Questions and Replies

Reply:

a) The total number of applications for business travel received from 1 October to 11 November 2020 was 8,878. Applications are not separated, or processed according to nationality.

b) (i) Approved: 6,778. This figure includes business people including South African permanent residents and long-term visa holders who used this e-mail address. 2,100 applications were in process up until the 11 November 2020.

(ii) Rejected: None. Those who did not meet the requirements were requested to submit outstanding information and their cases were approved once the information was received.

c) All cases are finalised between 1 to 10 days.

 

END

Reply:

Information is being collated from all the provinces to enable us to respond to these questions. The full details will be furnished to Parliament as soon as they are received from the provinces.

END.

Reply:

a) The total number of graduate doctors in the Republic –

(i) are waiting to be placed as interns is zero for the Annual January 2021 Cycle;

(ii) also, there are no interns currently unemployed.

The National Departmernt of Health has allocated a total of 2,367 medical interns and 1,693 community service: medical service officers who are eligible and qualifying South African Citizens and Permanent Residents to posts.

b) Only applicants who meet the requirements in accordance with employment Regulations in South Africa and are able to commence duty on 01 January 2021 have been allocated.

END.

Reply:

According to the records received from the Gauteng Provincial Department of Health and confirmed by the PERSAL System –

a) there were only 6 students employed as medical interns, after completion of their studies, during the past three years period (i.e. 2018 to 2020) and no other professions including administration categories were placed or appointed for Internship at the Hospital during the said reporting period;

b) the medical interns were placed under supervision in the eight domains of medical rotation, i.e General Medicine; General Surgery; Paediatrics; Obstetrics and Gynaecology; Anesthesiology; Orthopaedics; Psychiatry; Family Medicine/Primary Care) as prescribed by the Health Professions Council of South Africa (HPCSA) and their log-books were signed off at the end of their two years of the internship period;

c) all medical interns in the Public Service are remunerated in accordance with the Occupational Specific Dispensation (OSD) for medical practitioners and as such all the six (6) medical interns at Jubilee Hospital were remunerated accordingly and did not receive a stipend

END.

Reply:

According to the Gauteng Provincial Department of Health,

a) The project of refurbishing the eight (8) wards as, indicated in the response to Question 2743 by Ms N Chirwa was successfully completed and the wards are fully operational. Below are the dates of occupation achieved for each of the wards:

 

Ward 1: 13 July 2020

Ward 2: 08 July 2020

Ward 3: 31 July 2020

Ward 4: 28 August 2020

Ward 5: 13 July 2020

Ward 6: 08 July 2020

Ward 7: 28 August 2020

Ward 8: 28 August 2020

b) The refurbishment project was done at a cost of R186,000,000.

END.

Reply:

The KwaZulu Natal Provincial Department of Health provides students with bursaries with a view that they will return and serve back to the Department, this is done in good faith and is dependent on the Department having the necessary funding to employ the said bursary holders. Unfortunately, the KZN Department of Health is experiencing financial constraints and so is the entire Public Service.

It must be mentioned that the categories mentioned above which are Medical Orthotics and Prosthetics are not the only group of students that were funded by the Department and are yet to be placed for employment.

There are currently 39 bursary holders for Medical Orthotics and Prosthetics that are yet to be placed.

The KZN Health Department has confirmed that it is working with the Office of the Premier and KZN Treasury to find a solution in this regard.

END.

Reply:

a) Wards 1 to 8 at Dr George Mukhari Academic Hospital that were earmarked for refurbishments were successfully refurbished and currently fully operational. Below are the dates of occupation achieved for each of the wards:

Ward 1: 13 July 2020

Ward 2: 08 July 2020

Ward 3: 31 July 2020

Ward 4: 28 August 2020

Ward 5: 13 July 2020

Ward 6: 08 July 2020

Ward 7: 28 August 2020

Ward 8: 28 August 2020

b) The refurbishment project was done at a cost of R186,000,000.

END.

Reply:

The KwaZulu-Natal Department of Health informed me that they have sufficient funds from the National Health Insurance (NHI) Direct Grant for contracting of General Practitioners in line with their 2020/21 business plan.

The uMgungundlovu Health District has a one hundred percent (100%) Doctor coverage in its Primary Health Care (PHC) facilities.

The Department of Health issued notices only to five (5) Doctors who are over the age of seventy (70) years and eighty (80) years for their end of contract in order to achieve the following:-

1. Comply with the Public Service Act (PSA) section 16.

2. Re-distribution of Doctors to the neediest clinics in other Districts (as there were clinics under UMgungundlovu that had contracted between two (2) and three (3) Doctors per clinic, whereas there were shortages in other Districts).

3. Compliance with the National Development Plan (NDP) 2030 health sector strategy “more health professionals should be on hand, especially in poor communities.”

END.

Reply:

a) All District Offices and hospitals in the Eastern Cape have been provided with the Action Plan to prepare the hospitals for an envisaged resurgence. This includes practical measures that hospitals must implement to enhance the readiness for the rising numbers of COVID-19 in the Province. The essential respiratory support devices and donated oxygen equipment have been distributed to central, regional and district facilities with an emphasis to have adequately trained staff and infrastructure at all these facilities. The Department initiated an audit of oxygen reticulation infrastructure which was completed at 64 priority hospitals in the Province. This audit was aimed at the improvement of oxygen delivery capabilities at these facilities. The Provincial Department is implementing suggested rectification actions within the current national financial constraints, to improve the availability of bulk liquid oxygen. At five hospitals the current cylinder oxygen banks are to be replaced with bulk oxygen tanks to provide additional constant supply to the hospitals. Cement Plinths to accommodate these tanks are constructed at the hospitals and tanks are moved to the new positions and coupled to the reticulation. Oxygen cylinder resupply is closely monitored and has been scaled to meet the additional demand. Hospital facilities in Nelson Mandela Bay are supported by a large Field Hospital facility to provide additional beds. The facilities are increasing the available isolation and treatment beds to accommodate the additional demand. Wards with an additional ninety (90) oxygenated beds have also been completed at the Dora Nginza Hospital and a basement area at the Livingstone Hospital has been converted to provide 74 additional oxygenated beds. Both facilities are in the process of commissioning, with the recruitment of staff in process.

b) Various lessons were learnt in the response to the first wave, with adjustment of the implementation interventions:

(i) The lessons learnt in the first wave were captured in an Intra Action Review of the response under the guidance of the World Health Organisation (WHO). Where necessary rectifying actions have been implemented. The lessons learnt are being reviewed on an ongoing basis in a daily Incident Management Team (IMT) meeting of the Province.

(ii) The importance of the use of the personal protective equipment (PPE) is because it contributes towards the protection of the health care workers from infection. With the correct use of the PPE, the staff is able to avoid infection and as such is always on duty to provide the services to the people. In this regard the Department conducts ongoing training on the correct use of the required PPE for frontline workers. Stock levels of PPE are monitored continuously by the provincial pharmacy supply chain management, as reported regularly to the IMT. This ensures that PPE are always available to the frontline workers. At high volume facilities, marshals have been stationed to monitor the continuous sanitation of hands and use of masks and PPE.

END.

Reply:

On review of the report of the Commission, I sought to get more details of each complainant by appointing the independent Obstetrician to review and analyse all the case records of the complainants and get advice on each individual case so that by the time they are met, there is enough clinical information from the records.

I presented a report on this matter to the Joint meeting of the Portfolio Committees on Health and of Women, Youth and Persons with Disabilities, on 25 November 2020.

END.

Reply:

(1) The Department of Health has not conducted a review on the state of psychiatric care since the beginning of COVID-19. The last formal review of the state of psychiatric care in the Republic was conducted by the South African Human Rights Commission (SAHRC) and a report was released in March 2019. The report is publicly available. The report remains instructive and the main source of information on the state of psychiatric care.

The disruptions caused by the COVID-19 pandemic have derailed the implementation of the recommendations by the SAHRC, which we have committed to implement to ensure that the status core changes for the better.

The Department utilises information collected through the District Health Information System to track utilization of mental health services at primary health care, admissions to inpatient mental health units in general hospitals, and bed utilization rates in specialized psychiatric hospitals. The tables below provide information on these selected indicators showing the status in psychiatric care pre COVID-19 and during COVID-19:

Table 1: DHIS data on the number of clients of all ages seen at ambulatory (non-inpatient) services for mental health conditions

	EC	Free State	Gauteng	KZN	Limpopo	MPU	NC
	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020
March	29840	29855	14651	14259	41382	42768	39671	40389	33666	32210	11753	13463	5071	4645
April	31015	23721	14047	10312	44560	36605	41869	36894	32321	21158	12146	9022	5047	4168
May	31638	22990	15076	9055	45034	35622	44029	35475	34513	18936	14934	10726	4958	4385
June	28330	21425	13371	8135	40419	37720	41605	37824	32319	21165	12895	10548	4303	4347
July	31233	24569	15130	7775	50316	40393	45163	37608	33467	19947	6476	8175	5797	4638
Aug	30232	23244	15470	8354	45517	40886	42665	35994	34332	18466	16377	7766	5138	5118
Sept	29747	25839	14329	7927	42594	42635	40442	38246	35029	20838	17022	8453	4738	5021

	NW	WC
	2019	2020	2019	2020
March	9391	8682	18591	20750
April	9600	10038	20447	14434
May	9735	8805	20710	12763
June	8473	7118	18592	14465
July	10118	8408	22773	15374
Aug	9714	7331	21109	15094
Sept	9756	7540	20920	16734

Table 2: Number of clients of all ages admitted for mental health problems in mental health units attached to general hospitals

	EC	Free State	Gauteng	KZN	Limpopo	MPU	NC
	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020	2019	2020
March	963	787	2488	2340	680	818	1049	1492	626	685	290	298	59	45
April	883	733	2232	2028	800	548	1612	2160	716	498	264	210	107	67
May	1019	531	4993	3236	912	628	1426	1563	652	608	244	243	120	135
June	909	561	4407	4289	643	587	1510	1381	614	570	201	196	100	51
July	910	758	3350	3923	801	630	1751	1139	767	597	255	190	128	29
Aug	905	553	2538	4019	736	764	1618	1136	814	644	197	204	60	49
Sept	883	1400	2291	4494	688	905	1440	1361	712	858	230	204	66	47

	NW	WC
	2019	2020	2019	2020
March	194	205	1663	2057
April	205	164	1660	1307
May	182	175	1706	1221
June	306	188	1585	1406
July	360	226	1811	1501
Aug	364	194	1850	1468
Sept	235	218	1796	1772

Table 3: National average data for the Specialised Psychiatric Hospitals Bed utilization rate (beds occupied compared to the total number of beds) (%)

	2019	2020
March	75.5	147.3
April	147.4	64.7
May	154.4	70.2
June	149.1	68.1
July	152.8	70.3
Aug	153.8	67.7
Sept	81.1	69

Table 4: National average data for the Specialised Psychiatric Hospitals discharges (n)

 

	2019	2020
March	1131	1297
April	1218	1288
May	1223	751
June	1254	805
July	1255	824
Aug	1188	608
Sept	1076	800

(2) Through the equitable share, each of the nine provinces receives an allocation for the provision of health care services directly from National Treasury through the provincial treasuries. Provincial Departments of Health determine the allocation of resources to health programmes including psychiatric care. In this regard, information regarding reprioritisation of resources due to Covid-19 is currently being sourced from each of the nine Provincial Departments of Health to be able to respond to this question. The response to the Parliamentary Question will be provided in due course.

END.

Reply:

1. Hormonal medicines used in transgender patients include testosterone for masculinising, and oestrogen for feminising. Access to these agents for use in transgender patients is currently off-label (i.e. not registered for this indication) and is only available at a tertiary level of care requiring specialist approval. The overall management of transgender patients requires specialised clinical skills and access to complex psychosocial assessment and interventions. The Robert Mangaliso Sobukwe Hospital in Kimberley is a Tertiary Hospital in the Northern Cape and is currently in the process of putting systems in place to offer this service. Currently, patients are managed with the support of the clinical expertise from the Universitas Hospital in the Free State.

2. Yes, the medicine has been approved by the National Essential Medicines List Committee for inclusion on the Essential Medicines List at the tertiary level of care. Inclusion of any medicine on the Essential Medicine List is based on evidence of efficacy, quality, safety. Registration by the national regulatory authority, the South African Health Products Regulatory Authority, is therefore required for human consumption.

END.

Reply:

a) Digital Vibes was appointed on the 15th of November 2019 through a deviation process to provide communication services in relation to the National Health Insurance (NHI) Bill as released by the Cabinet for Parliament consideration. A closed tender process for the appointment was followed and supported by National Treasury. On the 25th of March 2020, the Department extended the scope of work of Digital Vibes to include Covid-19. This deviation was supported by National Treasury on a letter dated 24 June 2020 in terms of emergency procurement. It must however be recalled that the National Institute for Communicable Diseases (NICD) confirmed the first positive case of Covid-19 in the country on the 5th of March 2020 from patients who had entered the country on the 1st of March 2020. Therefore, even though the President had made a formal announcement of lockdown on the 23rd of March 2020, the Department of Health had already started with the groundwork of curbing the spread of the virus, which included information dissemination, education, public awareness and media communication on Covid-19 long before the lockdown started. The irregular expenditure identified by AGSA is still to be investigated as per irregular expenditure framework. The Department maintains that the transaction in question was not irregular as there was a contract already in place.

b) (i) Digital Vibes contract was supposed to come to an end on the 30th of November 2020, however due to logistical arrangements, National Treasury was requested to extend the contract on a month-to-month basis for a period not exceeding four (4) months while procurement process to appoint a new service provider who will provide the same service for all health programmes like HIV, TB etc is in progress. The requested and approved extension will end on 31 March 2021.

(ii) The appointment is based on activity-based costing (ABC), which means as and when services are required. The current expenditure to date is R82 471 856.80 (VAT Incl).

c) Yes, the Department of Health entered into a Service Level Agreement with Digital Vibes.

d) Digital Vibes was appointed through a deviation process to provide communication services in relation to the National Health Insurance (NHI) Bill as released by the Cabinet for Parliament consideration. The scope of the contract was expanded to include information dissemination, education, public awareness and media communication on Covid-19.

e) A deviation from normal procurement processes was followed in the appointment of Digital Vibes. This was following a Cabinet meeting of the 3rd of July 2019 which made a recommendation that there must be a clear media strategy at the time that the NHI Bill is released by Cabinet to Parliament as the Bill will be in the public domain. The National Department of Health was required to prepare this plan within a very short time frame and a skilled professional in this area of work was required immediately. This led to the Department requesting National Treasury for a deviation from normal procurement processes. National Treasury recommended that the Department must advertised a tender for a shortened period of 14 days. Pursuant to this response from National Treasury a meeting was held between representatives from NDoH and National Treasury and during this meeting it was resolved that NDoH must identify at least 10 service providers, operating within the public relations and professional communication services who are registered on Central Supplier Database (CSD) and issue them with the terms of reference in order for them to present proposals to the Department for further consideration. The recommendation from National Treasury was followed and at the closing date only two (2) out of ten (10) service providers responded to the invitation. Digital Vibes was then recommended and awarded based on meeting all the requirements of the bid.

END.

Reply:

a) Health facilities throughout the country implement a number of programmes and strategies which aim to ensure that children remain healthy, and reach their full developmental potential. These services are all free of charge and include:

 

• Well Child/Early Childhood Development (ECD) services
• Expanded Programme in Immunisation (EPI)
• Integrated Management of Childhood Illness (IMCI) including provision of paediatric HIV services.
• Child nutrition services 
• Specialist services: these include rehabilitation services such as physiotherapy, occupational therapy and speech and language therapy, oral health, eye care and mental health
• Adolescent and Youth Health services
• Mass media campaigns especially the Side-by-Side campaign which aims to support parents and other caregivers to provide all aspects of care that children require.

The Integrated School Health Programme (ISHP) is implemented jointly with the Department of Basic Education (DBE). The ISHP provides onsite screening services to school-going children once during each of the four educational phases, (foundation phase (Gr R-3), intermediate phase (Gr 4-6), senior phase (Gr 7-9) and Further Education and Training (FET) (Gr 10-12). This focuses primarily on identifying health barriers to learning, as well as identifying children who have or are at risk for long-term health, psychosocial or other problems. Additional individual assessments, offered by a professional nurse, should also be offered to all learners who are repeating grades or at the request of an educator, parent or at the request of the learner/self-referral.

The Department of Health also works with the Department of Social Development to ensure that eligible children receive social grants, and are able to access other social services.

b) Whilst some specialist services are only provided at hospital levels, efforts have been made to expand provision of services at primary health care levels. Such efforts include appointment of District Clinical Specialist Teams, ensuring that all primary health care facilities are visited by doctors and allocating therapists who are completing their community service to primary health care facilities.

Where learners are identified as requiring health and other services that cannot be provided on-site through routine school health services, outreach services are provided through specialised school health mobiles.

In areas where specialised mobiles are not operating, learners are referred to fixed facilities including PHC clinics, community health centres (CHCs) and hospitals. Plans are in place to ensure that learners are seen at appropriate times (i.e. in the afternoon or during the school holidays). These arrangements must be made with the facility prior to the screening of learners.

Services may also be provided using existing mobile services, both PHC mobiles and specialised mobiles (such as dental mobiles or optometric mobiles). These services may be provided by DOH employees or by other providers on a regular or intermittent basis (e.g. services provided by NGOs or by professional societies on a voluntary basis). The Department of Social Development (DSD) is responsible for assisting learners to access services, particularly providing transport to accessing services where financial barriers exist.

Data and indicators regarding screening of learners is available at all levels of care, however DBE has data on learners with learning disabilities per grade, gender and type of disability as the custodian of providing learning and teaching to all learners. This is provided in line with the 2014 Screening, Identification, Assessment and Support (SIAS) policy, which provides a standardised programme for all learners who require additional support to enhance inclusion in schools.

END.

Reply:

According to the Northern Cape Provincial Department of Health, the Compensation of Employee budget has been cut by R276 million in the adjustment budget, thus the Department’s plans for the full operationalization of hospitals (including Connie Vorster Hospital) could not be implemented.

Nevertheless, in line with a path towards the full implementation of the National Health Insurance (NHI) in the Province, District hospitals in the Province have been established as the Centre of our CUPS. As a result, Connie Vorster Hospital is designated to be the Main Health Facility for the Phokwane and Magareng CUP which will include Pampierstad, Jan Kempdorp, Hartswater and Warrenton.

Even though it is envisaged that Connie Vorster Hospital will be NHI ready by 2026, an improvement Plan for the Hospital that includes the establishment of a proper Management Structure has already been set in motion. Currently, a Nursing Service Manager as well as a Clinical Manager have been appointed. Again in the past few months 6 Sessional Nurses have been sourced to assist the Hospital to improve service delivery. 

There is further recruitment process underway to fill another 8 vacant funded clinical posts and 6 non-clinical posts on contract basis. It is envisaged that they will commence duty by January 2021.

END.

Reply:

1. The full implementation of NHI is dependent on the finalisation of the Bill. The envisaged timelines in finalising the Bill have been adversely impacted by the COVID-19 pandemic. The public hearings have also been delayed as result of the restrictions that had to be implemented as part of the National Disaster Management response to manage the pandemic nationwide. While it is acknowledged that the health system has faced several challenges over the years, and in response to the COVID-19 pandemic, it is still farfetched to indicate that the system is overwhelmed. It may suffer pressures in some instances, for instance due to the resurgence of the COVID-19 infections and the number of patients needing to be admitted and treated in some provinces and districts.

In recognition of the challenges facing the health system and as part of the initiatives to holistically address them, the Department of Health has developed and is implementing several interrelated interventions. The focus of these interventions includes:

a) Strengthening community level health care delivery platform

Primary health care(PHC) as a bed-rock of the system and that provides an accessible, cost-effective and sustainable platform for the speedy realisation of universal health coverage. Our efforts in this area focus on initiatives directed at strengthening community mobilisation in health promotion, improved screening, disease prevention, rehabilitation and early treatment of disease. An expansive network of Community Health Workers serving a catchment population will be linked to support the delivery of PHC services in our communities. This has been so especially during screening and contact-tracing that has been implemented to manage the spread of theCOVID-19 epidemic at the local level. A well-organised referral system to support the delivery of PHC services through referral to our clinics is being implemented. The Ideal Clinic and Integrated School Health Programmes have been implemented to strengthen the PHC platform.

b) Improving the health systems health information systems

Over the past few years, the NHI information systems capacity has been augmented, strengthened, and dramatically improved. The investments made in these improvements will all remain and enhance the capability of the department to manage the health system into the future.  We have also established a patient registry through the deployment of the Health Patient Registration System in our PHC facilities and public hospitals. The National Department of Health in response to the stipulation of Section 74 (1) and (2) of the National Health Act has established structures and process with key stakeholders for the coordination of health data and information. The Health Normative Standards for Interoperability have been completed after wide consultation. The Department has already done work on the Health Patient Registration System using a single patient identifier. The system has been rolled out in several facilities for piloting.

c) Health infrastructure delivery

One of the NDP Implementation goals is to build health infrastructure for effective service delivery. The Department has developed a 10-year national health infrastructure plan to improve health facility planning to ensure construction of appropriate health facilities on a sustainable basis. Healthcare infrastructure will focus on the provision of new hospitals, CHC’s, clinics and maintenance, upgrading of established facilities that needs to be expedited to improve citizen’s access to more advance healthcare facilities. The Department is also implementing a programme to address health infrastructure backlogs as part of the preparation for the accelerated roll-out of NHI. The COVID-19 pandemic experience has necessitated the need to improve our health technology and equipment such as oxygen reticulation, ICU equipment and increasing our bed capacity through field hospitals. This will also contribute to job creation and stimulating economic growth and transformation of the construction sector. We believe that this health infrastructure programme will improve public confidence in the public health care system.

d) Human resources

In terms of improving health system capacity, one of the core areas we are focusing on is to address the human resources gaps in the system with finality. We are pleased that between the period January to July 2020, Medical Interns and Community Service Personnel were allocated to existing Statutory Posts. It is further expected that an additional number of these personnel will be allocated in January 2021.This increase in the number of staff employed in critical posts in the health sector indicates a positive step that the national and provincial departments are taking to prioritise and meet the health needs of South Africans in line with the progressive realisation of the right to health as enshrined in the Constitution.

It is important to note that all these interventions are already being implemented to ensure consistency with the global vision that health care should be seen as a social investment and not be subject to market trading as a mere commodity.

2. Funding for NHI will not be from increased taxes, but rather from the strategic reprioritisation of healthcare financing resources that are already available in the health sector. These details are outlined in Chapter 10 of the NHI Bill which provides details outlining the chief sources of funding that will be utilised to finance the NHI implementation programme.

South African citizens will benefit from NHI as outlined in Chapter 2 section 4 which provides the details on how the population (including non-citizens) will be covered informed by the functions of the Health Benefits Advisory Committee.

Non-citizens also provided for in line with international obligations. Chapter 2 of the Bill emphasises the population coverage criteria and how South Africans will be prioritised, how their rights as users will be protected and provided for within the NHI set up, how costs associated to accessing and utilising services will be covered and which comprehensive healthcare services they will be entitled to.

Our plans to implement NHI reflect the kind of society we wish to live in: one based on the values of social solidarity, equity, justice and fairness. It is for this very reason that these values are enshrined in the White Paper on NHI as well as the NHI Bill that is currently before Parliament.

END.

Reply:

1. The National Department of Health followed an established acquisition method for emergency state of affairs. Paragraph 8.1 and 8.2 of the National Treasury’s SCM Instruction Note 03 of 2016/17 on Prevention and Combating Abuse in the Supply Chain Management Systems states the following:

“8.1 The Accounting Officer/Accounting Authority must only deviate from inviting competitive bids in cases of emergency and sole supplier status. 8.2. An emergency may occur when there is a serious and unexpected situation that poses an immediate risk to the health, life, property and environment which calls an agency to action and there is insufficient time to invite competitive bids.”

The Covid-19 is a worldwide pandemic, hence the declaration of National State of Disaster earlier this year. Various activities had to be conducted by the country to curb the spread of the virus, which amongst others, included the repatriation of South Africans from different countries. Due to the City of Wuhan being declared as the epicentre of the virus, the South African Government prioritised the repatriation of its citizens that were either studying, working or had travelled to China for various reasons. A process was followed by the Department in conjunction with the South African National Defence Force to identify the most appropriate site for quarantine of the repatriates from Wuhan, China. The repatriation followed immediately after the closure of most businesses. Based on limited knowledge of the virus at the time, not all businesses (in this case accommodation facilities) were willing to take the risk of accommodating people whose status was unknown as well as the consequences that their business would have suffered thereafter. Eighty-four (84) facilities were considered for quarantine of which six (6) were inspected across the country and two (2), namely The Ranch Hotel and Black Mountain Resorts, were deemed suitable due to weather conditions, which was amongst other considerations.

Both facilities were found willing to take the risk associated with Covid-19 and to accommodate SA Citizens who were repatriated. The quotation received from Black Mountain Resorts was however considered exorbitant and The Ranch Hotel was a preferred supplier. The National Department of Health therefore followed the emergency acquisition method in procuring services to accommodate repatriated SA Citizens from Wuhan as indicated in the extract of Instruction Note 3 of 2016/17 quoted above. This was an urgent situation with serious pressures arising Wuhan with our South African citizens in Wuhan regarding food, physical and mental health as well as great deal of stress and anguish by the parents back home. We then entered into negotiations with the owners of the Ranch for emergency procurement as our repatriates were returning within the same week.

It must further be noted that the main objective of the Minister and the Department at the time was to prioritise the lives of South Africans who were distressed and facing a highly infectious virus in China, hence the followed procurement method in securing proper accommodation for them while waiting for their Covid-19 test results.

Based on the above clarification, the Minister we have not found that the National Department of Health has set a poor example by doing business in this kind of manner as the Department followed an approved method as per prescripts in procuring services of this nature.

2. Provincial Departments of Health either as provinces are classified as autonomous levels of government according to the Constitution of the Republic of South Africa. Provinces have their own MECs, accounting Officers and Supply Chain Management Systems which are guided by Provincial Treasuries and National Treasury. Provincial Departments therefore run their own procurement processes independently from the National Department of Health. If there are any alleged non-compliance issues from Provinces, it is expected that Provincial Accounting Officers will conduct an investigation and take appropriate actions where necessary. These investigations will also involve the use of various Law Enforcement Agencies and the National Department of Health will be updated of any progress by the Provincial Departments.

END.

Reply:

1. (a) The ambulances parked at Bronkhorspruit Hospital premises are awaiting the completion of the disposal process by the Asset Disposal Committee. There was a delay in appointing an auctioneer due to the COVID-19 pandemic lockdown during which time auctioneers were not operational. However, since 17 November 2020 and at a subsequent meeting on 25 November 2020, it is anticipated that the auction of 117 ambulances will be held in the third week of December 2020 subject to the relevant supply chain management processes.

(b) The relevant details of the (i) registration number, (ii) fleet number and (iii) faults of each ambulance are listed in the table below.

Number	(i) Registration Number	(ii) Fleet Number	Model year	(iii) Faults
	BS88FWGP	Debranded - no fleet number	2012	Beyond economical repair
	BS88JXGP	Debranded - no fleet number	2012	Beyond economical repair
	BS88KKGP	Debranded - no fleet number	2012	Beyond economical repair
	BS88LBGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ73BJGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ73CPGP	Debranded - no fleet number	2012	Beyond economical repair
	CS56DYGP	Debranded - no fleet number	2013	Beyond economical repair
	CS58TVGP	Debranded - no fleet number	2013	Beyond economical repair
	CS58WDGP	Debranded - no fleet number	2013	Beyond economical repair
	CT01TRGP	Debranded - no fleet number	2013	Beyond economical repair
	CT10ZGGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11DBGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11FLGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11JVGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81PCGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81RDGP	Debranded - no fleet number	2013	Beyond economical repair
	CV21CMGP	Debranded - no fleet number	2013	Beyond economical repair
	CV29LRGP	Debranded - no fleet number	2014	Beyond economical repair
	DP36BGGP	Debranded - no fleet number	2014	Beyond economical repair
	DP36CHGP	Debranded - no fleet number	2014	Beyond economical repair
	FB49NJGP	Debranded - no fleet number	2016	Beyond economical repair
	HD82HWGP	Debranded - no fleet number	2005	Beyond economical repair
	SMV923GP	Debranded - no fleet number	2005	Beyond economical repair
	SYN357GP	Debranded - no fleet number	2004	Beyond economical repair
	XMM523GP	Debranded - no fleet number	2008	Beyond economical repair
	XPR662GP	Debranded - no fleet number	2008	Beyond economical repair
	XZF465GP	Debranded - no fleet number	2008	Beyond economical repair
	YHN788GP	Debranded - no fleet number	2009	Beyond economical repair
	YNF923GP	Debranded - no fleet number	2008	Beyond economical repair
	YNF933GP	Debranded - no fleet number	2008	Beyond economical repair
	YNN381GP	Debranded - no fleet number	2008	Beyond economical repair
	ZHZ434GP	Debranded - no fleet number	2009	Beyond economical repair
	ZJG569GP	Debranded - no fleet number	2010	Beyond economical repair
	ZJK442GP	Debranded - no fleet number	2009	Beyond economical repair
	CJ72SSGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ72THGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ72XNGP	Debranded - no fleet number	2012	Beyond economical repair
	CR21KKGP	Debranded - no fleet number	2013	Beyond economical repair
	CR21LZGP	Debranded - no fleet number	2013	Beyond economical repair
	CS56GTGP	Debranded - no fleet number	2013	Beyond economical repair
	CS58TZGP	Debranded - no fleet number	2013	Beyond economical repair
	CS58VKGP	Debranded - no fleet number	2013	Beyond economical repair
	CS59BXGP	Debranded - no fleet number	2013	Beyond economical repair
	CS59JGGP	Debranded - no fleet number	2013	Beyond economical repair
	CS59KXGP	Debranded - no fleet number	2013	Beyond economical repair
	CT01TKGP	Debranded - no fleet number	2013	Beyond economical repair
	CT01TWGP	Debranded - no fleet number	2013	Beyond economical repair
	CT01VHGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11HCGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11HVGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11JDGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11JJGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11JRGP	Debranded - no fleet number	2013	Beyond economical repair
	CT11KJGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81NXGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81RMGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81RRGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81TCGP	Debranded - no fleet number	2013	Beyond economical repair
	CV20NWGP	Debranded - no fleet number	2013	Beyond economical repair
	CV48SNGP	Debranded - no fleet number	2013	Beyond economical repair
	CV48VYGP	Debranded - no fleet number	2013	Beyond economical repair
	CV48XJGP	Debranded - no fleet number	2013	Beyond economical repair
	DM41VHGP	Debranded - no fleet number	2014	Beyond economical repair
	DP36BNGP	Debranded - no fleet number	2015	Beyond economical repair
	DP36DMGP	Debranded - no fleet number	2014	Beyond economical repair
	DP36FLGP	Debranded - no fleet number	2014	Beyond economical repair
	FN74JPGP	Debranded - no fleet number	2009	Beyond economical repair
	XFH009GP	Debranded - no fleet number	2006	Beyond economical repair
	XTX877GP	Debranded - no fleet number	2008	Beyond economical repair
	YFS623GP	Debranded - no fleet number	2008	Beyond economical repair
	YHZ037GP	Debranded - no fleet number	2009	Beyond economical repair
	ZML334GP	Debranded - no fleet number	2009	Beyond economical repair
	BS88GGGP	Debranded - no fleet number	2012	Beyond economical repair
	BS88FHGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ72VWGP	Debranded - no fleet number	2012	Beyond economical repair
	CJ72RKGP	Debranded - no fleet number	2012	Beyond economical repair
	CV48PLGP	Debranded - no fleet number	2013	Beyond economical repair
	RBH693GP	Debranded - no fleet number	2004	Beyond economical repair
	SGB875GP	Debranded - no fleet number	2005	Beyond economical repair
	XRW491GP	Debranded - no fleet number	2008	Beyond economical repair
	XRW501GP	Debranded - no fleet number	2008	Beyond economical repair
	YHP647GP	Debranded - no fleet number	2009	Beyond economical repair
	YNN390GP	Debranded - no fleet number	2008	Beyond economical repair
	YRD953GP	Debranded - no fleet number	2008	Beyond economical repair
	YSJ418GP	Debranded - no fleet number	2008	Beyond economical repair
	CJ72ZNGP	Debranded - no fleet number	2012	Beyond economical repair
	YNF879GP	Debranded - no fleet number	2008	Beyond economical repair
	TRT411GP	Debranded - no fleet number	2004	Beyond economical repair
	YHZ076GP	Debranded - no fleet number	2009	Beyond economical repair
	YPP388GP	Debranded - no fleet number	2008	Beyond economical repair
	ZJK413GP	Debranded - no fleet number	2009	Beyond economical repair
	CS58STGP	Debranded - no fleet number	2013	Beyond economical repair
	CT81PSGP	Debranded - no fleet number	2013	Beyond economical repair
	CV20PWGP	Debranded - no fleet number	2013	Beyond economical repair
	FB49MYGP	Debranded - no fleet number	2016	Beyond economical repair
	FL93BVGP	Debranded - no fleet number	2016	Beyond economical repair
	RPW155GP	Debranded - no fleet number	2004	Beyond economical repair
	SYN342GP	Debranded - no fleet number	2004	Beyond economical repair
	TTL254GP	Debranded - no fleet number	2006	Beyond economical repair
	XDZ379GP	Debranded - no fleet number	2005	Beyond economical repair
	XDZ425GP	Debranded - no fleet number	2006	Beyond economical repair
	XFV596GP	Debranded - no fleet number	2005	Beyond economical repair
	XVJ137GP	Debranded - no fleet number	2008	Beyond economical repair
	YHN810GP	Debranded - no fleet number	2009	Beyond economical repair
	YHP651GP	Debranded - no fleet number	2009	Beyond economical repair
	YHP728GP	Debranded - no fleet number	2009	Beyond economical repair
	YNF902 GP	Debranded - no fleet number	2009	Beyond economical repair
	YPP377GP	Debranded - no fleet number	2008	Beyond economical repair
	YPP435GP	Debranded - no fleet number	2008	Beyond economical repair
	ZML369GP	Debranded - no fleet number	2009	Beyond economical repair
	ZPC489GP	Debranded - no fleet number	2010	Beyond economical repair
	CJ72SJGP	Debranded - no fleet number	2012	Beyond economical repair
	XTX871GP	Debranded - no fleet number	2008	Beyond economical repair
	ZHZ411GP	Debranded - no fleet number	2009	Beyond economical repair
	ZJG589GP	Debranded - no fleet number	2010	Beyond economical repair
	YHN955GP	Debranded - no fleet number	2009	Beyond economical repair
	YPP382GP	Debranded - no fleet number	2008	Beyond economical repair

2. There is no intention to repair the ambulances as these ambulances are beyond economical repair and have been replaced in the 2020/21 financial year. A total of 250 new ambulances were launched on 10 December 2020..

END.

Reply:

Most health and rehabilitation services for children with disabilities are provided at fixed health facilities including Primary Health Care facilities (clinics and community health centres) and hospitals. Children with disabilities are assessed and, based on the outcome of the assessment, provided with appropriate therapy and assistive devices where required.

Where children need to be referred to receive specialised services at a higher level of care, referrals are made either through emergency medical services (e.g. ambulance) or more usually through Planned Patient Transport (PPT).

The Department of Health is also committed to bringing services closer to children. Strategies to achieve this include:

• Specialised clinicians and allied health/rehabilitation professionals provide specialised outreach services at primary health care facilities.
• At household and community level Ward Based Primary Health Care Outreach Teams screen and refer children to local clinics.
• Provision of outreach services through Primary Health Care and specialised mobiles (such as dental mobiles or optometric mobiles).
• Non-governmental organisations provide community based rehabilitation services including home based services on behalf of the Department of Health.
• The Department of Health also collaborates with the Department of Social Development to ensure that eligible children receive social grants, and are able to access other social services.

END.

Reply:

After realizing that there are problems of patients waiting time at Brits hospital in Madibeng, North West Province, an intervention team was deployed by the Administrator on 29.10.2020. Tet ream identified issues for intervention and implementation:

• The long waiting time could be attributed to the fact that the hospital does not have the gateway clinic, as it is the center of the town. Long-term plan is to develop a Gateway Clinic at Brits Hospital to relieve the load of non-urgent or minor cases self-referring to the hospital.

• There was poor management of the Outpatients which contributed to the delay in attending to them and thus increasing the waiting time.

• Implementation of the Integrated Clinical Services Management approach;
• Uni-directional patient flow to be mapped out and introduced which includes screening and sorting of patients;
• Use of a queue marshall to improve patient movement;
• Introduction of a patient appointment system to decrease long waiting times.

• Casualty

• Appropriate triage protocol to be followed to avoid patient waiting in wrong queues or a delay in attending to the serious patients.
• The clinicians will be allocated based on rosters which was developed as a response to identified needs and peak times.

END.

Reply:

The Standard Treatment Guidelines (STGs) and Essential Medicines List (EML), are the foundation of appropriate medicine use in South Africa. Review of medicines by the National Essential Medicines List Committee (NEMLC) for inclusion on the Essential Medicine List (EML) is based on priority conditions in the country and takes into consideration the clinical need, evidence of efficacy, quality, safety, affordability and implications for practice.

The current edition (2018) of the Primary Health Care STGs and EML includes a Guideline for albinism and recommends the use of sunscreens with a high sun protection factor (SPF) of between 20 and 230 for adequate protection. Sunscreen is therefore on the Essential Medicines List and can be accessed at all levels of care. Sunscreen products can be purchased by provinces off the current National Contract (HP08-20120SSP).

Monitoring of the availability of essential medicines at a national level, including sunscreen for use in albinism, is done through the Affordable Medicines Directorate’s (AMD) National Surveillance Centre (NSC).

The review of the EML is dynamic and ongoing, with disorders/medicines being reviewed continuously based on factors such as the changing clinical need, change in clinical evidence, price of medicines etc. Hence any additional requirements for the management of albinism is considered on an ongoing basis as the clinical need arises.

END.

Reply:

Yes, there is a comprehensive campaign that is inclusive of HIV, TB and NCD. It is known as Cheka iMpilo National Wellness Campaign, which seeks to enable early diagnosis and treatment of HIV, TB, STI, diabetes, and hypertension, through stimulating health seeking behaviour, specifically in under-tested high-risk groups. The campaign was launched by the Deputy President, David Mabuza in 2018. Further, annually during the month of November to mark the World diabetes day, the Department together with its partners intensify education on Diabetes using various media platforms.

END.

Reply:

a) There is an overall 12% vacant posts in Clinics. The table below reflects a summary of the PERSAL report on the vacancy rate in Clinics. A detailed report on the vacancy rate in clinics in terms of vacant position, post salary level and names of the Clinic is attached as Annexure 1

Summary of vacancy rate in Clinic's as at October 2020	% Vacancy rate
Province	Clinic's
Eastern Cape	CLINIC	17%
	GATEWAY CLINICS	20%
	MOBILE CLINIC	28%
Eastern Cape Total		18%
Gauteng	CLINIC	6%
	PRIMARY HEALTH CARE CLINIC	100%
Gauteng Total		6%
KwaZulu Natal	CLINIC	15%
	GATEWAY CLINICS	14%
	MOBILE CLINIC	14%
	PRIMARY HEALTH CARE CLINIC	13%
	PRIMARY HEALTH CARE CLINIC A (8HOURS 5DAYS)	13%
	PRIMARY HEALTH CARE CLINIC B (12HOURS 7DAYS)	12%
	PRIMARY HEALTH CARE CLINIC C (24HOURS 7DAYS)	14%
KwaZulu Natal Total		13%
Mpumalanga	CLINIC	9%
	MOBILE CLINIC	13%
Mpumalanga Total		9%
North West	CLINIC	31%
	GATEWAY CLINICS	46%
	MOBILE CLINIC	10%
North West Total		27%
Northern Cape	CLINIC	12%
	MOBILE CLINIC	8%
Northern Cape Total		12%
Western Cape	CLINIC	5%
	MOBILE CLINIC	3%
	PRIMARY HEALTH CARE CLINIC	8%
	PRIMARY HEALTH CARE CLINIC B (12HOURS 7DAYS)	100%
Western Cape Total		5%
Grand Total		12%

(b) There is an overall 11% vacant posts in Hospitals. The table below reflects a summary of the PERSAL report on the vacancy rate in Hospitals. A detail report on Hospital vacancy rate in terms of vacant position, post salary level and names of the facilities is attached.

Summary of vacancy rate in Hospitals as at October 2020	% Vacancy rate
Province	Hospital Services
Eastern Cape	DISTRICT HOSPITAL	15%
	HOSPITAL	0%
	PSYCHIATRIC HOSPITAL	22%
	REGIONAL HOSPITAL	11%
	TB HOSPITAL	18%
	TERTIARY HOSPITAL	50%
Eastern Cape Total		15%
Gauteng	DISTRICT HOSPITAL	9%
	HOSPITAL	7%
	ORAL AND DENTAL TRAINING HOSPITAL	30%
	PSYCHIATRIC HOSPITAL	12%
	REGIONAL HOSPITAL	5%
Gauteng Total		8%
KwaZulu Natal	DISTRICT HOSPITAL	11%
	DISTRICT HOSPITAL LARGE	13%
	DISTRICT HOSPITAL MEDIUM A	13%
	DISTRICT HOSPITAL MEDIUM B	13%
	DISTRICT HOSPITAL SMALL A	9%
	DISTRICT HOSPITAL SMALL B	16%
	HOSPITAL	15%
	HOSPITAL COMPLEX	32%
	ORAL AND DENTAL TRAINING HOSPITAL	10%
	PSYCHIATRIC HOSPITAL	14%
	REGIONAL HOSPITAL	12%
	SPECIALISED CHRONIC HOSPITAL	21%
	TB HOSPITAL	17%
	TERTIARY HOSPITAL	11%
KwaZulu Natal Total		13%
Limpopo Province	DISTRICT HOSPITAL	3%
	HOSPITAL	3%
	HOSPITAL COMPLEX	3%
	REGIONAL HOSPITAL	2%
	SPECIALISED CHRONIC HOSPITAL	2%
	TERTIARY HOSPITAL	3%
Limpopo Province Total		3%
Mpumalanga	DISTRICT HOSPITAL	12%
	REGIONAL HOSPITAL	9%
	TB HOSPITAL	13%
	TERTIARY HOSPITAL	10%
Mpumalanga Total		11%
North West	DISTRICT HOSPITAL	15%
	PSYCHIATRIC HOSPITAL	0%
	REGIONAL HOSPITAL	36%
	TERTIARY HOSPITAL	33%
North West Total		20%
Northern Cape	DISTRICT HOSPITAL	16%
	HOSPITAL	50%
Northern Cape Total		16%
Western Cape	DAY HOSPITAL	17%
	DISTRICT HOSPITAL	46%
	HOSPITAL	7%
	MATERNITY HOSPITAL	6%
	ORAL AND DENTAL TRAINING HOSPITAL	4%
	PSYCHIATRIC HOSPITAL	6%
	REGIONAL HOSPITAL	8%
	TB HOSPITAL	16%
	TERTIARY HOSPITAL	30%
Western Cape Total		11%
Grand Total		11%

END.

Reply:

Renosterberg Clinic is currently operating for 24 hours using 24 hours call system. Every day staff rotate on standby. The Clinic has three (3) professional nurses and one (1) nursing assistant. There is an EMS in standby for emergency. The Clinic is supported by a hospital which is 50 km away.

END.

Reply:

According to information drawn from the PERSAL System as on 30 October 2020, the overall vacancy rate for Medical Specialists in the Public Health Sector is 0.9%. The table below reflects the (a) vacancy rate in each (i) province and (ii) not per the categories of specialized medical personnel (Information not captured as such on the PERSAL System) and (b) number of overall vacancies of specialized medical personnel in each province.

Provincial Departments of Health have been requested to provide categories of Medical Specialists in each province since the information cannot be drawn from the PERSAL System and the information will be shared as soon as received.

Medical Specialist as at October 2020	Filled / Vacant	% Vacancy Rate
Province	Health Professions	Filled	Vacant	Grand Total
Eastern Cape	Medical Specialist (Sub-Speciality) Grade 1	3	0	3	0.0
	Medical Specialist (Sub-Speciality) Grade 2	2	0	2	0.0
	Medical Specialist Grade 1	106	1	107	0.9
	Medical Specialist Grade 2	32	0	32	0.0
	Medical Specialist Grade 3	16	0	16	0.0
	Medical Specialist(Senior)L12	2	0	2	0.0
Total		161	1	162	0.6
Free State	Medical Specialist (Sub-Speciality) Grade 1	1	0	1	0.0
	Medical Specialist (Sub-Speciality) Grade 2	1	0	1	0.0
	Medical Specialist (Sub-Speciality) Grade 3	1	0	1	0.0
	Medical Specialist Grade 1	87	0	87	0.0
	Medical Specialist Grade 2	13	0	13	0.0
	Medical Specialist Grade 3	14	0	14	0.0
Total		117		117	0.0
Gauteng	Medical Specialist (Sub-Speciality) Grade 1	5	0	5	0.0
	Medical Specialist (Sub-Speciality) Grade 2	3	0	3	0.0
	Medical Specialist Grade 1	495	3	498	0.6
	Medical Specialist Grade 2	196	1	197	0.5
	Medical Specialist Grade 3	162	2	164	1.2
Gauteng Total		861	6	867	0.7
KwaZulu Natal	Medical Specialist (Sub-Speciality) Grade 1	2	0	2	0.0
	Medical Specialist Grade 1	297	1	298	0.3
	Medical Specialist Grade 2	129	1	130	0.8
	Medical Specialist Grade 3	121	1	122	0.8
Total		549	3	552	0.5
Limpopo Province	Medical Specialist (Sub-Speciality) Grade 1	2	0	2	0.0
	Medical Specialist Grade 1	41	3	44	6.8
	Medical Specialist Grade 2	10	0	10	0.0
	Medical Specialist Grade 3	13	0	13	0.0
Total		66	3	69	4.3
Mpumalanga	Medical Specialist (Sessions)	2	0	2	0.0
	Medical Specialist (Sub-Speciality) Grade 1	1	0	1	0.0
	Medical Specialist Grade 1	10	0	10	0.0
	Medical Specialist Grade 2	17	0	17	0.0
	Medical Specialist Grade 3	11	0	11	0.0
Total		41	0	41	0.0
North West	Medical Specialist (Sub-Speciality) Grade 1	1	0	1	0.0
	Medical Specialist Grade 1	55	4	59	6.8
	Medical Specialist Grade 2	10	0	10	0.0
	Medical Specialist Grade 3	16	1	17	5.9
Total		82	5	87	5.7
Northern Cape	Medical Specialist Grade 1	15	0	15	0.0
	Medical Specialist Grade 2	9	0	9	0.0
	Medical Specialist Grade 3	3	0	3	0.0
Total		27	0	27	0.0
Western Cape	Medical Specialist (Sub-Speciality) Grade 1	29	0	29	0.0
	Medical Specialist (Sub-Speciality) Grade 2	31	0	31	0.0
	Medical Specialist (Sub-Speciality) Grade 3	56	0	56	0.0
	Medical Specialist Grade 1	310	5	315	1.6
	Medical Specialist Grade 2	157	1	158	0.6
	Medical Specialist Grade 3	196	0	196	0.0
Total		779	6	785	0.8
Grand Total		2683	24	2707	0.9

END.

Reply:

1. (i) on 27 July 2020;

(ii) Accordingly, the ruling in the award is following:

(a) The respondent is to table a sustainable model with salary levels and notches for FPO, s within 30 days of receipt of this award.

(b) There is no order as to costs.

2. Yes, the National Health Council Technical Committee met on 17 September 2020, wherein the issue of Forensic Pathology Officer sustainable model was one of the agenda items as per the award, which agree that the draft sustainable model be shared with the respective recognised unions through the General Secretary of the Public Health and Social Development Sectoral Bargaining Council (PHSDSBC).

Council met on the 16th October 2020, for the parties (Employer and Labour unions) to deliberate on the model. The model was presented in this meeting by the employer. It was agreed that the matter will be discussed further on 7 November 2020 after consultations with the labour union constituencies.

END.

Reply:

1. The Gauteng Provincial Department of Health confirms that there are alleged corruption implications laid against some Hospital managers in the Gauteng Health Department related to the procurement of personal protective equipment. However, investigations are still underway by the Security Agencies. The Hospital Managers are still occupying the posts and therefore no process to fill the posts has commenced yet. It should be noted that in accordance with the Public Service Regulations, only vacant funded posts can be advertised to be filled.

2. The implicated officials have not yet been officially charged because the investigations are still proceeding and no further details can be provided to safeguard the interest of the investigation process.

END.

Reply:

The village mentioned as Tlhabane could not be identified in this area, between Delareyville and Vryburg as stated in this Question. There is however a village called Broedesput in the area. Tlhabane is a township in Rustenburg in Bojanala District. Broedesput is a village between Delareyville and Vryburg and has a population of 780. Initially, this village was part of Ngaka Modiri Molema (NMM) District but it was redemarcated into Naledi Sub-district in Dr. Ruth Segomotsi Mompati District.

Given the population size, there is no fixed health structure in this area, but the community is serviced through mobile clinic from both Dr Ruth Segomotsi Mompati (Naledi Sub District) and NMM,which services are delivered as follows:

1. Mobile clinic from Naledi Sub-district visits the area fortnightly, twice a week each fortnight; The first day of the visit is focused on the youth and children and the second day is dedicated for Chronic health services;

2. Mobile clinic from NNM visit the area once a month; and

3. The Medical Officer from Naledi Sub-district assisted by a Professional Nurse also visit the area twice a month.

The latest patient headcounts are as follows:

MONTH	NALEDI HEADCOUNT	NMM MOBILE CLINIC
July	362	45
August	202	41
September	201	37

END.

Reply:

(1) (a) The awarding of tenders to supply Personal Protective Equipment (PPE) for COVID-19 does not fall within the mandate of the South African Health Products Regulatory Authority (SAHPRA) therefore, SAHPRA does not have record of the unlicensed suppliers in this regard. SAHPRA publishes a list of licence holders who are authorised to manufacture, distribute (including import and export) and wholesale medical devices and in-vitro medical devices (IVDs). This list is available on the SAHPRA website which can be accessed at this address: www.sahpra.org.za

(b) SAHPRA does not have record of the names of government-wide unlicensed suppliers for PPE tenders and their Board of Directors.

(2) (a)-(b) Not applicable to SAHPRA. The Entity does not have record of unlicensed suppliers who were awarded tenders to supply Class A and Class B medical devices to hospitals.

(3) There were no amendments made to the guidelines and regulations made in terms of the Medicines and Related Substances Act, 1965 (Act 101 of 1965) as amended, to facilitate the awarding of contracts to unlicensed providers. SAHPRA has published a series of communication documents during the pandemic to communicate the existing regulatory requirements and processes to stakeholders in accordance with SAHPRA’s mandate.

END.

Reply:

a) Four (4) complaints were lodged against Dr Pretorius;

b) The details of each complaint are as follows:

• 1. Complications following cancer treatment;
  2. Incompetence;
  3. Use of off-label insulin to treat cancer; and
  4. Negligence related to cancer treatment: allegations of misrepresentation as a cancer treatment doctor and further investigation related to whether the amount of R400,000.00 charged over a period of 7 months was in line with the treatment provided.

c) All the complaints were investigated but the investigations did not include a site visit to his practice;

d) Below is the list of cases and (e) the outcomes of each complaintare as follows:

Case	Outcome
(i) Complications following cancer treatment	The complaint was withdrawn in Feb 2020 at Inquiry by the complainant. File closed
(ii) Incompetence	At Inquiry awaiting an expert opinion and the matter will be set down for a hearing
(iii) Use of off-label insulin to treat cancer	Inquiry matter. Hearing set down for February 2021
(iv) Negligence	Matter under investigation. Lodged in Oct 2020

END.

Reply:

1. The National Department of Health in collaboration with South African Bureau of Standards (SABS) and the South African Health Products Regulatory Authority (SAHPRA), the National Regulator for Compulsory Specifications (NRCS) set the quality standards for the various personal protective equipment items. Each province is responsible for ensuring that the quality standards of PPE procured are maintained. The National Department of Health has also supported the provinces with availing a Policy on Respiratory Protective Equipment and a list of PPE specifications that provinces can utilise to guide the PPE procurement process. In addition, PPE quality assurance training was conducted for provinces. The Department of Trade, Industry and Competition (DTIC) also provides support to the manufacturers and distributors in respect of applicable standards and conformity assessments to assist them to prepare for the licensing and approval processes. The Department of Health intends to approach National Treasury to seek approval for single sourcing of Quality Assurance Companies to undertake assessment of the PPE procured and to be delivered in all health care facilities for quality assessment. This will ensure that such PPE is of acceptable quality and standards. This intervention will be executed in line with or in compliance to section 79 of the Public Finance Management Act, which allows organs of state to apply for deviations from open competitive bidding process based on good grounds and urgency of this matter in protecting health care workers. This is to further ensure that health care workers are provided with PPE that is complaint to standards and quality requirements subject to concurrence and approval of National Treasury.

2. Each province, district and facility have Occupational Health and Safety Committees that since 1 October 2020 are verifying the availability of PPE reported by health facilities on the Stock Visibility System on a weekly basis. The Occupational Health and Safety grievance processes are followed at a local level and escalated accordingly.

END.

Reply:

In accordance with Section 11 of the Public Service Act, 1994, as amended, appointments and the filling of posts in the public service shall be in accordance with equality and the other democratic values and principles enshrined in the Constitution. Thus, all persons who qualify for the appointment, transfer or promotion concerned shall be considered. Also, the evaluation of persons shall be based on training, skills, competence, knowledge and the need to redress the imbalances of the past to achieve a public service broadly representative of the South African people, including representation according to race, gender and disability.

1. Currently there is no one appointed as Senior Clinical Manager at Mankweng Hospital, as this post does not exist on the approved organisational structure of the Hospital.

(a) Not applicable;

(b) Not applicable.

2. Not applicable.

3. Not applicable.

END.

Reply:

Yes, daily students travelling from Eswatini are not required to produce COVID-19 test results as they are screened daily on arrival and departure through the point of entry by health officials to determine if they are experiencing symptoms consistent with COVID-19. Weekly learners are taken through the same screening protocol at the border, however this is conducted once weekly on entry and departure. As the weekly learners do not travel daily, a health official is not in a position to detect whether or not they are symptomatic during their weekly stay. Should a student potentially become symptomatic during their weekly stay, this may result in further transmission as well as importation of COVID-19 as they would not have undergone the daily screening by a health official. It is important to also note that the Department of Basic Education has issued a directive  that all schools conduct daily screening of  learners so both day students and weekly boarders are screened.

END.

Reply:

1. (a) The Senior Clinical Manager (SCM) of Mokopane Hospital attained his medical degree on the 31st December 2013;

(b) He completed his medical internship during the period 1 January 2014 to 31 December 2015.

2. (a) The SCM had 2 years and 6 months as a medical practitioner before his promotion on 1 July 2018. The breakdown is as follows: Medical Practitioner: Community Service (01 January – 31 December 2016) and Medical Practitioner: Independent Practice (1 year 6 months as (01 January 2017 – 30 June 2018).

(b) The experiential requirements for the post of SCM is “a minimum of 3 years as Medical Practitioner after registration with the Health Professions Council of South Africa (HPCSA).

Even though, the SCM did not have the three years minimum years of experience at the time of promotion, since he had only two (2) years and six (6) months experience as a medical practitioner, he was considered as a suitable candidate following a directive by the Executive Authority that where the Province is unable to recruit a suitable candidate during interviews, candidates acting as Clinical Managers can be considered for appointment, provided they are deemed compete during the selection process by the interviewing panel. At the time of promotion, the SCM was an Acting Clinical Manager at WF Knoble Hospital.

3. No action will be taken as the candidate concerned has the requisite qualifications as a medical practitioner certified by the Health Professions Council of South Africa (HPCSA). Furthermore, the Executive Authority exercised her wrights in terms of Sub-Section 67 (7) of the Public Service Regulations, 2016 that (7) ”If the selection committee is unable to recommend a suitable person for appointment from those who applied in terms of sub regulation (5), the Executive Authority may, after that selection process has been completed, approve the head-hunting of one or more persons with the requisite competencies and subject such person or persons to the same selection process as those who applied.

END.

Reply:

a) Discovery Health supported the Department of Health to develop the CovidAlert App;

b) The Department has not awarded any procurement contract for the CovidAlert App. The Department received an offer of support from Discovery Health’s CEO. The Department in its press release/media statement on 1st September 2020 mentioned that: “COVID Alert SA was developed at no cost to the Department, through a partnership with world-class developers at Discovery Health, Apple and Google”;

c) (i) Total value of the contract is 0.

(ii) The Department has not paid any money for the CovidAlertApp.

END.

Reply:

The following responses were received from the Provincial Departments of Health:

1. Eastern Cape

The Department complies with the requirements of Local Content for the designated items.

a) Linen

The Department issued a competitive (and transparent) bid through the government tender bulletin. The bid requirements included compliance with Local Content, including SBD 6.2 and relevant Annexures for declaration. Awards were made to companies that complied with this requirement.

b) Food

The department procures patient food for the ECDOH facilities and where processed vegetables are procured; Local Content requirements are complied with. The department currently has a combination of procurement strategies which include long term rate-based contracts and quotations, compliance to this requirement is monitored on an ongoing basis.

The Department did not do any limited bidding specifically targeted support by the Department of Trade, Industry and Competition department.

2. Free State

The Department procures goods, services and works in line with the applicable laws and regulations governing Public Sector Supply Chain Management Systems in the Country. The procurement of (a) bed linen and (b) food may only be done directly from aforementioned group on directive and/ or instruction by the Minister of Finance at National Treasury.

3. Gauteng

The Department has adopted a radical approach to transform health economy by encouraging sub-contracting to Township Enterprises and designated groups through the value chains of health sector markets which have proven to be monopolistic in nature. This will assist the department to achieve by embracing the system thinking approach and involving the current market structures towards inclusive health economies.

The Department gives preference to targeted groups including township suppliers when procuring the following:

a) Procurement of Patient Clothing and Hospital Linen from Women Cooperatives.

b) Food supplies

• • Meat, fish & Poultry
  • Bread and confectionary
  • Milk and milk products
  • Processed Vegetables
  • Fruits and vegetables

In addition, and where possible, the Department has enforced Subcontracting of building alterations during procurement of medical equipment.

4. KwaZulu-Natal

The Department source goods from black industrialists sponsored and/or funded by the Department of Trade, Industry and Competition for items such as:

a) Bed linen

Yes

(b) Food

Yes

5. Limpopo

(a)-(b) The procurement of goods or any services within the public sector is guided by Section 217 of the Constitution of South Africa which says “When an organ of state in the national, provincial or local sphere of government, or any other institution identified in national legislation, contracts for goods or services, it must do so in accordance with a system which is fair, equitable, transparent, competitive and cost-effective”.

The Department does not object to any plans to source goods from black industrialists sponsored and/or funded by the Department of Trade, Industry and Competition. At this stage the Department is unaware of the procurement process that includes the DTI & Competition or any approval from National Treasury for procurement of goods through set asides.

It is the position of the Department to implement Preferential Procurement Regulations, 2017 “REGULATION 4” (Pre-Qualification Conditions) in order to advance designated groups when advertising tenders where possible.

6. Mpumalanga

a) The Department is in the process of finalizing a specification for the supply and delivery of bed linen and patient clothing for advertisement in the new future. The specification will include requirement for minimum threshold for local content and production. The bed linen are currently procured on a contract that was extended on a month-to-month basis for a period not exceeding six months effective from 01st June 2020. The Department will also consider the use of pre-qualification criteria in terms of the Preferential Procurement Regulations, 2017 to address black ownership.

b) The following bid with a closing date of 08th November 2019 was advertised in the Mpumalanga Provincial Supply Chain Management Bid Bulletin Volume No. 283 published on 09th October 2019:

NR	DESCRIPTION	BID NUMBER
1	SUPPLY AND DELIVERY OF PERISHABLE AND NON-PERISHABLE FOOD FOR HOSPITALS AND INSTITUTIONS IN THE MPUMALANGA DEPARTMENT OF HEALTH FOR A PERIOD OF THREE (03) YEARS	HEAL/046/19/MP

The above bid was evaluated, adjudicated and awarded to twenty-three service providers effective from 01st June 2020. Any plans to source goods from black industrialists sponsored and/or funded by the Department of Trade, Industry and Competition can only be considered after expiring of the existing contract

7. Northern Cape

a) The Northern Cape department of Health is considering procurement from companies listed on the Department of Trade and Industry and Competition on bed linen.

b) Not yet.

8. North West

As the Provincial Health Department we always strive to source items from black-owned companies regardless of whether or not they are sponsored and/or funded by DTI and Competition. It is usually difficult to determine who funds the companies, as it is usually not a requirement, in terms of PPR 2017 (Preferential Procurement Regulations 2017) when requesting bids for items. In the case where there are no black companies in the relevant sector i.e. Medical Equipment, we ensure their participation through sub-contracting of 30% of the total cost of the bid amount to SMME’s.

9. Western Cape

Western Cape Government Health (WCGH) currently has no such plans, however:

a) WCGH procures its linen from Service Products (Supported Employee Enterprises) which is an entity of the Department of Labour; and

b) WCGH is compliant to the requirements regarding local content & production regarding designated sectors, which include agro-processing, textiles/leather and footwear and furniture, with awards being made to bidders who are compliant to local content requirements and who score the highest total preference points.

END.

Reply:

In accordance with Section 11 of the Public Service Act, 1994, as amended, appointments and the filling of posts in the public service shall be in accordance with equality and the other democratic values and principles enshrined in the Constitution. Thus, all persons who qualify for the appointment, transfer or promotion concerned shall be considered; and the evaluation of persons shall be based on training, skills, competence, knowledge and the need to redress the imbalances of the past to achieve a public service broadly representative of the South African people, including representation according to race, gender and disability.

The Department is not aware of any unfair discrimination to qualifying applicants and when there were no applicant from a targeted group in terms of Employment Equity Targets institutions requests deviation on Employment Equity targets as per Departmental prescripts namely Human Resource Management Circular number 82 and 90 of 2017.

(a) The criteria for recruiting all prospective employees including but not limited to medical personnel within KZN Department of Health is done in line with the Recruitment and Selection Policy circulated under Human Resource Management Circular number 08 of 2018.

The Department is also mandated to comply with section 20 of the Employment Equity Act number 55 of 1998, as amended.

(b) (i) Human Resource processes are followed to fill the posts.

(ii) Posts being re-advertised are filled following HR processes.

(c) (i),(ii),(iii) The vacancy rate as at 30September 2020 the overall vacancy rate for Medical Specialists is 26.1% and for Dieticians is 15,6% while for the various Pediatrics and Surgery specialties, the average vacancy rate is 18, 5%.

Specified Ranks	Filled Post	Vacant Post	Grand Total	Vacancy rate
Allied Health: Dietician	179	33	212	16%
Medical Specialist	639	226	865	26%

(iv) Other specialists in the KZN hospitals

Discipline	Filled Posts	Vacant Posts	Grand Total	Vacancy Rate
ANAESTHETICS	55	29	84	34.5%
CARDIOLOGY	7	5	12	41 .7%

Discipline	Filled Post	Vacant Post	Grand Total	Vacancy Rate
CARDIOTHORACIC SURGERY	7	6	13	46.20/0
DERMATOLOGY	6	1	7	14.3%
ENDOCRINOLOGY	2	2	4	50.0%
FAMILY MEDICINE	13	3	16	18.8%
GASTROENTEROLOGY		1	1	100.0%
INTENSIVE CARE UNIT	10	9		47.4%
INTERNAL MEDICINE	49	12	61	19.7%
MAXILLO FACIAL & ORAL SURGEON	4	2	6	33.3%
MEDICINE	28		47	40.4%
NEONATOLOGY	19	2	21	9.5%
NEPHROLOGY	10		10	0.0%
NEUROLOGY	9	1	10	10.0%
NEUROSURGERY	6	2	8	25.0%
OBSTETRICS & GYNAECOLOGY	76	18	94	19.1%
ONCOLOGY	6	3	9	33.3%
OPHTHALMOLOGY	15	8	23	34.8%
ORTHO SURGERY & OPHTHALM.	3	2	5	40.0%
ORTHOPAEDICS	40	14	54	25.9%
OTORHINOLARYNGOLOGY	10	7	17	41 .2%
PAEDIATRICS & NEONATOLOGY	9		9	0.0%
PAEDIATRIC SURGERY	10		10	0.0%
PAEDIATRIC NEUROLOGY	2		2	0.0%
PAEDIATRICS	57	12	69	17.4%
PATHOLOGY FORENSIC	6	1	7	14.3%
PATHOLOGY HAEMATOLOGICAL	3		3	0.0%
PLASTIC SURG	6	3	9	33.3%
PSYCHIATRY	30	15	45	33.3%
PUBLIC HEALTH	2	3	5	60.0%
PULMONOLOGY	4		4	0.0%
RADIATION ONCOLOGY		2	2	100.0%
RADIOLOGY	27	13	40	32.5%
RHEUMATOLOGY	5		5	0.0%
SURGERY	72	13	85	15.3%
TRAUMA & EMERGENCY	23	11	34	32.4%
UROLOGY	8	7	15	46.7%
TOTAL (MEDICAL SPECIALISTS	639	226	865	26.1%

 

Reply:

According to the Eastern Cape Provincial Department of Health,

1. Community Health Workers (CHWs) at BJ Vorster Hospital in Kareedouw in the Eastern Cape Province were employed on a temporary basis for a fixed term contract to specifically capacitate the Health Services to respond to the additional demand for services due to Covid-19 at the Hospital. These CHWs were contracted with funding for Covid-19, of which the term will end on 31 March 2021.Assessment of anyfurther employment of these CHWs will be conducted towards the end of their contract and a decision will be taken then, which would also be guided by the availability of funding.

2. Performance of CHWs in the Province is continuously being assessed and this includes the 16 CHWs contracted at BJ Vorster Hospital and necessary support is provided to ensure that their performance is of acceptable standards, since CHWs play a critical support function in the management of Covid-19 in the Province.

END.

Reply:

(a) (i) A sufficient number of nurses

We can confirm today that Reivilo Community Health Centre (CHC) has ten (10) professional nurses. These include eight (8) permanent nurses and two (2) community service professional nurses. The headcount for 2019/2020 was 18,722 and the headcount seen by professional nurses is 17,722. The workload per professional nurses is 11.9 per day. The headcount for the year 2020/2021 (April – September 2020) is 8,506. The workload is nine (9). The workload per professional nurse to date is 9 clients/professional nurse per day. The normal workload per professional nurses is 25 clients per day. This means that Reivilio CHC has sufficient number of nurses

(ii) Enough medicine

The availability of medicines as at 26 October 2020 was 94% against a target of 80%. This is regarded as enough medicines in terms of drug availability and Stock Availability System (SVS).

b) Based on the above workload the number of professional nurses and 80% medicine availability, at Reivilo CHC will be able to operate well to render quality health services.

END.

Reply:

Information on this matter is still being sought from the provincial Department of Health to enable the Minister to respond to the question. The response will be furnished as soon as the relevant information has been solicited from the Province in this regard.

END.

Reply:

Hospitals do not have beds in the emergency centers, and as such the information that is required is not available. The Department does however have a record of the head count for the casualty per province for the same period, which is reflected here below, which does not show marked change. This could be due to the fact that the opening of alcohol sales was for a shorter period with added restrictions, coupled with health education.

Province	Element	April 2020	May 2020	June 2020	July 2020
Eastern Cape	Casualty headcount - total	19 523	17 371	21 618	19 232
Free State	Casualty headcount - total	5378	6294	7036	6727
Gauteng	Casualty headcount - total	10 520	10 930	14 876	7 244
KwaZulu-Natal	Casualty headcount - total	23456	23966	25521	27460
Limpopo	Casualty headcount - total	17661	16584	18103	16147
Mpumalanga	Casualty headcount - total	12 096	13 705	15 312	13 686
Northern Cape	Casualty headcount - total	4 353	3 288	4 740	3 791
North West	Casualty headcount - total	7483	9652	10734	9330
Western Cape	Casualty headcount - total	5275	2701	1636	2391
South Africa	Casualty headcount - total	96 000	95 594	112 320	116 482

NB: Western Cape

The figures for Western Cape are low due to the fact that they conducted a sentinel trauma survey in the following hospitals to establish the trends in the number of alcohol induced injuries treated at hospitals: Michell’s Plain, Groote Schuur, George, Heideveld and Tygerberg Hospitals

END.

Reply:

The proposal of using taxes from alcohol to fund healthcare services is referring to as earmarking. The earmarking is usually legislated and would usually lead to all or a portion of the funds being used to finance healthcare services in general or a specific aspect of healthcare, e.g messaging on the harmful effects of alcohol. This legislative mandate lies with the Minister of Finance.

Historically the National Department of Health has raised the earmarking of sin taxes (alcohol, tobacco, sugar) as an option with the National Treasury. The National Treasury has been reluctant to accept the earmarking proposal citing the following reasons:

• It introduces rigidities in the budgetary process, limiting availability of funds for alternative and (sometimes) more urgent purposes;
• Can lead to waste of resources when not carefully planned by recipient institution/ programme;
• When tax revenue collection is low then the dependent programme will be negatively affected;
• This may result in fragmentation of pooling and similar demands from other sectors;
• Will eventually shrink as consumption of harmful/unhealthy products declines.

END.

Reply:

a) The estimated time-frame for the completion of the project is 6-8 months including the planning, budget allocation, approval of drawings, submission and approval of site development plans to the City of Tshwane.

b) The Project Initiation report (PIR) was submitted to the end-user for approval in early 2020 with several subsequent revisions. The plan at this time includes an Onsite birthing unit, short stay ward and 24-hour clinic with a Radiology unit. Currently the final PIR is drafted following meetings held with the end-users and some concept drawings that were provided to the end-user for approval. The final draft of the PIR was submitted to the end-user for approval on the 10th September 2020. The planned unit will be a modular Alternative Built Technology structure. The budget allocation will only be approved once the PIR is approved by the HOD.

END.

Reply:

(a) The total number of Medical Doctors in the Public Health Sector, reported by the Provincial Departments of Health as being over the age of 60 is 810, and the number of doctors that are over the age of 60 and/or have underlying illnesses that make them vulnerable to Covid-19 is 250;

(b) The table outlines the steps taken by Provinces in each affected District/Regions to replace them:

 

EASTERN CAPE

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
Alfred Ndzo	2	During this Covid-19 pandemic period the Province appointed an additional 81 (on either permanent or short term contract) medical doctors to strengthen services during Surge.
Joe Gqabi:	2
Dora Nginza Regional Hospital:	1
TOTAL	5

FREE STATE

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
Free State Province	0	Not applicable
Total	0

GAUTENG

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
Gauteng Province	102	During this Covid-19 pandemic period the Province appointed an additional 473 (on either permanent or short term contract) medical doctors to strengthen services during Surge.
Total	102

KWAZULU NATAL

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
KwaZulu Natal	0	Not applicable
Total	0

LIMPOPO

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
Limpopo	0	Not applicable
Total	0

MPUMALANGA

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
Mpumalanga Province	0	Not applicable
Total	0

NORTH WEST

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
NgakaModiriMolema	3	During this Covid-19 pandemic period the Province appointed an additional 128 (on either permanent or short term contract) medical doctors to strengthen services during Surge.
Bojanala	17
Dr KK	1
Dr RSM	0
Total	21

NORTHERN CAPE

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
PixleyKaSeme District	1	During this Covid-19 pandemic period the Province appointed an additional 166 (on either permanent or short term contract) medical doctors to strengthen services during Surge.
Total	1

WESTERN CAPE

Institution/District/Region	Total number of doctors recorded	Steps taken to replace them:
GENSES and EMS	6	During this Covid-19 pandemic period the Province appointed an additional 82 (on either permanent or short term contract) medical doctors to strengthen services during Surge.
GSH	20
Metro	29
Rural	29
RXH	14
Tygerberg Hospital	23
Total	121

END.

Reply:

COVID-19 testing of the deceased persons is not conducted in mortuaries, however, specimen collection is done at mortuaries according to the Guidelines for COVID-19 Postmortem Testing. The specimens for COVID-19 Postmortem Testing are transported to the National Health Laboratory Service (NHLS) for testing.

The testing of the deceased persons applies only to persons that have died of natural causes outside of a health facility where their COVID status is not known. The reason for performing this test is to protect the close contacts of the deceased should the person have been positive then the close contacts may be infected. Secondly our death statistics for COVID do not include persons that had died of COVID outside of a health facility since nobody was aware if they were infected with COVID or not. This data will allow us to include deaths of persons outside of health facilities that are COVID positive.

According to the data from the NHLS there were 75 COVID-19 tests performed on deceased persons to date, of which 12 tests were positive.

END.

Reply:

1. Provincial Departments of Health must order PPEs from suppliers listed on the Central Supplier Database in accordance with National Treasury guidelines on specifications and price. The National Department of Health does not order or pay for the PPEs ordered.

The information on link below was extracted from the provincial stock visibility system from the North West Province. The table includes the quantities of the various PPEs by facility as at 11 September 2020.

https://pmg.org.za/files/RNW2027Table.pdf

END.

Reply:

1. (a) List of Countries from which donations were received

• Peoples Republic of China
• Germany
• Denmark
• United Arab Emirates
• Republic of Korea
• United States of America
• Turkey
• France

(b) List of organisations from whom donations were received

• The African Union
• Naspers
• First National Bank
• United Pharmaceutical Distributers
• Gift of the Givers
• European Union
• World Health Organization (WHO)
• Ford Motor Company
• Solidarity Fund
• S A Society of Anaesthesiology
• Motsepe Foundation
• Jack Ma Foundation
• Bank of Republic of China
• Province of Hannan
• Hikvision (Pty) Ltd S A
• Right to Care (CHW Programme)
• AstraZeneca Pharmaceuticals (Pty) Ltd
• The Church of Jesus Christ of the Latter Days
• Old Mutual
• Luke International
• Syntech Love Technology
• Huawei
• UVEX Safety SA (PTY) LTD
• Frasers
• Phillips
• KFW
• Global Energy Interconnection Dev & Co-op
• The Foundation for Professional Development (funded by KFW German Development Bank)
• Individual donors

(2) (a)-(b) The link table belows reflect the details in this regard.

https://pmg.org.za/files/RNW1965Table.pdf

(3) Yes, the National Health Laboratory Service (NHLS) donated nasopharyngeal swabs and viral transport media to Namibia

a) extent of the donation	b) details of the donation
5 000	Nasopharyngeal swabs
2 000	Viral transport media

(4) No, no material received was diverted to other countries as foreign aid.

a) Not applicable

bb) Not applicable

(5) We do make statements when receiving donations and we will continue doing so as and when required.

END.

Reply:

(1) (a)-(b) (i) The testing of deceased persons applies only to persons that have died of natural causes outside of a health facility where their COVID status is not known. The reason for performing this test is to protect the close contacts of the deceased should the person have been positive then the close contacts may be infected. Secondly our death statistics for COVID do not include persons that had died of COVID outside of a health facility since nobody was aware if they were infected with COVID. This data will allow us to include deaths of persons outside of health facilities that are COVID positive.

(b) (ii) The NHLS informs us that there were 86 tests performed on deceased persons to date, of which 13 tests were positive.

(2) The practice cannot be considered to be a waste of resources given that testing a deceased person for COVID-19 would assist in halting the spread of the infection from their contacts to others.

END.

Reply:

a) The Department has made provision in the Health Directions published on the 17 July 2020, paragraph 9(5) which states that: “once in the hospital or private mortuary, the body bag may be opened for family members (one at a time) to view the human remains”. This provision allows family members to view their loved ones and the current standard of labelling human remains still applies and there should not be challenges if everyone plays their roles. The normal practice of viewing human remains at home out of the mortuary is considered high risk and therefore prohibited to protect the funeral attendees.

b) All funeral undetakers are required to have a certificate of competence in order to operate. This certificate ensures that mortuary premises meet the minimum standards provided in the regulations. Government cannot provide security services to these facilities as they are privately operated but owners can provide such security services. Government mortuaries are within health facilities and most of these facilites have access control.

END.

Reply:

Pacaltsdorp Clinic is centrally located in Pacaltsdorp and provides a comprehensive service to a community of about 23 000 people.

Plans are afoot to upgrade the facility through the NHI project funded by the National Department of Health. In the proposed new clinic, the following upgrading will be included: eleven (11) consultation rooms, a pharmacy with a chronic dispensing unit, an emergency room and a multi-purpose room for meetings. These will all form part of the project. It is envisaged that the upgrades to the facility will extend infrastructure capacity to continue providing quality comprehensive primary health services to the community.

END.