stakeholder roadshow following the issuing of circulars 80 and 82. The purpose of these engagements that took place in the more significant part of January and February 2020 was to ensure that these primary insurance products demonstrate a significant shift towards complying with the Medical Schemes Act
- The agreement reached with the key stakeholders was that further engagements were necessary and that a Low-Cost Benefit Framework will need to be developed that will assist these primary insurance products to migrate into the medical schemes environment
- There was also an appreciation that the regulator cannot perpetually exempt these primary insurance products from complying with the Medical Schemes Act and its Regulations as this is the only legislation that is at its disposal for regulatory purposes
- The engagements in these Advisory Committees are proceeding well and have included three workstreams:
- Schemes and administrators
- Insurance providers and brokers
- Service providers, policyholders and consumers
Circulars 80 and 82 of December 2019 and Circular 56 of 2015 have no bearing on the ability of low-earning households to have access to quality medical care other than providing a guide for medical schemes to report better-managed services. However, a more relevant circular to low-earning households' affordability of care is circular 56 of 2020. The objective of circular 56 of 2020 was to provide an overall update regarding establishing the LCBO Advisory Committees and developing the Low-Cost Benefit Guidelines and notice of extension of exemption period to 31 March 2022.
The Advisory Committees were tasked with addressing the challenges faced by primary health insurance providers in complying with the Medical Schemes Act:
- The need for medical schemes to develop options for low-income earners.
- They would also develop a roadmap leading to the end of March 2022.
- Provide inputs on the LCBO framework before the CMS submits it for approval by the Minister of Health
- The Charter and Code of Conduct were issued to nominees during June/July 2020.
- A regulatory workshop with the National Department of Health, National Treasury, Prudential Authority, Financial Sector Conduct and the Council for Medical Schemes was held on 29 September 2020;
- Introductory workshops were held with interested parties and nominees during October 2020, whereafter the Charter and Code of Conduct was adopted.
END.