Questions and Replies

Reply:

a) The COVID-19 vaccination education drive is a multi-faceted programme that involves the public and private sectors across the entire government (all departments and all three spheres) and that has many contributing private companies.

• High programme visibility: Specific Activities

• Visible signage of the vaccine roll-out on large key billboards in high transit areas
• Use of taxi rank TV, Digital Billboards and others to promote vaccination messages
• Conspicuous telescopic and other large banners at malls, places of worship, taxi ranks, retail stores, schools
• Conspicuous and recognizable branding and clear signage at vaccine sites
• Champions: Identifying apolitical vaccine champions that are relevant to the target group and have wide reaching influence (key influential leaders; Traditional Leaders, Faith Based, Business sector, Civil society and Celebrities) e.g. Limpopo targeted ZCC church leader
• Involvement of Political leaders as champions: Health MEC and other political leaders such as Premiers, Mayors, Ward Counsellors
• Partnership with private sector to collaborate on media campaigns and vaccine roll-out branding e.g. Medical Aids like GEMS, Discovery etc. and other businesses

• Information in people’s hands: Specific Activities

• Guide the community on where they should go to, who they should listen to and which number they should call to get the correct information on anything to do with vaccines
• Use the time that clients spend at vaccination sites to empower them to be vaccine ambassadors
• Use the observation time to educate the clients and equip them to be able to answer common misinformation questions e.g. Is it true that people are dying after they vaccinate?
• Provide comprehensive IEC material on vaccines and adverse events following immunization with the call center number clearly visible that they can refer to and share with others.
• Share information on the nearest functional vaccination sites; operating hours; dates for outreach with all stakeholders: radio stations, newspapers, community leaders, religious leaders, schools, workplaces, and all social media platforms
• Use of social media to get the correct information into young people’s hands so that they do not discourage the elderly from vaccinating through sharing of misinformation they consume on social media
• Use of teachers to get the right information into young people’s hands so that they can correct misinformation from social media and other sources at home
• Address the play-off between various vaccines and preferences

• Use of local media: Specific Activities

• Continuous engagement to reinforce positive messages about vaccinations and to counter misinformation and disinformation
• Ongoing “human” stories by individuals representing the target group to show authentic stories of registration and vaccination on radio, local newspapers, and all social media platforms
• Radio stories addressing identified concerns about vaccines in local languages
• Radio slots to boost confidence in vaccination explaining all the key steps in the vaccination journey
• Collaboration with local newspapers, Radio stations, leadership, NGOs, Civil society organizations, tertiary institutions, schools, Unions, businesses, private vaccination sites in spreading correct information about vaccines
• Public health messaging to raise public awareness of the notable fatality rate and potential long-term sequela of COVID-19
• Weekly local radio station slots for advocacy messaging, adverts in local print media.

• Local mobilisation and canvassing: Specific Activities

• Whole society area based (ward-based) approach improving reach and raising capacity through collaboration with other stakeholders i.e. Private sites, Sector engagements (Business, Civil Society, FBOs, Traditional Authorities, Men’s Forum, Older Person’s Forum and people with disabilities e.tc. to be engaged during the month of August)
• Identify and appoint area-based leads, local civil society activators and communicators who will play the catalytic role of bringing all these people together
• Out-reach service: share the schedule with the sites, times and dates; plan well with all relevant local stakeholders to ensure that there is sufficient demand creation and social mobilization in the community leading up to the out-reach date including use of loud hailers
• Identify individuals who can be vaccination ambassadors or champions with vaccine branded clothing with messages like do have any questions about vaccines? ‘Ask me’, who can be easily identifiable as they walk around the community and use local media to inform the community about them and to ask them questions.
• Use of community WhatsApp groups to communicate correct information and counter misinformation and disinformation.
• Work with local comedians to create fun videos on platforms like TikTok that can be shared on social media
• Coordinating all of the community development practitioners, health care workers and resources to intensify the together with Door-to-door, Site visits by Executive Council and Mayors to mobilise communities.

• Access strategies: Specific Activities

• Transport: provide transport where possible; ensure that clients know when, how, which number to call, where to go and who is eligible to access this service
• Home based vaccinations
• District based promotion of vaccination sites, available assistance at all sites, pop up sites taken to remote areas, ward-based vaccination sites, mass vaccination sites opened across the districts, more sites opened on weekends to provide access to those at work during the week.
• Increase outreach/mobile sites and strategical place them in areas with low uptake as informed by data
• Increase sites in underserved areas
• Increase sites that operate on weekends and make sure they are advertised widely including operation hours
• Adopt specific strategies like Churches on Sunday, Malls on Saturdays, especially on weekends
• Build trust in the system by providing excellent client friendly service so that positive reviews spread by word of mouth
• Use familiar sites as vaccination sites e.g. churches, synagogues, mosques, malls

• Other Activities

• Continue with regular feedback and monitoring of daily performance through feedback sessions between Province & districts Mon-Fri
• Each district, through the district vaccination coordinating committees meets at least three times a week to monitor progress and identify pressure points and problem areas to reaching targets.
• Retain focus on >60 years as the most vulnerable population group until targets are met
• Encourage clinicians to counter patients’ anecdotal “bad reaction” stories with “good reaction” stories rather than statistics.
• Use messaging like “your parents made sure you were vaccinated as a child now it’s your turn to return the favour”, to encourage younger people to bring older people.
• Coming up with little songs about vaccinations that can be taught at ECDs and Schools and share it through ECD networks (Vaccine, Vaccine on your arm, Will keep you safe from COVID-19).

b) Budgets that have been set aside for this come from all partners. Some are directly budgeted items funded from government departments, including GCIS, but the majority are cash and cash-in-kind contributions from the private sector (through Solidarity Fund and by media houses). We do not have a Rand value for all of these contributions at this stage.

c) The relevant time frames are that several activities have already commenced and all are continuing for the remainder of this year and into 2022.

END.

Reply:

South African Nursing Council (SANC)

1. The SANC is looking into allegations made against Dr Manamela as nurse practitioner, registered in terms of the Nursing Act, 2005 (Act No. 33 of 2005).

The process to discipline nurse practitioners is prescribed in regulations, and the SANC follows the legislated processes to investigate any allegations of unprofessional conduct against nurse practitioners so that where there is evidence of unprofessional conduct, appropriate action is taken.

The time it takes to finalise cases is dependent on the complexity of the matter as well as the number of and co-operation from role players involved in the matter and the timeous submission of the required information to SANC

2. (a) The disciplinary cases of the health official is still ongoing.

There was no delay on the side of SANC. Several correspondences to Gauteng Province were issued as soon as the matter was brought to the attention of SANC to request for further information to enable the relevant committee of Council to conduct the investigation accordingly.

There was, however, a delay in the provision of such information despite several follow ups made by the office of the Registrar at SANC.

(b) This is not possible to predict as it is dependent on many external factors and procedural factors for instance but in no way limited to:

1. Availability of evidence;
2. Availability of witnesses;
3. Any legal challenges against or during the process; and
4. Volume of the evidence both written and oral to be considered and or canvased

(c) Two committees of Council are responsible for the majority of the process, the Preliminary Investigating Committee, which has finalised the preliminary investigation and the Professional Conduct Committee, to which the matter has been referred, to effect a formal hearing.

The Health Professions Council of South Africa (HPCSA)

1. The HPCSA has taken disciplinary steps against Dr TE Selebano following the report of the Health Ombudsman.

The investigation was conducted and on the 11&12 October 2018 the matter was placed before the Fourth Preliminary Committee of Inquiry of the Medical and Dental Professional Board (“the Committee”).

After deliberations based on the available evidence the committee determined that there are grounds for a professional conduct inquiry into the conduct of Dr TE Selebano and directed that an inquiry into matter be held.

2. (a) The disciplinary cases of the health official is still ongoing

The matter had been set down for hearing on several occasions and had been postponed for a variety of reason including the obtainment of the transcripts from Judge Moseneke’s arbitration, lockdown due to COVID 19 making it impossible to have a physical hearing (and respondent objecting to virtual hearing), the delays in the appointment of new professional boards in 2020, unavailability of respondent legal representative, and inquest proceedings.

(b) The parties have agreed to set the matter down for 13-15 October 2021.

(c) Fourth Preliminary Committee of Inquiry of the Medical and Dental Professional Board.

END.

Reply:

1. The reference date of 2 May 2021 was before the start of the National Vaccination rollout programme on the 17 May 2021. As of 31 August 2021, at 14h50 a total of 3,567,652 individuals older than 60 had registered for vaccination on the EVDS;

2. The response is as follows:

• There are three options to self-register at no cost to the individual namely:
• • • Through the internet at vaccine.enroll.health.gov.za
    • Through WhatsApp by sending a Whatsapp Message – Register to 0600123456
    • Through USSD by dialling *134*832#

    Two options for assisted registration exist namely:

• Registration points at vaccination sites
• Dial the National Call Centre Toll free numbers 0800029999, the call centres agents will assist the individual to register while on the call.

3. Yes.

 

END.

Reply:

(1) The Gauteng Health Department reported that immediately after the fire, the City of Johannesburg inspected the facility and found out that the hospital was not compliant in several aspects. The hospital has more than 1500 fire doors, which are at the back of the wards and lead to the fire escape routes. The hospital had to remove burglar doors next to the fire doors and this meant wards were left with no protection on access to the wards. This meant that the risk of criminals entering the wards was high in the wards using the back side of the wards without being detected. Plans are in place to review different options of securing the units without compromising fire regulations policies, including extending the CCTV installation to the fire escape routes.

(2) The hospital entered into a Service Level Agreement (SLA) with the security company. The SLA under schedule of penalties give guidance to parties on handling of violations to any terms contained in the agreement. It has been difficult to apportion the liability to the security company as all hospital staff had to vacate the building due to the uncertainty on the safety of the building, including security personnel.

During the temporary closure of the hospital, the Department of Infrastructure Development (DID) took advantage of the situation and invited contractors to do fire remedial work and some maintenance work in the wards. This meant that the hospital had several contractors on site.

(3) Most of the hospital walkways are covered by camera surveillance except for the fire escape routes as per a response to question number 1. The fire escape routes did not have CCTV coverage, they had bugler proofs. As a result, it was not possible to review that footage in the areas where equipment was stolen.

The monthly payment of R450 000 is for repairs and maintenance of CCTV equipment. The monitoring/surveillance of cameras is done by physical security.

CCTV’s have assisted before in identifying and investigation of criminal activities within the hospital. Where criminals are identified the hospital submitted footage to SAPS and had successful prosecutions before. It is for this reason, that the hospital is now exploring the latest technology to have surveillance in fire escape routes.

END.

Reply:

a) Covid-19 Vaccines are widely available across all provinces and there are vaccination sites, fixed or mobile in every local municipal area.

b) (i) Two vaccines are presently in daily use

(ii) Pfizer and Johnson & Johnson

c) (i) Sinovac has been conditionally approved by SAHPRA for use in adults. The conditions primarily relate to evidence of efficacy and safety for use in people with HIV & AIDS and evidence of efficacy against Delta variant in a real-life setting (not laboratory Based). The NDOH has conducted an economic assessment and is presently engaged in the preparatory procurement process to obtain a price and availability information from the applicant.

(ii) The regulator has received two applications for Sputnik V vaccine but neither has been approved for use yet..

END.

Reply:

1. (a) Please be informed that the Government Employees Medical Scheme (GEMS) has taken steps against the parties implicated/involved, including civil litigation, as such the matter is sub-judice and we cannot disclose the names of the parties and companies involved in line with the Constitution of the Republic. The matter is now with the Law Enforcement Agencies.

• The tender irregularities were uncovered in 2016 after whistle-blower complaints were received;
• A comprehensive forensic investigation, overseen by the Board was launched and was completed early in 2018. At the commencement of the investigation, key stakeholders including the Council for Medical Schemes (CMS) and the Minister for the Public Service and Administration were briefed. Members of GEMS were informed at the Scheme’s Annual General Meeting held on 31 July 2017 and the updates that could subsequently be provided were included in the GEMS Annual Integrated Reports. A copy of the signed 2017 AGM minutes can be provided if required. Stakeholders were kept informed as the investigation unfolded and the finalised forensic reports were handed over to the Council for Medical Schemes;
• Criminal charges were laid with the SAPS on conclusion of the investigation and the forensic investigation reports were submitted to the SAPS. The matter is with the HAWKS at present;
• The Scheme bound by the Laws of the Republic is unable to provide the names of the individuals as well as companies until this matter has been heard in court.

(b) With regards to GEMS executives who directly benefitted from such irregular payments -

• As a result of the investigation by GEMS, disciplinary cases were brought against 7 employees. Of the 7 employees, 5 resigned during the disciplinary hearings in 2017 and 2 employees were dismissed after the hearings, also in 2017. The Scheme terminated all implicated contracts; and
• The Scheme has taken steps against the parties as indicated above, laying criminal charges (Case number: CAS 244/04/2018 was opened at Brooklyn Police Station). Civil litigation is also underway and as such the matter is sub-judice and GEMS cannot disclose the names of the parties involved in line with the Constitution of the Republic. The matter is now with the Law Enforcement Agencies.

(2) (a) Processes, policies and procedures that are in place in GEMS to prevent corruption and fraud

• The Scheme strengthened existing controls, implemented new controls and enhanced policies and systems subsequent to the forensic investigation. This includes the implementation of a strengthened ethics management programme and enhanced/new policies regulating supply chain management, vetting of Scheme officers, recruitment of employees and whistleblowing;
• There was also the introduction of an internal whistle-blowing hotline and the establishment of an internal forensic investigation unit in addition to the systems already in place for investigating member and healthcare provider claims fraud.

(b) Checks and balances are in place to prevent conflicts of interest

The Government Employees Medical Scheme (GEMS) is registered as a restricted membership medical scheme under the Medical Schemes Act 131 of 1998, as amended.

• The Scheme is run by a Board of Trustees, where 50% of the Trustees are elected by members and 50% appointed by the Minister for the Public Service and Administration;
• The Scheme finances and systems are subjected to internal and independent external audit reviews and these are reported to the Board via the Audit Committee and ultimately the Public through the Annual Integrated Report;
• All GEMS officers, including the Independent Audit Committee members are subjected to vetting. Vetting reports are compared to the Declaration of Interest forms submitted by Scheme officers (and updated annually) and inconsistencies/red flags are followed-up;

• During the Scheme’s procurement processes, all Board members, Scheme Management and employees involved in the procurement processes are required to complete additional declarations of interest. In this regard, Scheme Officers are provided with a list of bidders, the directors and shareholders of bidders as well the bidders’ employees who would be involved in rendering services should the bidders be contracted. Scheme officers are then required to declare any conflict of interest against this information. Should a potential conflict be declared, the matter is referred for an independent legal opinion;
• Further to the declarations of interests submitted, checks are performed against a procurement database to rule out any conflict of interest;

The Scheme is also implementing lifestyle audits for executives and has already piloted the new process.

END.

Reply:

a) Yes, Social Workers are front-line workers in the care of the public.

b) Yes Social Workers were prioritised in the vaccination roll-out. After the healthcare workers the vaccination programme embarked on vaccination of workers in the basic education sector, police, social development and several other priority essential services sectors. Social Workers (public and private), along with all Social Service Professions registered with the Council were offered vaccination. The table below provide the details.



NO	CATEGORY / ELIGIBILITY	RATIONALE
1	Group A: DSD National and Provincial Staff (all on PERSAL) (Incl. of SACSSP Staff as well as cleaning and security staff)	Rationale: All frontline staff who are in direct contact with members of the public through NPO registration, monitoring and evaluation, processing of child protection register applications, consultations for adoptions, engagements with CSOs, civil society and stakeholders, incl. distribution of food parcels to the public, customer related queries etc. amongst others.
2	Group B: SASSA Staff Nationwide (all on PERSAL)	All front frontline staff dealing with grant applications incl. home visitations to assist i.e. the elderly, persons with disabilities, and child support grant beneficiaries amongst others,
3	Group C: National Development Agency: (all on NDA database)	Our staff are in direct contact with the public collecting applications on a daily basis for consideration of grant funding for projects, in addition, they do capacity building training and monitor projects on sites across the republic. Furthermore, they include a cohort of people who assist in manning SASSA queues.
4	Group D: Social Service Professions; (incl. SW +ASW + CYCCs + ACYCCs +Student Social Workers + CDPs)	Social workers who provide psychosocial support to citizens affected and infected by covid-19 as well as other social ills, conduct site visits and work with DoH across the country. Incl. of CDPs. Incl. Private sector/ NGO’s / Public Sector etc.
5	Group E: ECD Workforce: (Incl. of entire workforce)	A cohort of educators looking after children at ECD centers which remain open during the current lockdown alert level, and are thus at risk in the a similar manner in which school teachers are. Data base from ECD PES + ISF (for unregistered ECDs)

 

END.

Reply:

The national minimum standards for provision of air ambulances, regardless of whether is a rotor-wing helicopter or a fixed-wing aircraft used, is prescribed in the EMS Regulations, 2017.

EMS Regulations in relation to aeromedical services indicate that:

• the provider is required to be registered to provide such services within the category of Aeromedical Services with the respective provincial Department of Health where it is operating from.
• This registration should also involve the inspection and accreditation of the station/hangar operated from.
• The aircraft operator must hold the appropriate G7 licence and CATS Part 138 accreditation as specified by the Civil Aviation Authority of South Africa.

An extensive minimum list of equipment is detailed in the attached Annexure B of the EMS Regulations.

With regards to the medical crew:

• The senior medical staff member on the air ambulance must be registered in the category of a Paramedic or Emergency Care Technician or Emergency Care Practitioner with the Health Professions Council of South Africa, who shall hold valid CAT 138, Aviation Health Care Provider, Advanced Cardiac Life Support, Intermediate Trauma Life Support or Advanced Trauma Life Support and Paediatric Advanced Life Support or equivalent certificates.
• The minimum staffing requirement for the second staff member on an ambulance shall be a person registered in at least the category of Basic Ambulance Assistant with the Health Professions Council of South Africa.
• All crew are required to practice within their respective scope of practice as approved by the Health Professions Council of South Africa: Professional Board for Emergency Care.

Annexure B

Airway Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Oropharyngeal Airway Nos. 00,0,1,2,3,4	2 each	2 each	2 each	2 each	2 each	2 each
Hard Suction Catheter (Paediatric)	2	2	2	2	2	2
Neonatal Suction Catheters Size No. 5 FG	2	2	2	2	2	2
Neonatal Suction Catheters Size No. 6 FG	2	2	2	2	2	2
Neonatal Suction Catheters Size No 8 FG	2	2	2	2	2	2
Paediatric Suction Catheter Size No. 10 FG	1	1	1	1	1	1
Adult Suction Catheter Size No. 12 FG h	1	1	1	1	1	1
Adult Suction Catheter Size No. 14 FG	1	1	1	1	1	1
Neonatal Suction Catheters Size No. 5 FG	1	1	1	1	1	1
Neonatal Suction Catheters Size No. 6 FG	1	1	1	1	1	1
Neonatal Suction Catheters Size No 8 FG	1	1	1	1	1	1
Paediatric Suction Catheter Size No. 10 FG	1	OPTIONAL	1	1	OPTIONAL	OPTIONAL
Adult Suction Catheter Size No. 12 FG	0	1	0	0	1	1
Adult Suction Catheter Size No. 14 FG	2	2	2	2	2	2
Portable Suction Apparatus (Combination of Battery and Electrically Operated)	1	1	1	1	1	1
Manual Hand Operated Portable Suction Apparatus (As a backup device)	1	1	1	1	1	1
Stethoscope (Combination of diaphragm and bell type head)	1	1	1	1	1	1

Endotracheal Intubation Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Laryngoscope set for adult and paediatric including the following:
Handle with batteries in full working condition	0	1	0	0	1	1
Batteries - spare for laryngoscope	0	2	0	0	2	2
Size 0 blade	0	1	0	0	1	1
Size 1 blade	0	1	0	0	1	1
Size 2 blade	0	1	0	0	1	1
Size 3 blade	0	1	0	0	1	1
Size 4 blade	0	1	0	0	1	1
Size 5 blade	0	OPTIONAL	0	0	OPTIONAL	OPTIONAL
Disposable, sterile ET tubes including the following:
Size 2.5 mm ID ET tube	0	2	0	0	2	2
Size 3 mm ID ET tube	0	2	0	0	2	2
Size 3.5 mm ID ET tube	0	2	0	0	2	2
Size 4 mm ID ET tube	0	2	0	0	2	2
Size 4.5 mm ID ET tube	0	2	0	0	2	2
Size 5 mm ID ET tube	0	2	0	0	2	2
Size 5 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 5.5 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 6 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 6.5 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 7 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 7.5 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 8 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Size 8.5 mm ID ET tube (cuffed, high volume, low pressure)	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 1	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 1.5	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 2	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 2.5	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 3	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 3.5	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 4	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 4.5	0	2	0	0	2	2
Sub-glottic Laryngeal Mask (LMA), size 5	0	2	0	0	2	2

Endotracheal Intubation Equipment Continued	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Small ET tube introducer	0	1	0	0	1	1
Large ET tube introducer	0	1	0	0	1	1
Gum Elastic Bougie	0	1	0	0	1	1
Magill forceps - Adult	1	1	1	1	1	1
Magill forceps - Paediatric	1	1	1	1	1	1
10ml syringes	0	1	0	0	1	1
20ml syringes	0	2	0	0	2	2
Pair sharp, clean scissors	0	1	0	0	1	1
1m Tape / ET tube securing device	0	2	0	0	2	2
Water soluble lubricant gel	0	2	0	0	2	2
Heimlich type Flutter valves	0	2	0	0	2	2
Heat moisture exchanger valve for ventilated patients	0	1	0	0	1	1

Breathing / Ventilation Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Adult oxygen masks providing 40% inhaled oxygen with tubing	4	4	4	4	4	4
Adult non-rebreather masks providing 100% inhaled oxygen with tubing	2	2	2	2	2	2
Adult oxygen nebuliser masks including tubing and fluid reservoir	2	2	2	2	2	2
Nasal cannula with tubing	2	2	2	2	2	2
Paediatric oxygen masks providing 40% inhaled oxygen with tubing	2	2	2	2	2	2
Paediatric non-rebreather masks providing 100% inhaled oxygen with tubing	2	2	2	2	2	2
Paediatric oxygen nebuliser masks including tubing and a fluid reservoir	2	2	2	2	2	2
Oxygen T-Piece with tubing	2	2	2	2	2	2
Adult Bag-Valve-Mask with Reservoir and adult mask (size 4)	1	1	1	1	1	1
Paediatric Bag-Valve-Mask with Reservoir and paediatric mask (size 1)	1	1	1	1	1	1
Neonatal Bag-Valve-Mask with Reservoir and neonatal mask (size 0)	1	1	1	1	1	1
Oxygen Humidification Device	1	1	0	0	1	1

Oxygen Supply	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Minimum of a portable oxygen cylinder. Size “D”	2	2	2	2	2	2
Portable oxygen cylinder gauge with flow meter	1	1	1	1	1	1
Fitted oxygen cylinder/s, size “F” capable of supplying a minimum of 30 minutes of oxygen at a flow rate of at least 15 litres per minute.	2	2	0	0	0	2
Fitted oxygen cylinder gauge with flow meter	1	1	0	0	0	1

Ventilator	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Mechanical volume cycled ventilator with PEEP valve & pressure relief valve, with appropriate fitting allowing connection to fitted oxygen supply within the ambulance, including the following features (requires annual calibration certification):	0	1	0	0	1	1
• Volume and pressure control:
• Volume
• Inspiratory Pressure
• PEEP
• Fi02
• Rate
• Alarms (Peak Inspiratory Pressure, Low Pressure)
Heat moisture exchanger valve for both manual as well as mechanical ventilation methods.	2	2	2	2	2	2

Diagnostic /Therapeutic Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Sphygmomanometer including adult, paediatric and neonatal cuffs	1	1	1	1	1	1
Pupil torch	1	1	1	1	1	1
Glucometer and blood glucose monitoring strips	1	1	1	1	1	1
Pulse Oximeter (if not included as a feature of an ECG monitor or electronic patient monitor)	1	1	1	1	1	1
Automated External Defibrillator (AED) (annual calibration not required due to self-testing and self-calibration of the unit)	0	0	0	0	0	0
Automated External Defibrillator (AED) that is approved by the manufacturer for use in a moving vehicle, To be used in combination with a Vital Signs Monitor that includes visual 3 lead ECG Monitoring and a ECG rhythm printer/recorder feature (Vital Signs Monitor requires annual calibration certification)	1	0	1	1	0	0
OR
ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, 3 lead cable, AED capability, AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)	1	0	1	1	0	0
ECG monitor and defibrillator featuring 3 lead ECG monitoring capability, external cardiac pacing, cardioversion, pacing/AED pads, manual defibrillation, recorder / printer with paper and hard defibrillation paddles (requires annual calibration certification)	0	1	0	0	1	1
Defibrillation gel	1	1	1	1	1	1
End Tidal CO2 Monitor – Capnograph (if not included as a feature of an ECG monitor or electronic patient monitor)	0	1	0	0	1	1

Miscellaneous Disposable Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Boxes of disposable examination gloves (S,M,L)	1 each	1 each	1 each	1 Each	1 Each	1 each
Wound dressings 100mm x 100mm	5	5	5	5	5	5
Wound dressings 100mm x 200mm	4	4	4	4	4	4
Hydrogel Burn Dressing 100mm x 100mm	2	2	2	2	2	2
Hydrogel Burn Dressing 200mm x 200mm	1	1	1	1	1	1
Hydrogel Burn Dressing 200mm x 450mm	2	2	2	2	2	2
Gauze swabs (100mm x 100mm)	20	20	20	20	20	20
Roll of 25 mm adhesive tape (zinc oxide)	1	1	1	1	1	1
Roll of 10 mm adhesive tape (hypo-allergenic)	1	1	1	1	1	1
75mm elasticised bandages	4	4	4	4	4	4
100mm elasticised bandages	4	4	4	4	4	4
Sealed maternity pack (including 2 x sealed & sterile surgical blades, 4 x sealed sanitary pads, 2 x sealed space blankets, 4 x sealed & sterile umbilical cord clamps, 1 x sealed & sterile mucous extractor)	1	1	1	1	1	1
Regurgitation bags Or Large kidney bowl / receiver (may not be a bedpan)	4	4	0	0	0	4
	1	1	0	0	0	4
Sealed space blanket	4	4	4	4	4	4
Clear safety goggles	2	2	2	2	2	2
Range of nasogastric tubes, including:	0	1	0	0	1	1
Size 5 French	0	1	0	0	1	1
Size 8 French	0	1	0	0	1	1
Size 10 French	0	1	0	0	1	1
Size 12 French	0	1	0	0	1	1
Size 14 French	0	1	0	0	1	1
Size 18 French	0	1	0	0	1	1
Urine drainage bag	0	2	0	0	2	2
Foleys catheters FG5, 8, 10, 12, 14, 16, 18	0	1	0	0	1	1

Intravenous Therapy Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Alcohol Swab (30mm x 30mm)	30	30	30	30	30	30
14 gauge intra-venous catheters	2	2	2	2	2	2
16 gauge intra-venous catheters	2	2	2	2	2	2
18 gauge intra-venous catheters	2	2	2	2	2	2
20 gauge intra-venous catheters	2	2	2	2	2	2
22 gauge intra-venous catheters	2	2	2	2	2	2
24 gauge intra-venous catheters	2	2	2	2	2	2
60 micro drops / ml – Administration Sets	2	2	2	2	2	2
Intraosseous needle or device with needle	0	1	0	0	1	1
15 drops / ml or 20 drops / ml- Administration Sets	2	2	2	2	2	2
10 drops / ml – Blood Administration Set	2	2	2	2	2	2
High Capacity 10 drops / ml Administration Set	0	1	0	0	1	1
Volume Control Administration Set (eg. Buretrol, Dosifix)	0	1	0	0	1	1
200ml Normal Saline – IV Fluid	2	2	2	2	2	2
1000ml Ringers Lactate – IV Fluid Or 1000ml Balsol – IV Fluid	2	2	2	2	2	2
	2	2	2	2	2	2
500ml Synthetic Colloid e.g. Haemacell / Haes-sterile	1	1	1	1	1	1
Transparent, waterproof, IV securing dressing (e.g. Tegaderm or similar) minimum of 10cm x 12cm dimensions	8	8	8	8	8	8
Infusion flow regulators (eg Dial-a-Flow, Dosi Flow)	2	2	2	2	2	2
3 Way Stopcock	1	2	1	1	2	2
Spencer Wells Artery Forceps	2	2	2	2	2	2
Pressure Infusion Bags	0	2	0	0	2	2

Medicines Therapy Sundries	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
50 ml syringes	0	1	0	0	1	1
20 ml syringes	2	2	2	2	2	2
10 ml syringes	2	2	2	2	2	2
5 ml syringes	2	2	2	2	2	2
2 ml syringes	2	2	2	2	2	2
1 ml syringes	0	2	0	0	2	2
16 gauge needles	4	4	4	4	4	4
20 gauge needles	4	4	4	4	4	4

Medicines	ILS	ALS
	Medicines to be carried by the on-duty registered practitioner as per HPCSA approved scope of practice for a registered Ambulance Emergency Assistant or a registered Emergency Care Assistant.	Medicines to be carried by the on-duty registered practitioner as per HPCSA approved scope of practice for a registered Paramedic or a registered Emergency Care Technician or registered Emergency Care Practitioner.

Transport and Immobilization Equipment	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Hard/Stiff Neck Cervical Collars – Small	2	2	2	2	2	2
Hard/Stiff Neck Cervical Collars – Medium	2	2	2	2	2	2
Hard/Stiff Neck Cervical Collars – Large	2	2	2	2	2	2
Full set of Soft Cervical Collars (Small, Medium, Large)	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL
Patient Extrication Device – Adult (e.g. KED)	1	1	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL
Patient Extrication Device – Paediatric (e.g. KED)	1	1	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL
Long spine board	1	1	0	0	0	OPTIONAL
Scoop stretcher	1	1	0	1	0	1
Vacuum Mattress	OPTIONAL	OPTIONAL	0	0	0	1
Set Head Blocks	2	2	OPTIONAL	OPTIONAL	OPTIONAL	2
Spider harness	2	2	OPTIONAL	OPTIONAL	OPTIONAL	2
Lower extremity traction splint – Adult	1	1	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL
Lower extremity traction splint – Paediatric	1	1	OPTIONAL	OPTIONAL	OPTIONAL	OPTIONAL
Long splints – Leg	6	6	6	6	6	6
Short splints – Arm	4	4	4	4	4	4

Other	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Pillow	2	2	0	0	0	2
Sheet	6	6	1	0	1	1
Blanket	2	2	0	0	0	1
Bedpan/urinal	1	1	0	0	0	OPTIONAL
Waste disposal facility (enclosed container)	1	1	0	0	0	1
Red, medical waste disposal plastic bags	6	6	6	6	6	2
Enclosed, commercially manufactured, disposable sharps container	1	1	1	1	1	1
Suitably manufactured Jump Bag for safe, clean and secure storage and transportation of medical equipment	1	1	1	1	1	1
Suitably manufactured Drug Pouch for safe, clean and secure storage and transportation of medication and administration accessories	0	1	0	0	1	1
Pair rescue scissors	1	1	1	1	1	1
High visibility, reflective vest and / or jacket	2	2	1	2	1	OPTIONAL
Safety helmet	2	2	1	2	1	OPTIONAL
Fire Extinguisher (minimum of 2KG dry powder)	1	1	1	1	1	OPTIONAL
Thermometer (standard)	1	1	1	1	1	1
Casebook or patient record sheet	1	1	1	1	1	1
Map book or fitted GPS device	1	1	1	1	1	1

Requirements for MICU transfers - the following requirements are per station, and not per vehicle (mandatory)	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Vital signs monitor (requires annual calibration certification) - or separate automated NIBP, SpO2, electronic capnograph	0	1	0	0	1	1
Infusion pump including appropriate administration sets (requires annual calibration certification)	0	1	0	0	1	1
Syringe driver including approved syringes (requires annual calibration certification)	0	1	0	0	1	1

Requirements for MICU neonatal transfers – the following requirements are per station, and not per vehicle (optional):	ILS Ambulance	ALS Ambulance	ILS Response Vehicle	Medical Rescue Vehicle	ALS Response Vehicle	ALS Air Ambulance
Automated neonatal ventilator (requires annual calibration certification) - or mechanical ventilator featuring neonatal, paediatric and adult ventilation modes	0	access	0	0	access	1
Transport incubator with backup power and on board alarms (requires annual confirmation of servicing)	0	access	0	0	access	1
Vital signs monitor with neonatal probes (requires annual calibration certification)	0	access	0	0	access	1
Oxygen inspired analyser	0	access	0	0	access	1
Incubator head box	0	access	0	0	access	1
Neonatal SPO2 probe and monitor (if not included as a feature of the vital signs monitor)	0	access	0	0	access	1

 

END.

Reply:

When an individual is exposed and then infected with COVID–19 the signs and symptoms usually appear after 5 to 7 days. If these symptoms are significant the person would then probably seek medical attention. It is at that point usually that a COVID test is recommended and results become available about 2 days later so from the time of infection an individual will be confirmed as positive only 7 to 9 days later. Most infected persons have very limited recollection of all the activities they were involved in a week ago and of those activities it would be impossible for a person to know exactly where or when exactly he/she became infected or the circumstances that lead to them becoming infected. Provincial health departments also report that persons that test positive are either unable to recall or reluctant to share information about their contacts as well which has hampered contact tracing efforts.

We therefore do not have data on exactly where a particular person has been infected.

END.

Reply:

I am assured by the KwaZulu Natal Provincial Department of Health that the management of the Prince Mshiyeni Memorial Hospital is in good order. All senior management positions at the Hospital have been filled. The current management is capable of handling challenges that emanate from managing this large and busy regional hospital.

END.

Reply:

I am not able to respond to this Question as I am still waiting for the Honourable Member to share the report that the Honourable Member is referring to. Once the Honourable member has furnished me with the report, that would enable me to reply fully to the information requested by the question.

END.

Reply:

1. The respirators that did not meet the minimum standard as per the laboratory test were not distributed to health care workers. Where the respirators were distributed these were immediately removed from circulation on instruction to the head of the institution and replaced with respirators that complied with the minimum standard. Communication was sent out to hospitals that received a consignment of donated KN95 that had to be recalled. In this instance the donor replaced the respirators with a new consignment.

2. The National Department of Health: Policy for the Regulation of Quality Respiratory Protective Equipment (RPE) Supply in Healthcare, August 2020 makes the following provision, in accordance with SAHPRA requirements, for all licensed establishments to conduct post marketing surveillance:

“Prior to use of respirators purchased, a minimum of 10 respirators per 1000 (or part thereof) and at least 100 units of 10000 should be randomly picked by the purchaser from the boxes in their possession and sent at a minimum for a Particulate Filter Penetration test at a published accredited South African test laboratory (to sodium chloride) which test must indicate that the respirator has passed the minimum specification. This cost is borne by the seller (incorporated into cost of sale) and selection of respirators for testing is conducted by the purchaser to maintain integrity of random selection, testing and reporting to the purchaser.

a) If respirators pass this test, all respirators in the same production batch may be used, in the same purchase and having been delivered, and in possession of the purchaser.

b) Failed tests require a second batch of randomly selected (or the same) respirators be sent for formal testing as per point 6

c) The final result of the testing must be reported to the supplier and a copy supplied to SAHPRA and the NRCS. The supplier is then required by the regulators to report (as per pharmaceutical batch recalls), on a publicly accessible portal for the particular batch affected (as per many other global regulatory agency standards for quality testing) at a minimum on SAHPRA and NRCS websites (or a link from one to the other).

d) Publication will only reference the manufacturer, batch failed and test results. The implication should not necessarily be that all respirators from the manufacturer are defective.”

END.

Reply:

(1) The evidence is clear and has been documented in the World Health Organization (WHO) guidelines on Infection prevention and control (IPC) for safe management of a dead body in the context of COVID-19, interim guidance, 4 September 2020. The National Infection Prevention and Control Guidelines (South Africa), based on WHO recommendations, outlines the evidence and steps required for handling of COVID-19 bodies and safe burial. The Centers for Disease Control and Prevention, has clarified the difference between death from Ebola and COVID-19 and the burial requirement for each. There is no need for extra PPE- gloves and aprons will suffice since the route of transmission is not like Ebola where the virus survives post mortem in body fluids.

(2) No, to date, there is no reported case of SARS-CoV-2 transmission from a dead body to a human. There is very little risk of infection being transmitted from a dead body to those carefully handling the corpse.

(3) No, however;

a) When dealing with a dead body, all handlers must ensure that IPC precautions are in place such as wearing appropriate personal protective equipment (PPE) which protects the body, respiratory tract and mucous membranes from accidental splash contamination. Hand hygiene, good ventilation and a clean environment is essential. Good general hygiene is importanct to make sure that working surfaces are free from contamination and by so doing this will ensure safety of everyone using the premises.

b) There is no evidence that SARS-COV-2 can be transmitted via body secretions post mortem.

END.

Reply:

1. People with disabilities who live in care homes of any description are vaccinated through the outreach programmes through the ‘congregate settings’ programme. People who are bedridden can, where it is possible, be visited and vaccinated at home. Insured patients should arrange this with their medical aids. For public patients this will depend on the capacity of the provincial health department.

2. The Electronic Vaccine Distribution System (EVDS) is programmed to schedule vaccinations in age bands as determined by the government from time to time (after advice from various Ministerial Advisory and other committees).

3. Vaccination of every person in South Africa is considered important and urgent. The reality is that the capacity of the combined public and private health services to vaccinate people is limited. There are many competing priorities for vaccination and these priorities are addressed within the capacity of the system and the availability of vaccine. There is no objective way to choose one person’s health needs above another, so the focus has started with the groups where the greatest concentration of risk has been identified and that is in the age group over 60 years. The rollout to others is as fast as the vaccine and the services can manage.

END.

Reply:

1. The SAMRC has a variety of grant programs (both internal and through strategic partnerships) that are supporting drug discovery research and development in key health priority areas. These projects are leading to novel drug targets and candidate molecules and include plant-based medicines as well as biologicals such as vaccines and monoclonal antibodies.

The Technology Innovation Agency, with funding from the Department of Science and Innovation has established an API Cluster aimed at increasing the capacity of the country to develop the processes and manufacturing capability for the manufacture of active pharmaceutical ingredients. This cluster links innovators at the universities and science councils with industry, including development partners and pilot production facilities. This provides a mechanism to advance new drugs in development by local innovators towards testing and approval. One of the objectives is to synthesise molecules that may have efficacy against Covid to ensure continuity of supply. We are in discussions with international partners round this.

Government, through the Department of Science and Innovation, is a shareholder in The Biovac Institute, which has embarked on an ambitious journey to bring manufacture of vaccine APIs to the country. Biovac has been pursuing a backward integration strategy and has undertaken technology transfers with major pharmaceutical companies to establish the capacity for formulation, fill and finish of vaccines. It is raising funding to expand this capacity and to add a production suite for antigens/immunogens/biologicals. The same applies for Afrigen Biologics. Biovac and Afrigen are, further, developing its own vaccine candidates. Government has also been supporting the CSIR’s efforts to establish GMP manufacture of biologicals using plant production systems. The team are actively working on a concerted strategy to leverage off South Africa’s scientific investments to see if these can translate into products.

There are a number of pockets of excellence in drug discovery and vaccine development research in South Africa, situated predominantly at the universities and science councils. A key bottleneck, however, is the pilot scale manufacture of these under GMP conditions for clinical trials and later commercial manufacture at scale. This is where further investment is required to ensure that the full pharmaceutical and vaccine development value chain is in place in the country.

2. On 2 October 2020, India and South Africa proposed the TRIPS Waiver”, a proposal to suspend intellectual property protections for products and technologies needed for the fight against COVID-19, including vaccines, for the duration of the pandemic. This would involve a temporary suspension of certain rules set out in the Trips agreement, the intellectual property treaty of the World Trade Organization (WTO). The waiver proposal by India and South Africa presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access through a concrete step at the international level that can provide an automatic and expedited solution to address IP and technology challenges collectively.   The TRIPS Waiver proposal is now gaining support from major drug manufacturing countries.

The Department of Science and Innovation, and Trade, Industry and Competition are developing strategies for the local production of pharmaceuticals, especially the production of the active pharmaceutical ingredients.

Inter-Ministerial Committee on Covid-19 vaccines has a DPME lead Technical Working Group tasked with mobilizing local capacity to deliver the dosages required and building a long-term capability step by step using current capacity from upstream to downstream to prepare for the next pandemic. They are starting by looking at the vaccines already developed and approved and those in the pipeline to determine what they can do locally in ensuring dosages by using a fill/finish strategy and then move to how to build capabilities to enable future pandemic response.

The following are key milestones that have been achieved to date:

1. Several partnerships established with current and under development Covid-19 vaccines developers (Biological E partnership; ImmunityBio; Centre for Genetic Engineering and Biotechnology of Cuba; Greenlight BioScience for technology transfer of mRNA technology; Kentucky Bio-Products; and J&J – already manufacturing locally through Aspen)
2. South Africa have the following competitive advantages which can be used to build permanent State Infrastructure to enable future pandemic response

      a) South Africa has experienced principal investigators who are employees of universities and Science Councils which is an advantage.

       b) Bioanalytical laboratories e.g. North-West University/DSI – Preclinical Drug Development Platform facility has been developed for this purpose

       c) Ethics related expertise including individuals for the data safety and management board

       d) Existing capabilities locally: CAPRISA, SAMRC, AURUM, DESMOND TUTU, WITS HEALTH, AHRI, and others on the clinical research side

END.

Reply:

The Gamaleya Institute is still undergoing investigations into the effectiveness of the Sputnik V in the presence of the 501Y.V2 (B.1.351, or Beta) variant, which is the main circulating strain of COVID-19 in South Africa. The published results do not represent the effectiveness of this vaccine against this variant. Also, concern was raised with regards to the second booster dose which uses the Ad5 vector, where previous work in the Phamibili study showed that using this vector may increase the acquisition of HIV, particularly in males. 

The Ministerial Advisory Committee on COVID-19 Vaccines has been engaging with the Gameleya Institute to investigate these matters further.

END.

Reply:

a) South Africa’s national COVID-19 vaccination strategy is designed along the principles of equitable access, social solidarity and fair pricing. Our main priority as government is to ensure that we have the most rational approach to procuring, distributing and administering the vaccine to all members of the national population, irrespective of whether they have medical scheme cover or not.

Medical schemes, as per the provisions of the Medical Schemes Act and its enabling regulations, are mandated to fund for all their members’ costs associated with the diagnosis, treatment, management and vaccination for COVID-19. These costs are to be paid for in full as per the categorization of COVID-19 as a Prescribed Minimum Benefit. Government has also put into place a mechanism to support medical schemes, and their administrators, in establishing accredited COVID-19 vaccination sites across the country. This is intended to expand the number of sites that medical scheme members and non-members can access in order for them to receive their vaccination as per their registration and scheduling on the Electronic Vaccination Data System (EVDS).

b) Government position is that the effective, fair and sustainable achievement of the targets outlined in the vaccination plan requires a collaborative effort involving a number of partners. Private hospitals, including general practitioner as well as community and corporate pharmacies, are playing a role in the roll-out of the COVID-19 vaccination strategy. The National Department of Health, in liaison with the South African Pharmacy Council, has determined clear criteria that all facilities must comply with (such as having the appropriate cold change facilities and trained personnel to administer the vaccines) in order to receive accreditation as a vaccination site. Therefore, private hospitals would also need to comply with these requirements to be able to participate in the roll-out. Private hospitals and private pharmacies are already participating in the vaccines roll-out program.

END.

Reply:

a) Race is not a data element recorded nor collected as part of the vaccination record for vaccinees.

b) Total number of Vaccinations as at 9 May 2021 at 15h30 total 382 568.

• Number of Male Vaccinees = 93 220 which represents 24.4 % of the total number of Vaccinees

• Number of Female Vaccinees = 382568 which represents 75.4 % of the total number of Vaccinees

END.

Reply:

a) According to records on the Internship and Community Service Placement (ISCP) online System, 257 medical students were confirmed to have met the requirements to be allocated for medical internship as at end of April 2021 (i.e. 138 NMFC students who passed the Cuban National Exam; 26 passed the HPCSA Medical Board Exam; and 93 completed their blocks in local universities which made them eligible for medical internship posts, (i) 0 has been allocated on medical interns on 1 April 2021, as there are only two allocation cycle for medical internship, which are 1 January and 1 July of each year and (ii) 257 are still waiting for allocation and will be allocated during June to take up positions on 1 July 2021 and (b) (i) there was no delay as the applicants were not yet eligible for medical internship at the time (ii) the ICSP online System will opened applications from 14 May 2021. Only after the application process is closed, the actual application numbers will be confirmed as more students are becoming eligible (i.e. completing blocks).

b) Due to increased number of qualifying applicants for medical internship posts the Public health sector remains challenged by budget cuts to fund additional internship posts and to accredit excessive number of medical internship posts in health facilities as it requires additional resources (appointment of additional specialists and senior medical doctors).

END.

Reply:

The Department of Health strives to take reasonable legislative and other measures to achieve the progressive realisation of the right to have access to health care services including reproductive health care in terms of its Constitutional obligations. Section 27 (1) (a) of the Constitution of the Republic of South Africa states that everyone has the right to have access to health care services, including reproductive health care. Section 27 (3) further states that no one may be refused emergency medical treatment.

The statistics on the total number of babies who were born to undocumented foreign nationals and/or illegal migrants in government health facilities in each year in the past five years is not available as our health facilities do not keep statistics on foreign nationals.

END.

Reply:

The National Department of Health is still awaiting information from the Gauteng Provincial Department of Health, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the Provincial Department of Health.

END.

Reply:

The two major vaccine manufacturing countries are China and Russia. Vaccines require regulatory approval from SAHPRA. Countries cannot be the applicant and have to work through commercial entities to obtain approval. We have been in discussion with a number of companies having obtained marketing approval from the Gamaleya Institute of Russia for the Sputnik vaccine and with Numolux for the Sinovac vaccine. When all regulatory mattera have been attended to, the negotiations will progress further.

END.

Reply:

First and foremost, on the matter of handling of alleged rape cases, it must be borne in mind that the process of investigating the alleged rape must follow a specific and prescribed chain of evidence to ensure that medico-legally there is no compromise to the quality of evidence collected, thus protecting the victim when the evidence is before a court of law. Bearing this in mind, the response to this question is as follows:

(a) The total number of Thuthuzela care centres (TCCs) in the country is 55.

Eastern Cape: 9

Free State: 4

Gauteng: 7

KwaZulu Natal: 8

Limpopo: 7

Mpumalanga: 5

Northern Cape: 4

North West: 5

Western Cape: 6

a) Hospitals are not obligated to have rape kits as the Department of Health is not involved in the procurement and delivery of rape kits as procurement and delivery is the responsibility of the South African Police Service (SAPS). The SAPS brings these kits along to the Thuthuzela Care Centres (TCCs) as and when there is a sexual assault reported. Therefore the issue of keeping rape kits at health facilities only emanates where there is a discussion between the health facility and the SAPS station responsible.

b) Not applicable based on the response in 1(b). 

2. There is no prescribed number of rape kits required in each hospital. The provision of rape kits is a competency of the SAPS. However as Department of Health we take Gender based violence very seriously and it is our duty to ensure that these rape kits are available at all times to execute evidence collection at our health facilities.

We are therefore working closely together with SAPS to ensure that rape kits are always available. These kits are then delivered to the health facilities by the SAPS, for collection of evidence by health professionals, during physical examination of the survivors of sexual violence. The evidence collected by health professional using these rape kits, is then taken by SAPS to the Police Forensic Laboratory for DNA analysis.

(3) Yes, hospital staff in emergency wards is trained in processing a rape victim.

The Department of health provides service at all hospitals to manage and process survivors of rape. This is done through:

• qualified clinical forensic nurses and doctors
• Ten (10) to more days training using the manual developed by the South African Medical Research Council, the content of which is highlighted below. if not, why not; if so, what are the relevant details; 

Health professionals provide the following services to survivors of rape:

• physical examination,
• Collection of forensic evidence using J88 form. Medico-legal evidence comprises both documentation on the examination done and DNA evidence collected during the examination.
• in children, laboratory evidence of particular sexually transmitted infections can also be used as evidence.
• reporting child abuse, neglect and exploitation to Department of Social Development and SAPS where necessary.
• registration of women and children seen for sexual assaults at health facilities
• providing HIV testing and counselling, which includes providing post exposure prophylaxis
• provision of Prophylaxis (PEP) medication to survivors of rape; which should be available 24 hours a day and patients should be prioritised irrespective of the nature of physical injuries among others.
• provision of ccomfort packs for rape victims;
• referral of women and children to Department of Social Development in the instance their safety is at risk to ensure that they are provided a safe environment such as shelters.
• referral to Psychiatrists and Psychologist to manage emotional and psychological trauma.

(4) No, hospitals are not precluded from processing a rape survivor if that person has not given a statement at a police station first. Survivors of rape have a choice of which authority they wish to access first. We however have noted that majority of rape survivors access the health facility first before they report the matter to a police station and are not dismissed at all.

END.

Reply:

1. (a) The total number of children born in the Republic in the period 1 January 2011 to 31 December 2020 was 9, 609, 814.

(b) The total number of children born in the Republic in each year in the period 1 January 2011 to 31 December 2020 was as follows:

2011	2012	2013	2014	2015	2016	2017	2018	2019	2020
947,912	962,705	957,798	961,036	926,723	891,482	924,898	970,698	1,010,853	1,055,709

Source: DHIS

2. (a) The total number of children born in each province in the period 1 January 2011 to 31 December 2020 was as follows:

Province	Year 2011 to 2020
Eastern Cape Province	1,124,581
Free State Province	471,875
Gauteng Province	2,178,280
KwaZulu-Natal Province	1,964,786
Limpopo Province	1,283,147
Mpumalanga Province	795,754
Northern Cape Province	220,051
North West Province	592,056
Western Cape Province	979,284
Total	9,609,814

Source: DHIS

b) The total number of children born in each province in the period 1 January 2011 to 31 December 2020 was as follows:

Province	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020
EC	119,7	121,606	118,302	120,048	113,52	103,988	101,902	106,139	108,034	111,342
FS	48,55	49,439	47,377	46,432	44,992	41,625	45,769	48,394	49,598	49,699
GP	207,963	211,389	212,873	211,247	209,181	206,18	218,149	224,414	231,927	244,957
KZN	195,541	196,27	194,074	193,032	182,634	177,795	184,828	202,388	218,535	219,689
LIMP	129,695	129,807	129,952	130,059	122,813	119,09	121,728	125,612	131,004	143,387
MPU	75,891	78,53	78,146	79,472	75,654	72,928	77,239	81,482	83,698	92,714
NC	21,473	22,643	22,24	22,973	22,318	20,549	20,918	22,079	22,313	22,545
NW	59,004	59,695	58,999	58,304	57,55	56,309	57,362	59,8	61,591	63,442
WC	90,095	93,326	95,835	99,469	98,061	93,018	97,003	100,39	104,153	107,934
Total	947,912	962,705	957,798	961,036	926,723	891,482	924,898	970,698	1010,853	1055,709

Source: DHIS

END.

Reply:

1. (i) There were three Johnson&Johnson trials conducted in South Africa, the ENSEMBLE 1 trial which was a Phase 3 single dose study, ENSEMBLE 2 which is a phase 3 two dose study (which is still ongoing), and the SISONKE study which was an open label phase 3b trial. 

(ii) The SISONKE trial ended recently (on 17 May 2021) and the analysis is only just starting. 

The ENSEMBLE trial was published in the New England Journal of Medicine, main author GJ Sadoff: Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. A summary of the results: “A single dose of vaccine protected against symptomatic Covid-19 and asymptomatic COVID-19 infection and was effective against severe-critical disease, including hospitalisation and death. Safety appeared to be similar to that in other phase 3 trials of Covid-19 vaccines. 

(iii)-(iv) (aa) SISONKE: the trial ended on 17 May and the analysis on the data is starting now. 

ENSEMBLE: a total of 44 325 participants underwent randomisation of which 43 783 received either placebo or vaccine. The per-protocol population included 39 321 participants, 19630 of which received vaccine and 19630 received placebo. 

(bb) SISONKE: the trial ended on 17 May and the analysis on the data is starting now. 

ENSEMBLE participants 

Median age: 52 years

Gender: female 45% male 54.9% other <0.1%

Ethnicity: American Indian/Alaskan native <1%; South American 9%; Asian 3%; Black 19%; Pacific Islander <1%; White 58%; Multiracial 6%; unknown 3%.

Country: Latin America 40.9%; South Africa 15%; USA 44.1%

> coexisting condition: 40.8%

Outcomes & Results: Vaccine efficacy after 28 days administration

Moderate to severe-critical COVID-19: 66.1% (95% confidence interval 55.0 – 74.8%)

Symptomatic COVID-19 of any severity: 66.5% (55.5-75.1)

No differences in vaccine efficacy were observed among subgroups (sex, race or ethnic group). Only a marginal decrease in vaccine efficacy noted in participants > 60 with comorbidities after 28 days after administration. Vaccine efficacy against hospitalisation was 100% 28 days after administration. Of the South Africa population, 95% of participants had the 501Y.V2 variant, but the vaccine efficacy remained high. 

 

(2) (a) ENSEMBLE was conducted in South Africa, Latin America (Argentina, Brazil, Chile, Colombia, Mexico, Peru) and the USA.

SISONKE was conducted in the following 17 institutions, from all 9 provinces:

EC: Frere, Livingstone, Nelson Mandela Academic, Netcare Greenacres hospitals

FS: Bongani, Fezi Ngumbentombi, Life Rosepark, Pelonomi, Universitas hospitals

GP: Ahmed Kathrada, Charlotte Maxeke, Chris Hani Baragwanath, Dr George Mukhari, Netcare Milpark, Steve Biko Academic hospitals

KZN: General Justice Gizenga Mpanza, Edendale, Madadeni, Netcare St Augustines, Prince Mshiyeni Memorial hospitals

LP: Tshilidzini, Donald Fraser, Malamulele, Mediclinic Polokwane, Netcare Pholoso, St Ritas hospitals

MP: Ermelo, Life Cosmos, Mediclinic Nelspruit, Mapulaneng, Rob Ferreira hospitals

NC: Mediclinic Upington, Robert Mangaliso Sobukwe hospitals

NW: Job Shimankana Tabane, Klerksdorp-Tshephong Tertiary, Life Peglarae, Mahikeng Provincial, Moses Kotane hospitals

WC: Groote Schuur, Tygerberg, Gatesville, George, Karl Bremer, Khayelitsha District, Paarl, Worcester hospitals.

(b) ENSEMBLE was a multi-national study funded by Janssen Research and Development and others. 

Vaccines for SISONKE were secured by the Department of Health and were administered by teams of researchers and vaccinators. Research staff from the South African Medical Research Council where responsible for ensuring the cold chain and drawing up the correct amount of vaccine. Vaccinators where responsible for complete assessment checks, administering the vaccine and monitoring the participants for a few minutes after administration. END.

Reply:

The (a) full details of the person(s) and/or companies that provide funding to the SA Health Products Regulatory Authority (SAHPRA) and (b) breakdown of the total amounts provided by each funder are indicated in the table below:

Full details of the person(s) and/or company that provide funding to the SAHPRA	Breakdown of the total amounts provided by each funder
Clinton Health Access Initiative	R 1 441 170 (Direct donation)
Centers for Disease Control	R 16 739 056 (Direct donation through NDOH)
Public Health Enhancement Fund	R 2 580 000 (Services in kind)
Right to Care	R 94 204 (Services in kind – Office accommodation)
Bill and Mellinda Gates Foundation	R 73 000 000 (Services in kind)
National Treasury	R60 000 000 (Conditional Grant)

END.

Reply:

According to the information provided by the Provincial Health Departments the reply is as follows:

EASTERN CAPE

a) The following table reflects the details in this regard.

PERIOD	CATEGORY	TOTAL NUMBER OF CASES	CASES ABOVE R100,0000
	FRAUD	CORRUPTION
2017/2018	7	11	18	2
2018/2019	7	13	20	2
2019/2020	2	8	10	-
2020/2021	2	3	5	-
TOTAL	18	35	53	4

b) No tenders have been cancelled as a result of irregularities or corruption.

c) The bulk of irregular expenditure as per the table below comprises of extension of contracts above the 15% NT threshold. The 2020/21 figure not yet final.

d) All bids above R500k are advertised on the e-Tender portal other than deviations due to sole source or emergency procurement.

e) All bids above R500k are advertised on the e-Tender portal other than deviations due to sole source or emergency procurement.

f) (ii) The Eastern Cape Department of Health is currently using manual systems which are paper based. The plans to digitise procurement processes have been included on the departmental strategic plan and processes are underway to engage SITA for assistance.

FREE STATE

a) Free State Psychiatric Complex – Fraudulent payment to various transactions to suppliers at FSPC. Double payment were made to various suppliers on same order numbers by means of LOGIS and Sundry Payments (BAS System). Cost involved R7,821,587.62.

b) None, tenders were not cancelled due to irregularities or allegations of corruptions.

c) The total amount registered for Free State Department of Health is: R1,605,678,521.22.

d) 100% all tenders were published on e-Tender portal.

e) 100% tenders were uploaded on e-Tender portal and published on the Provincial Tender Bulleting.

f) (ii) 80% processes are paper based.

GAUTENG

a) 

Year	No of Cases of Corruption	Costs
2020-21	None	R0
2019-20	6	R12 600 944.78
2018-19	1	R2 773 209.60
2017-18	7	R2 875 716.49
2016-17	1	R987 032.00

b) There are two tender that have been cancelled, are as follows;

• GT/GDH/118/119/120/121/2016) Supply of Physical Security Services
• (GT/GDH/123/2013)-ICT Infrastructure Refresh – the provision of V-Blocks to Head Office, Zola, New, Natalspruit, Steve Biko and Charlotte Maxeke Hospitals.

Year	Amount
2017	2 050 841 000
2018	1 703 205 000
2019	2 862 156 000
2020	2 318 994 000
2021	3 549 745 000
TOTAL	12 484 941 000

d) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin.

e) 100% Tenders are advertised by E-Gove as well as Government Tender Bulletin.

f) (ii) All tenders are advertised through National Tender Bulletin and can be downloaded from respective provincial e-tender portal by prospective bidders.

KWAZULU-NATAL

FY 2016/2017 R 16 918 744,00

FY 2017/2018 R 8 505 932,68

FY 2018/2019 R 118 169 545,62

FY 2019/2020 R 474 767,75

FY 2020/2021 R 110 000,00

b) No tenders have been cancelled in the province in the past 5 years due to irregularities and/or corruption in KZN.

c) 

	‘000	‘000	‘000	ROOO	ROOO
Period	2015/2016	2016/2017	2017/2018	2018/2019	2019/2020
Totals	R1,257,484	R1,325,084	R1,464,342	R1,541,732	R1,433,975

d) 100%. All tenders in the province have been advertised on the e-Tender portal.

e) 100%

f) (ii) 100%

LIMPOPO

a) None.

b) None.

c) No irregular expenditure as a result of corruption within the department.

f) 100% of tenders were put on the e-Tender portal in the past five years.

e) 100% of tenders were uploaded on e-Tender portal site of the department.

f) (ii) 100% of tender process are paper based in the department

MPUMALANGA

a) The Department does not have known cases of corruption reported

b) The Department has cancelled contracts for appointed service provider for supply of perishable and non-perishable food due to non-compliance with UIF

c) 

Financial year	2016/17	2017/18	2018/19	2019/2020
Amount	1 552 623 000	309 920 000	138 899 000	122 157 000

d) Not applicable – Provincial Treasury competency

e) Not applicable – Provincial Treasury competency

f) (ii) Not applicable

NORTHERN CAPE

a) No cost of corruption incurred in the past five financial years

b) No contract was cancelled as a result of irregularities and/or corruption in the past five years.

c) 

2016/17: R574,183,000

2018/19: R714,939,000

2019/20: R497,829,000

2020/21: R492,748,000 (Preliminary)

Total: R2,692,078,000

d) 

2016/17: No tenders issued

2017/18: 60% (3 out of 5)

2018/19: 0%

2019/20: 0%

2020/21: 0%

e) No tenders were ever uploaded on the e-Portal site.

f) (ii)

2016/17: No tenders issued

2017/18: 40% (2 out of 5)

2018/19: 100%

2019/20: 100%

2020/21: 100%

NORTH WEST

a) No cost of corruption incurred in the past five financial years

b) NWDOH 40/2021, Supply of Physical Security Services

c) 

Year	Amount
2016/2017	721 445 000
2017/2018	809 267 000
2019	1 333 654 000
2020	1 189 467 000
2021	682 000 000
TOTAL	4 735 833 000

d) Irregular expenditure for the past 5 years = R4 728 202 000.

e) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin

f) 100%- Tenders are advertised by E-Gove as well as Government Tender Bulletin

g) (ii) All tenders are advertised through National Tender Bulletin and can be downloaded from respective provincial e-tender portal by prospective bidders

WESTERN CAPE

a) None.

b) None based.

c) 

(R’000)

2020/21:               2,452 (unaudited)

2019/20:               6,472

2018/19:             13,260

2017/18:             23,553

2016/17:             11,459

2015/16:               7,284

d) Indeterminable. E-portal is a NT app and has been off-line for a few months. NT unable to provide date as to when it will become available.

e) Indeterminable. E-portal is a NT app and has been off-line for a few months. NT unable to provide date as to when it will become available.

f) (ii) BSC, BEC, BAC processes were paper based up to March 2020. Since March 2020, documents had to be worked on electronically, meetings had to be held electronically and declarations of interest and confidentiality of meetings had to be declared at each virtual meeting.

END.

Reply:

The National Department of Health is still awaiting information from the Gauteng Provincial Department of Health, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the Provincial Department of Health.

END.

Reply:

a) Government procurement of vaccines is supported by the allocation of funds from National Treasury to the National Department of Health as earmarked funds.

b) (i) As sole procurer of vaccines from manufacturers, all the vaccines are purchased by the National Department of Health

(ii)-(iii) The vaccines are supplied to vaccination sites in the private and public sector who administer vaccines. Private sector sites buy the vaccine from the NDOH and will claim from medical schemes for the vaccine and administration of vaccines to the insured patients. For uninsured patients, the vaccination sites will claim from the Department

END.

Reply:

END.

Reply:

Only a marginal reduction in efficacy has been noted the elderly (>60-65 years) in the trials conducted to date. With regards to comorbidities, current trials have shown no difference in efficacy compared to persons without comorbidities. Theoretically they may be less effective in persons with decreased immune system, however the limited trials to date have not shown this.  

There is currently no data on how long the vaccines will provide protection against re-infection.

END.

Reply:

The National Department of Health is still awaiting information from the University of Pretoria, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the University of Pretoria.

END.

Reply:

The National Department of Health is still awaiting information from the University of Pretoria, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the University of Pretoria.

END.

Reply:

1. The Department of Employment and Labour issued an improvement and contravention notice to the Forensic Chemistry Laboratory at 271 Visagie Street, Pretoria on 8 October 2018. The laboratory began immediately with the compliance requirement in the improvement notice under the Occupational Health and Safety Act, 85 of 1993. Copies of all relevant Acts and Regulations have been made available at the laboratory. Posters are also visible on the walls of the corridors of the laboratory. All DB boards in the laboratory have warning signs attached to them. This was done by the laboratory in October 2018.

2. The risk assessments and medical surveillance program of employees were part of a tender awarded to a service provider in 2019 to cover the National Department of Health and its decentralised units including the Forensic Chemistry Laboratories. The service provider was due to start the risk assessments and medical surveillance of employees in March 2020. Owing to the Covid-19 pandemic response the service provider undertook risk assessments related to Covid-19 only and not general health and safety assessments. In addition, many employees were not at work or undergoing rotational shifts in line with DPSA guidelines and thus the medical surveillance programme was placed on hold. It is envisaged that the risk assessments will be conducted in the third quarter of the 2021/22 financial year. Medical surveillance will be undertaken in the fourth quarter of the 2021/22 financial year after the risk assessments in order to link risk assessments to medical surveillance of individual employees.

Afrox was not able to assist the laboratory with the Certificate of Compliance for gases. The laboratory is following up with Afrox to take responsibility and provide a Certificate of Compliance.

The Department of Public Works and Infrastructure was contacted on the 23 October 2018 and to date despite follow up by the laboratory manager on multiple occasions has not responded on the contravention notice covering infrastructure, electrical and mechanical requirements under the Occupational Health and Safety Act, 85 of 1993.

3. The laboratory does not have any details or specific dates on when to expect the Department of Public Works and Infrastructure to attend to the request. The Director-General will write to the Director-General of Public Works and Infrastructure later this month requesting feedback and intervention.

END.

Reply:

Leaders including politicians who are eligible to be vaccinated based on the prevailing eligibility criteria have been encouraged to vaccinate in order to publicise the vaccine roll-out, and to build confidence in the programme amongst vaccine-hesitant citizens.

President Cyril Ramaphosa and Minister of Health, were vaccinated in public on 17th February 2021 at the Khayelitsha District Hospital in the Western Cape at the start of the Sisonke Early Access programme.

However, vaccination status of individuals remains confidential, and the National Department of Health is therefore not in a position to divulge the vaccination status of the other persons identified in the above question.

END.

Reply:

The National Department of Health is still awaiting information from the University of Pretoria, to enable the Minister to respond to this question. The response will be provided to Parliament as soon as information has been received from the University of Pretoria.

END.

Reply:

No. There were no reasons furnished to the minister that travel restrictions are not necessary to be imposed on persons who have travelled to India, in order to prevent the spread of the specific coronavirus variant, such as the B.1.617. This is because there are no direct flights from India to South Africa.

The Department of Health has made general recommendations on the additional travel control measures that should be applied to travellers from all “Countries of Concern” and not necessarily from India only, which is part of these countries. The proposed intervention is for travellers who have travelled from or transited through any “Country of Concern” within 14 days of arriving in South Africa to be subjected to antigen testing at the point of entry on arrival.

END.

Reply:

The targets for the vaccine roll-out as follows:

Phase	Time period	Number of vaccinations
1	February – May 2021	1.2 million
2	May – October 2021	16.6 million
3	November 2021 – February 2022	22.6 million

The targets remain as previously announced. The targets are linked to the vaccine supply pipeline, and may need to be revised if vaccine manufacturers do not supply vaccines according to the agreed timelines.

END.

Reply:

The COVID-19 pandemic has highlighted the need for increased vaccine security and therefore, self-reliance. However, the development of local vaccine manufacturing is a complex process that has high risk associated with it. To ensure the quality and consistency of vaccine manufacturing, hundreds of process steps need to be followed and there are thousands of check points for testing. The transfer of intellectual property rights as well knowledge transfer on vaccine manufacturing should be coupled with massive investment in manufacturing capacity. Currently there is an unprecedented level of support across African governments, African and Global Public Health (GPH) institutions, and the private sector, which is driven by the need for increased vaccine security and self-reliance highlighted by the COVID-19 pandemic. 

As part of the African Union we have embarked upon a project to understand the strengths to leverage and challenges that could be faced develop a framework on vaccine manufacturing on the continent including opportunities for collaboration with a range of public and private sector stakeholders. This work is ongoing and is aimed at future pandemic preparedness.

END.

Reply:

a) Ivermectin Authorisation Status 25/05/2021
	Approved	Rejected	Pending	Duplicate
Tier 3: Section 22C(1)(b) - licence holder	8	3	0	0
Tier 2: Healthcare Facility Stock	134	40	0	4
Tier 1: Named-patient	112	15	0	2
TOTAL	254	58	0	6	318

b) The use of Ivermectin in the treatment and prevention of COVID-19 infections received avid interest recently due to the antiviral and anti-inflammatory properties in vitro. Available data to date, mostly from small under-powered studies, show a trend towards some benefit in the management of COVID-19. National and international bodies have reviewed the data; and have concluded that there is unclear evidence of both benefit and harm, in the treatment and prevention of COVID-19. After consideration of the impact of the second wave as well as the clinical equipoise that was presented through the various studies reviewed, SAHPRA implemented an Ivermectin Controlled Compassionate Use Programme for approved unregistered ivermectin products to be accessed via a three-tier programme for Section 22C(1)(b) permit holders, healthcare facilities, and named-patient applications. On 16 March 2021,SAHPRA registered Soolantra 10mg/g cream formulation, which contains ivermectin. Soolantra Cream is indicated for the topical treatment of moderate to severe inflammatory lesions of papulopustular rosacea in adult patients and is not for the prevention or treatment of COVID-19. The registration of this product enabled the compounding of ivermectin on a prescription basis for specific patients as well as off label use of ivermectin under the section 21 Controlled Compassionate Use Programme.

END.

Reply:

(a)​  The overall percentage (%) rate for vacant posts in State Hospitals is 13%. The table below indicates the (%) rate of vacant posts in State Hospitals per Province as at end February 2021.

Province	% Vacant posts in Hospitals
Eastern Cape	13%
Free State	21%
Gauteng	11%
KwaZulu Natal	14%
Limpopo Province	7%
Mpumalanga	12%
North West	14%
Northern Cape	17%
Western Cape	15%
Overall Total	13%

(b) The recovery rate of COVID-19 patients without comorbidities reported as at 14 April 2021 is as below, please note that the comorbidities indicator is not covered as the current reporting classification does not include it:

 

PROVINCE	TOTAL RECOVERIES
	14 April 2021
Eastern Cape	184,064
Free State	79,579
Gauteng	405,110
KwaZulu-Natal	319,830
Limpopo	60,970
Mpumalanga	74,225
North West	61,631
Northern Cape	33,215
Western Cape	268,249
Total	1,486,873

END

Reply:

The following information is as received from the Provincial Departments of Health.

1. (a) The overall percentage (%) rate for vacant posts in state hospitals in each province is 13%. The table below indicates the percentage (%) of vacant posts in Government Hospitals per Province as at end February 2021.

Province	% Vacant posts in Hospitals
Eastern Cape	13%
Free State	21%
Gauteng	11%
KwaZulu Natal	14%
Limpopo Province	7%
Mpumalanga	12%
North West	14%
Northern Cape	17%
Western Cape	15%
Overall Total	13%

2. The total number of Chief Executive Officers in acting positions is 64. The table below illustrates numbers per Province.

Total acting CEOs per Province
Province	Acting CEO's
Eastern Cape	14
Free State	6
Gauteng	10
KwaZulu Natal	-
Limpopo Province	11
Mpumalanga	7
North West	7
Northern Cape	7
Western Cape	2
Overall Total	64

The National Department of Health (NDoH) acknowledges the reported number of acting Chief Executive Officers (CEOs) as high. As a result, the Director-General has written letters to the Provincial Heads of Health Departments to prioritise the appointment of experienced eligible candidates permanently to the positions of CEOs at their earliest convenience to ensure stability and service delivery continuity in the affected Hospitals.

(2) A full report on the infrastructure upgrades of state hospitals in each province is herewith attached as Annexure 1.

END.

Reply:

This question was previously responded to during a Portfolio Committee meeting. Nevertheless let us repeat our previous explanation as it suggests there is a lack of understanding of scientific terminology.

Excess deaths are typically defined as the difference between the total number of deaths reported in a specific time period and “expected” number of deaths in the same time periods.

The total number of deaths refers to the total number of people that died during a defined period of natural causes. The expected number of natural deaths is an estimate derived through modelling data, so it is not based on any confirmation of the actual cause of death. The model basically assumes that the trend in the number of deaths due to natural causes is similar to pre-COVID. Hence the excess deaths is an estimate as the difference between the total number of natural deaths and the estimated number of natural deaths. This exercise is useful for the purposes of assessing trends in mortality but cannot be used as an official statistics since it is based on an estimate. In the excess deaths estimate we cannot identify actual persons that may have died due to COVID.

(a) The Minister cannot update the official COVID death statistics based on an estimate of deaths. The official statistics is based on deaths of persons that are confirmed to have died due to COVID. This statistics is not an estimate.

(b) The official statistics of deaths due to COVID is an accurate representation of deaths in the country as each death reported is linked to the identity of a specific individual that died due to COVID. The excess deaths report from the MRC is an estimate that cannot be linked to the identity of a specific individual hence cannot form part of the official statistics.

END.

Reply:

According to the Provincial Departments of Health in the country –

(a) Most (4,601 including hospitals, clinics, mobiles and correctional centres report to DHIS) facilities have full capacity for ART treatment for HIV/AIDS in the Republic. All primary health care facilities and hospitals have full capacity for anti-retroviral treatment for HIV/AIDS in the Republic. However, small facilities often do not have more than 1 person trained to provide anti-retroviral treatment. Mobile health facilities do not have the full capacity for ART.

The table below indicate the number of Mobile health facilities per province.

Province	Number of mobile health facilities
Eastern Cape	177
Free State	135
Gauteng	106
KwaZulu-Natal	193
Limpopo	144
Mpumalanga	114
Northern Cape	54
North West	54
Western Cape	174
TOTAL	1,151

Where, mobile clinic facilities are not providing service, clients are referred to the nearest facility that provides for this service.

(b) (i) No patients were turned away from health care facilities without ARV treatment.

(ii) No facilities were affected in the country.

(c) All patients who visited health facilities received ART.

END.

Reply:

According to the North West Provincial Department of Health, Mokgareng Clinic has never been without medicines.

The Clinic has enough glucometers to assist diabetic patients. There may be times when one glucometer may be without batteries and because there is enough of them, the staff is able to continue with the work while the dead batteries of one glucometer are being replaced. The National Department of Health, working with the Provincial Department and the District will continue to monitor medicine as well as equipment availability in all facilities including for Mokgareng Clinic.

END.

Reply:

The following tables reflect the details in this regard.

NATIONAL DEPARTMENT OF HEALTH (NDOH)

NAME OF COMPANY	PURPOSE OF CONTRACT	VALUE OF CONTRACT	DURATION OF CONTRACT
RRA TRADING	Security Guarding	R13 366 618.60	36 Months - All Forensic laboratories and MBOD/CCOD (01 April 2020 – 31 March 2023) 12 Months - Civitas Building ( 01 April 2020 – 31 July 2021)

NATIONAL HEALTH LABOTORY SERVICE (NHLS)

NAME OF COMPANY	PURPOSE OF CONTRACT	VALUE OF CONTRACT	DURATION OF CONTRACT
Eldna Security Services	Not Applicable (NHLS insourced the security from February and March 2018)	Not Applicable	Not Applicable

OFFICE OF HEALTH STANDARDS COMPLIANCE (OHSC)

NAME OF COMPANY	PURPOSE OF CONTRACT	VALUE OF CONTRACT	DURATION OF CONTRACT
Eldna Security Services	Security Guarding	R2 765 088.00	36 Months (10 October 2020 – 10 October 2023)

SOUTH AFRICAN HEALTH PRODUCTS REGULATORY AUTHORITY (SAHPRA)

NAME OF COMPANY	PURPOSE OF CONTRACT	VALUE OF CONTRACT	DURATION OF CONTRACT
Tyeks Security Services	Security Guarding	In a process of procuring security service for 2021/2022 financial year	Not Applicable

SOUTH AFRICAN MEDICAL RESEARCH COUNCIL

NAME OF COMPANY	PURPOSE OF CONTRACT	VALUE OF CONTRACT	DURATION OF CONTRACT
Fidelity Services Group	Security Guarding	R 32 000 000.00	36 Months (01 June 2019 – 31 May 2022)

END.

Reply:

The functions and operations of the Council for Medical Schemes (CMS) are provided for in the provisions of the Medical Schemes Act (131 of 1998). The primary function of the CMS is to provide regulatory oversight over the medical schemes industry. The CMS’ annual performance plan, including the targets outlined in this plan, are developed and finalised by the CMS’ executive team in full consultation with the Board. These plans are intended to address the challenges that the industry is facing, especially beneficiaries. The budget for the CMS is determined through an analysis of the previous year’s expenditure including any emergent projects – this budget is based on the provisions of the CMS Levies Act (58 of 2000). The CMS budget is based on the quantum of the levy that they can raise based on the number of principal members registered with medical schemes; and the number of medical schemes members is causally linked to the level of economic growth and performance.

The resource constraints plaguing the CMS are multifaceted and include a funding model that is heavily reliant on levies, regulatory tariffs that have not kept pace with consumer price index increases over time and the overall poor performance of the economy in recent years. To assist the CMS in addressing their budgetary constraints, the National Department of Health has been engaging with CMS to develop a new funding model that is more sustainable and reduces reliance on the fiscus, innovatively minimises reliance on medical scheme member levies and progressively increases the quantum of the budget that comes from regulatory tariffs (i.e. fees charged for accreditation of administrators, managed care organisations and registration of schemes and rules). Other innovative revenue generation considerations include raising additional revenues from Board of Trustee and Principal Officer training sessions as well as from webinars and conferences.

 

Finally, I would like to take this opportunity to correct the impression that Government is considering medical schemes for facilitating National Health Insurance (NHI). The administration of National Health Insurance (NHI) is not going to be outsourced. There is no contemplation of subcontracting any administrator/s or schemes to manage the affairs of the NHI Fund.

END.

Reply:

The findings outlined in the Interim Report into Allegations of Racial Discrimination by Medical Schemes are very disconcerting. As part of the processes to better understand the findings, the recommendations emanating from these and also to determine the most appropriate actions required to ensure that the findings do not occur again, we had a briefing session with the Section 59 Panel on the 22nd December 2020. Given the nature of the findings and that the report is interim, there are no immediate actions being implemented. However, once all stakeholders have made their inputs and comments on the report and it is then finalised by the Panel, it is expected that the Council for Medical Schemes (CMS) will submit the final report to the Department.

One of the proposed interventions identified in the Interim Report is that the Department has to ensure that the CMS and the Boards of the Health Professions Council of South Africa (HPCSA) determine the action plans they would be considering, particularly in relation to the Panel’s recommendations as to the two regulatory authorities and their areas of lack of oversight and guidance on matters pertaining to Fraud, Waste and Abuse. Additionally, it is expected that the CMS would investigate the provisions of Section 59 of the Medical Schemes Act, and where necessary propose legislative amendments (including supporting regulations) pertaining to schemes and administrators. This includes providing clear and consistent guidance to their regulated entities on current procedures followed by schemes to enforce their rights in terms of section 59 of the Act. I will also be requesting the CMS Board to provide me with regular updates on all actions taken to address the findings and progress on interventions implemented.

END.

Reply:

In order to respond to this Question, information must be sourced from the provinces. The Department is still in the process of sourcing this information and as soon as all the information is received, the Minister will provide the response to the Question.

END.

Reply:

In order to respond to this Question, information must be sourced from the provinces. The Department is still in the process of sourcing this information and as soon as all the information is received, the Minister will provide the response to the Question.

END.