Questions and Replies

Reply:

a) Yes, on the 6th November 2023, the department still had COVID-19 Vaccine-Janssen in storage at the national level, at Biovac. A total of 192 000 doses are available for distribution.

b) The value of the 192 000 doses of COVID-19 Vaccine-Janssen vaccines, available at the national level is R 31 149 360,00 including VAT (Average ROE for USD R18.81).

c) The COVID-19 vaccine Janssen is currently being distributed and used in the COVID-19 vaccination programme as part of routine health services. Vaccines are accessible in provinces, and vaccination continues to be administered at health facilities. Individuals are strongly encouraged to receive the COVID-19 vaccine.

END.

Reply:

a) Total number of the assessed clinics and community health centres that have satisfied the criteria of an Ideal Clinic is 2046 (59%) to date. This is from 0% in 2014.

b) Interventions implemented to support the clinics to meet the standards of Ideal Clinics Programme are as follow:

• A team of national managers provide technical support for Ideal Clinic Realisation and Maintenance (ICRM) programme. One manager support two or more provinces.
• The department developed the ICRM framework in the form of ICRM Manuals and Assessment tools for clinics and community health centres which are used as standard operating procedures for reference and guidance.
• Where budget limitations prevent provinces from meeting Non - Negotiable Vital (NNV) elements which focuses on emergency room equipment and accessories, the NDoH assist where possible, within its own budget constraints, to procure the required equipment.
• The NDoH, introduced a dedicated program under the Health Facility Revitalisation Grant which aim to respond to infrastructure challenges highlighted by the Ideal Clinic assessment tool.
• Facilitates orientation sessions for new facility operational managers and to all managers when updates have been done to the ICRM Framework.
• National Department of Health developed:
• guidelines and schedules for managing patients waiting times, handling of complaints and compliments
• health commodity catalogue for ordering supplies
• guidelines and training manuals for governance structures

• The NDoH organizes and provide resources for the annual peer reviews

END.

Reply:

a) The facilities are supported by providing Computer Hardware, printers, and barcode scanners. The use of the HPRS is monitored on a weekly basis. A team of roving IT Technicians are providing HPRS implementation support at PHC facilities in 8 of the 9 Provinces.

b) The National Department of Health Digital Health unit continue to work with provincial teams to ensure sustainability on the use of the HPRS. The national department of health is working with the Department of Communication and Digital Technology through the SA Connect project for the provision of appropriate broadband connectivity at Health Facilities over the next 3 years.

END.

Reply:

a) Medium Term Budget Policy Statement indicates R17,5 billion to be allocation to Health and Education for the wage bill increase. Based on the discussions with National Treasury officials a preliminary allocation of around R6.8 billion might be allocated to health sector. The final budget allocation to cover the public sector wage increase will be confirmed at the later stage.

b) The department will identify the critical post which will be prioritized for recruitment once the allocation has been confirmed. The budget allocation will cover the shortfall resulted by public wage increase not for additional posts. Provinces annually appoint Employment Recruitment Teams lead by Heads of Health Departments or delegated officials at senior positions to develop recruitment plans prioritizing the filling of critical posts with a required skills mix to address the burden of diseases at all our levels of care guarding against overspending on provided/available budgets.

END.

Reply:

According to the Health Professions Council of South Africa:

1. (a) Three (3) officials have been dismissed for committing fraud and/or corruption;

(b) The offences related to firstly accepting compensation in cash or otherwise, from an HPCSA stakeholder in return of assisting applicants with their registration and secondly the commitment of fraud with the HPCSA credit card; and

(c) The legal and disciplinary process costs to the HPCSA concerning these specified cases was R300 680.00.

2. Supply chain management policies were followed with the impugned transactions involving the 3 officials;

(a) Registrations and Finance Department

(b) The total amount of wasteful expenditure is R171 534.

END.

Reply:

According to the Health Professions Council of South Africa:

The HPCSA can release information about practitioners but in strict adherence to the Protection of Personal Information Act 2013 (Act No. 4 of 2013).

(a)-(e) With that consideration in mind, the HPCSA can indicate the following regarding the registration of practitioners under the Psychology Professional Board:

BRD Code	Register Code	Register Name	Total
PSB	PM	Psycho-technicians	8
	PMT	Psychometrists	2106
	PRC	Registered counsellors	2689
	PS	Psychologists	9528
	PSIN	Intern psychologists	889
PSB Total	15220

END.

Reply:

1. The following information has been received from the Provincial Departments of Health. Information from Eastern Cape and Gauteng is still outstanding:

	FS	KZN	Limp	Mpu	NW	NC	WC
No Public Hospitals	32	22	40	28	19	14	52
b) i. Psychiatrists	12.5%	64%	40%	14.3%	10%	7.10%	21%
b) ii. Clinical Psychologists	25%	86%	82%	46.4%	36.8%	28.6%	31%
b) iii. Occ. Therapist	40%	95%	100%	92,8%	57.9%	57.1%	44%
b) iv. Child Psych.	31%	0	0	0	0	7.1	2%

Information was not received from the Eastern Cape and Gauteng Provinces at the time of submitting this response to Parliament.

It is important to note that Child Psychology is a sub-speciality of Clinical Psychology and most of the provinces do not segregate or sub-classify the appointment information hence the zero reporting specifically on Child Psychology.

(2) The vacancy rates per province are as follows (with Northern Cape providing actual vacancies instead of expressing in percentage).

Vacancy rate	FS	KZN	Limp	Mpu	NW	NC	WC
Psychiatrists	-	18.9%	82.5%	46%	-	13	4.26%
Clinical Psychologists	36%	19.4%	67.7%		20.68%	18	8.42%
Occupational Therapist	29%	20.5%	64.3%		30.76%	24	9.04%
Child Psychologist	0%	0%	0%	0%	0%	4	16.66%

Information was not received from the Eastern Cape and Gauteng Provinces at the time of submitting this response to Parliament.

Cost to fill specified vacancies	FS	KZN	Limp	Mpu	NW	NC	WC
Psychiatrists	-	R11m	R10.8m	R43m	-	R15m	R4m
Clinical Psychologists	R5m	R11m	R9.5m		-	R19m	R8m
Occupational Therapist	R4m	R11m	R19.2m		-	R17m	R9m
Child Psychologist		0	0	0	0	-	R1m

(3) (a)-(b) All public health facilities in South Africa offer mental health services at various levels with screening being a standard service even at Primary Health Care level. Depending on the service package at the particular facility, patients may be referred to another level of care for further management including admission in the designated Mental Health Facilities

END.

Reply:

a) The underspending within infrastructure funding amongst others, are mostly due to unforeseen incidents such as floods, construction interruption by communities, inability of service providers to deliver in time, which result in termination of contracts.

Current antiretroviral (ARVs) contracts within HIV&AIDS program were awarded at much lower rates compared to previous contracts, this has resulted in savings and in underspending while much needed drugs were delivered.

b) The department has started with the mid-year conditional spending reviews to identify the provinces with challenges. The conditional grant spending reviews includes the assessment of grant framework and improvement plans from the provinces.

All provinces are due to submit the revised business plans to shift funds from underperforming activities to ensure improved spending and provision of quality health care. Stopping and reallocation process will be completed before beginning of January 2024 to shift funds from underperforming provinces.

 

END.

Reply:

The Department of Health has continuously encouraged the provincial DoH’s to pay the NHLS for all services rendered and continue to support the NHLS in this matter and the debt is treated as a priority.

The NHLS CEO has advised that she is in continuous engagement with the provincial Heads of Department (HODs) to follow up on the outstanding debt and to ensure that all payments owed are received in full and timeously. Given the declines in provincial health budgets the debt has unfortunately been increasing. The NHLS is fortunately in a significant positive financial status. The National Department of Health is kept up to date and informed of the debt owed by the provincial Departments of Health.

END.

Reply:

1..(a) The National Department of Health has put the following interventions in place to increase the capacity to carry out caesarean sections:

• Department developed various support services to strengthen capacity at lower levels of care. Support services include in/outreach programmes by specialists, use of District Clinical Specialist Teams to address the issues of knowledge and skill to performance of C/Section. Use of family physicians to support midwives in identification of risk factors for women who may require caesarian section to be referred early to next level of care.
• The Provincial Departments implement the continuous drills at facility level to upskill the staff to timeously and efficiently prepare women for caesarian section even in the case of emergency, this is part of the Essential Steps on Management of Obstetric Emergency ( ESMOE) training course.

b) Each health facility conducts an essential equipment audit as described within the Caesarian section guideline (monologue) to determine the equipment deficit status and develop the replacement plans as prescribed by the supply chain management systems.

2. Department conducts an in-depth analysis of the causes of both maternal and neonatal mortality and morbidity which are communicated through the saving mothers and babies report. The latest report (2020-2022) indicate that the key causes of neonatal deaths are prematurity, asphyxia and infections. While the department acknowledges that there are incidences of human resource and equipment shortages, they are not documented as causes of neonatal deaths in public health facilities.

END.

Reply:

a) Progress on public healthcare sector transformation

The Minister was referring to transformation of health services in South Africa since 1994, which began with the Reconstruction and Development Programme (RDP) that emanated from the Freedom Charter. RDP aimed at redressing the harmful effects of apartheid and complete transformation of the entire health delivery system.

Key milestones in health transformation were: the establishment of a national health system (NHS) made up of various role players; the implementation of an extensive programme of public clinic building & upgrading; provision of free primary health care (PHC) health services and essential drugs in PHC facilities; the orientation of services and emphasis on PHC approach enshrined in the White Paper on the Transformation of the Health System in 1997 and the National Health Act of 2003; as well as the establishment of the district health system (DHS) as a vehicle to deliver & manage PHC services closer to where people live.

Several other initiatives were undertaken to transform health services delivery to ensure better access for all including:

• The Bilateral Health Cooperation Agreement signed between the Governments of the Republic of South Africa and Cuba in 1996 provided an opportunity for recruitment of young South African students to undergo medical training in Cuba through the Nelson Mandela Fidel Castro Medical Training Programme (NMFC). To date, 3071 doctors have been produced through the NMFC.

• The pricing legislation introduced Single Exit Prices (SEPs) in 2006 for registered and unregistered medicines, determining appropriate logistics fees for wholesalers and distributors of pharmaceuticals, as well as formulating the dispensing fees for pharmacists and licensed persons. This pricing legislation reduced medicines prices by 45%, which reduced financial barrier and increased access to much needed medicines for ordinary people.
• The shift from curative care to preventive care was strengthened by “PHC Reengineering” strategy adopted in 2010. PHC reengineering involved the deployment of community health workers, school health services and the district clinical specialist model which focussed on disease prevention and addressing key drivers of maternal and infant mortality.

• The Office of Health Standards and Compliance established in 2013 has been instrumental in safeguarding the quality of healthcare services in health facilities and ensuring compliance to norms and standards.

The health system strength was tested during COVID-19, and proved to be resilient enough to curb the pandemic and provide care to all those who needed it. Currently, the country is engaged in National Health Insurance (NHI) as a major health reform in pursuit of Universal Health Coverage.

The latest Auditor-General Report for FY2022/23 Annual Report acknowledged the progress that the Department is making to improve audit outcomes.

b) Public health service transformation is measured by monitoring indicator performance, evaluations of each individual component/intervention, conducting research surveys and analyzing civil registration vital statistics data to monitor outcomes at a population level. The examples are a) the District Health Barometer which gauges district performance on service delivery; b) Early Childhood Development programme evaluation; and c) the South African Demographic & Health Survey (SADHS)

The World Health Organization (WHO) introduced the UHC service coverage index to measure progress in the provision of UHC as required for the Sustainable Development Goals (SDGs). It is a single composite indicator that includes reproductive, maternal, newborn and child health; infectious diseases; non-communicable diseases; as well as service capacity and access among the general and the most disadvantaged population. The WHO Tracking Universal Health Coverage: 2023 Global Monitoring Report shows that SA UHC index improved from medium (43%) in 2000 to high (71%) in 2021.

END.

Reply:

No, Minister of Health is unable to furnish the Member with the referred report regarding the security contract in the North-West Provincial Department of Health as is not an official document of the Department. It has no legal status as its drafting and processing were never concluded, as such never necessitated the Department to give it consideration whatsoever.

END.

Reply:

On the 19 September 2023, the Zuikerbosch water treatment plant had a breakdown caused by a power trip, which affected the production of water supply.

(a) Short-term temporary intervention should there be a similar crisis: (i)&(ii) water tankers are on standby to prevent health services being affected by such crisis. Some of the hospitals in Gauteng have reservoirs and some have boreholes as part of the back-up alternative in case there are similar crisis.

(b) Long-term permanent intervention: (i)&(ii) Rand Water is in the process of commissioning a new purification plant which will be impacting all health facilities within the City of Tshwane, the City of Ekurhuleni and the City of Johannesburg, among others. This plant is intending to deliver 150-million litres of potable water a day into Rand Water’s system, and by the end of 2024.

END.

Reply:

According to the Health Professions Council of South Africa (HPCSA):

a) There were 405 foreign-qualified doctors eligible to write the HPCSA Board examination which includes both South Africans as well as foreign nationals. The eligible foreign-qualified doctors were invited to write the HPCSA examinations however only 217 applicants confirmed that they would write the examination.

b) A total of 217 foreign-trained doctors participated in the HPCSA examinations which were written on 25th October 2023.

c) The HPCSA examinations are conducted through medical schools. The HPCSA had embarked on a procurement process before its contract with Sefako Makgatho University had expired. The University of KwaZulu-Natal was successful, however, there were delays in the finalization of the contract between HPCSA and UKZN due to certain administrative requirements not being met by the University. These matters have now been resolved and the contract finalised which then led to the applicants being able to sit for the examination on 25th October 2023.

The National Department of Health is not involved in the contracting process of the HPCSA. HPCSA had previously contracted Sefako Makgatho University and this contract expired in March 2023. The new contract with the University of KwaZulu-Natal was signed in September 2023.

END.

Reply:

According to the Western Cape Department of Health:

The Dunoon Community Health Centre operates 24 hours and 7 days a week. On daily basis the facility attends to:

Adults :

• 150-200 Un-booked patients
• 180-200 Booked patients.
• 15-35 TB clients
• 75-100 Family planning

Staff allocation for these services is 6 Clinical Nurse Practitioners and 2 Medical Officers.

Children:

• 100-150 Sick Children
• 80-120 Immunizations

Staff allocation for these services is 2 Clinical Nurse Practitioners, 1 Professional Nurse and 2 Medical Officers.

Patients do experience long waiting times due to failures to adhere to bookings and non-booking appointments. All walk-in patients are attended to and also prioritizing the patients who require urgent medical assistance. Patients who missed appointments are handled through Standard Operating Procedure. Patients are advised to lodge complaints personally or to use the suggestions box at the facility. The facility has a functional clinic committee to attend to patients’ complaints.

A wellness hub that operates once a week to provide wellness services will be piloted in Dunoon Community Hall in November 2023.

END.

Reply:

a) (i) According to the Gauteng Provincial Department of Health, the top 10 (Ten) healthcare facilities which account for the most specified claims are as follows:

Health facilities:

• Chris Hani Baragwanath Hospital
• Thelle Mogoerane Regional Hospital
• Tembisa Hospital
• Dr. George Mukhari Hospital
• Charlotte Maxeke Academic Hospital
• Sebokeng Hospital
• Rahima Moosa Mother and Child Hospital
• Bertha Gxowa Hospital
• Pholosong Hospital
• Mamelodi Hospital

(ii) According to the Gauteng Provincial Department of Health, the Department is taking the following steps to intervene in the Gauteng Healthcare facilities:

• The Department is conducting root cause analysis at clinical level of cases that result in medico-legal claims and adverse incidents and also working at eliminating the challenges at the root cause level i.e the shortage of staff & medical equipment, theatres and generally improved service delivery;

• Improving clinical care as part of the clinical risk management process, based on specific clinical audits of adverse events;

• Implementing intervention strategies with the CEO’s of the Hospitals and implementation of consequence management;

• Increasing in the number of Doctors to enhance the patient to Doctor ratio and improving midwifery training of nurses;

(b) It is difficult to say that the intervention steps have improved the situation as the Department is currently undertaking these interventions.

(c) (i) According to the Gauteng Provincial Department of Health, the majority are Cerebral Palsy.

(ii) According to the Gauteng Provincial Department of Health, these matters would be resolved by intervention from clinical services through an intensive training of the clinicians dealing with patients at the healthcare facilities.

It is critical to note that not all medico-legal cases that have been laid against Provincial Departments are as the result of negligence as some are fraudulent.

The following are clinical interventions coordinated from the national level as the result of the Medico-Legal Summit Declaration where Provincial Departments are encouraged to implement:

• A culture of patient safety and medical accountability must be enforced by the Head of the institution i.e. in the case of hospitals, the Chief Executive Officer (CEO);

• All hospital managers must implement the Patients’ Rights Charter;

• Clinical governance must be uniformly implemented;

• Morbidity and Mortality (M&M) reviews and clinical audits of all adverse events must be implemented immediately;

• There must be a compulsory multidisciplinary approach in ward rounds, M&M and other peer review meetings;

• Continuous patient safety campaigns must be conducted;

• The referral of patients must occur at an early and appropriate time; and

• There must be strict adherence to standard operating procedures (SOPs) and scope of practice at all times to avoid preventable safety failures.

Furthermore, the Provinces are also encouraged to have facilities that are properly equipped to provide future medical treatment to address the issue of future medical expenses which normally constitute 80% Medico-Legal claims quantum.

The abovementioned interventions are assisting in reducing the actual amounts payable to the Plaintiffs.

END.

Reply:

According to the KwaZulu Natal Provincial Department of Health, there are 59 facilities that have experienced water shortages. The Table below is providing a list of health facilities that have experienced water shortages including the steps that were taken in resolving the crisis:

District	Facility name	Issues Experienced	Steps for sustainable Solution
Uthukela	St Chads Community Health Centre	No reliable water supply from the Municipality	Water is currently supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Amajuba	Niemeyer Hospital	Intermittent water supply from the District Municipality water scheme	Backup Steel water tank installation is in progress. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ilembe	Maphumulo Clinic	Water supply from the Municipality is not reliable	Installation of borehole project at planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ilembe	Ntunjambili Hospital	Water supply from the Municipality is not reliable	Installation of borehole project at planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ilembe	Montebello Hospital	Water supply from the Municipality is not reliable	Installation of borehole project at planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ilembe	Chibini Clinic	Water supply from the Municipality is not reliable	Installation of borehole project at planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Harry Gwala	Umzimkhulu Hospital	Water supply from the Municipality is not reliable	Borehole was installed and went dry after three months. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Harry Gwala	Franklin Clinic	Water supply from the Municipality is not reliable	Borehole installation in progress. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Mthimude Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Ezingolweni Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Thembalesizwe Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Thonjeni Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Mgayi Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Installation additional borehole is in progress. Water trucks are on standby in case there is more demand for water supply.
Ugu	Morrison Post Clinic	Water supply from the Municipality is not reliable	Planning for installation of a borehole in progress. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Gqayinyanga Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Mgangeni Clinic	Water supply from the Municipality is not reliable	Installation of borehole in progress. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Philani Clinic	Water supply from the Municipality is not reliable	Installation of borehole is in progress. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Nhlalwane Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Elim Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Pisgah Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Gamalakhe CHC	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Bhomela Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Braemer Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Ntabeni Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Mvutshini Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Ludimala Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Ugu	Gcilima Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Ezwenelisha Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Madwaleni Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Mpembeni Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Inhlwathi Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Mseleni Hospital	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Ezimpondweni Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
Umkhanyakude	Kwambuzi Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Bethesda Hospital	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Ophansi Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Othobothini CHC	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Nondabuya Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Gwaliweni Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Ophondweni Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umkhanyakude	Makhathini Clinic	Water supply from the Municipality is not reliable	Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umzinyathi	CJM Hospital	Water supply from the Municipality is not reliable	Borehole installation project is at Tender Stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umzinyathi	Greytown Hospital	Water supply from the Municipality is not reliable	Borehole installation project is at Tender Stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
Umzinyathi	Church of Scotland Hospital	Water supply from the Municipality is not reliable	Borehole installation project is at Tender Stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Sokhulu Clinic	Water supply from the Municipality is not reliable	Borehole installation has been awarded. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Ntambanana Clinic	Water supply from the Municipality is not reliable	Borehole installation has been awarded. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Cinci Clinic	Water supply from the Municipality is not reliable	Water is supplied through a borehole. Water trucks are on standby in case there is more demand for water supply.
King Cetshwayo	Halambu Clinic	Water supply from the Municipality is not reliable	Borehole installation project is on planning. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Ndabaningi Clinic	Water supply from the Municipality is not reliable	Borehole installation project is on planning. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Vumanhlavu Clinic	Water supply from the Municipality is not reliable	Borehole installation project is on planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Chwezi Clinic	Water supply from the Municipality is not reliable	Borehole installation project is on planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Nkandla Hospital	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Ewangu Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Vumanhlavu Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Halambu Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Ndabaningi Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Nongamlana Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Nxamalala Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.
King Cetshwayo	Chwezi Clinic	Water supply from the Municipality is not reliable	Borehole installation project is under the planning stage. Currently, water is supplied by the water trucks that were purchased by the KZN Provincial Health. These trucks are managed at a District Level.

In addition, the National Department of Health has provided financial support through the Hospital Facility Revitalization Grant (HFRG) for the following measures:

• The purchasing of water trucks; and
• The installation of boreholes to various facilities that are affected by the shortage of water supply.

END.

Reply:

1. We are not in a position to provide a list of all (a) hospitals, (b) clinics and (c) other public health facilities that have upgraded to electronic record-keeping per province because each province has a complex set of different solutions. However, we can report on the systems that are installed as follows:

The national department of Health together with provinces implemented the Health Patient Registration System (HPRS) as the first step to the development and implementation of a shared electronic health record. The HPRS records a patient’s visit and categorise the patient’s reason for visit.

A list of facilities where the HPRS has been installed is provided in a separate spreadsheet of 3474 public health facilities.

The following responses were received from the provinces

Eastern Cape

Eastern Cape is in the process of installing the Health Management System Version 2 (HMS2) system in the following 32 facilities and services:

Free State

Only 1 facility (National Hospital) has been upgraded to an electronic record-keeping system in the province.

Limpopo

41 hospitals are using ‘Enterprise Manager’ known in the province as Provincial Health Information System (PHIS). Clinics are using the Health Patient Registration System (HPRS).

Northern Cape

All Facilities are making use of manual record keeping. The province is upgrading the record keeping at facilities (new files, cabinets, etc) first and will then start to look at implementing an electronic version (digitization).

North West

No health facility in North West Province has upgraded to an electronic record keeping system. The province has approved a pilot project to be implemented in three health facilities as proof of concept for digitalization of patient record. The project is ongoing.

Mpumalanga

The Mpumalanga Department of Health appointed a service provider in 2022/23 financial year to scan and archive patient records in the following hospitals: Rob Ferreira Hospital, Themba Hospital, Ermelo Hospital, Witbank Hospital, Mapulaneng Hospital, Tintswalo Hospital, Middelburg Hospital, Bernice Samuel Hospital and Tonga Hospital.

Western Cape

The Western Cape Department of Health (WCDOH) has embarked on a journey to upgrade from paper record-keeping to electronic record-keeping which is a complex, medium to long term programme.

Patient Administration systems: Clinicom Patient Administration system in 53 hospitals. Primary Healthcare Information system (PHCIS) in all 308 primary healthcare facilities in the province. The PREHMIS primary care system in 95 of the City of Cape Town (CoCT) clinics.

Clinical investigations: The Trakcare laboratory system, can be accessed by all facilities. The RIS PACS is a digital imaging system in 13 Facilities.

The NDOH has not yet received an update from KwaZulu Natal (KZN) and Gauteng

2. Regarding the situation with public health facilities’ (a) telephones, (b) computers and/or laptops, (c) access to the internet and/or WiFi and (d) any other information and communications technology infrastructure.

A summary of Communication and ICT Infrastructure at PHC facilities is provided in tables and are provided in an Excel document. Data has been collected through self-assessment by facilities during the Ideal Clinic Assessment in 2023.

Tot # PHC Facilities:	3474
Tot # PHC Facilities that didn't conduct a self-assessment:	46
Number/Percentage of facilities that have a functional telephone/computer and internet access
Province	# Facilities conducted a self-assessment	# Facilities with Telephone	% of Facilities with Telephone	# Facilities with Computer	% of Facilities with Computer	# Facilities with Internet	% of Facilities with Internet
EC	773	564	73%	760	98%	661	86%
FS	212	205	97%	210	99%	210	99%
GP	364	332	91%	362	99%	345	95%
KZN	602	581	97%	598	99%	532	88%
LIMP	477	439	92%	471	99%	380	80%
MPU	291	266	91%	288	99%	167	57%
NW	305	292	96%	303	99%	293	96%
NC	159	147	92%	156	98%	141	89%
WC	245	241	98%	245	100%	243	99%
South Africa	3428	3067	89%	3393	99%	2972	87%

361 PHC Facilities indicated not to have telephones.

20 PHC Facilities indicated not to have computers.

452 PHC Facilities indicated no access to internet connectivity.

All hospitals have Telephones, Computers and Internet Connectivity

3. There are several factors that need to be considered that include the general communication infrastructure of the geography of where facilities are situated to ensure appropriate ICT infrastructure. Provinces reported that where facilities do not have access to fix line telephones they are provided with mobile telephones. The National Department of Health is working with the Department of Communication and Digital Technology through the SA Connect project for the provision of appropriate broadband connectivity at Health Facilities.

4. Because of the complexities involved the full costing of the upgrade of health facilities to appropriate ICT Infrastructure with specific reference to broadband connectivity to enable the digital health transformation, will be completed by September 2024.The estimated amount based on preliminary costing is R 500 million for infrastructure and annual recurring cost of approximately R 7 million.

END.

Reply:

1. (a) In accordance with the Persal data set as extracted for the month of September 2023 below is the table of the age demographics of all nurses employed in the public health sector

Age demographics: All Nurse categories per province (June 2023)

Age demographics of all nurses employed in the public health sector as at September 2023
Province	20-24yr	25-29yr	30-34yr	35-39yr	40-44yr	45-49yr	50-54yr	55-59yr	60-64yr	65-69yr	70-74yr	Grand Total
Eastern Cape	394	1602	2261	2735	3264	3676	2900	2538	1639	9		21018
Free State	38	225	728	930	931	967	1202	1282	529	1		6833
Gauteng	355	2219	3705	4839	5290	4978	4248	3555	1812	22	2	31025
KwaZulu Natal	586	1233	3140	5191	6516	6595	4779	3661	1613	5		33319
Limpopo	251	466	995	2084	2741	2842	2870	2424	825	1		15499
Mpumalanga	158	702	1177	1379	1801	1817	1535	1171	362			10102
North-West	69	621	1200	1210	1349	1551	1366	1100	476	45	9	8996
Northern Cape	5	155	275	238	338	405	399	438	244	10	4	2511
Western Cape	256	939	1690	1947	1964	2145	2091	1760	658	7		13457
Grand Total	2112	8162	15171	20553	24194	24976	21390	17929	8158	100	15	142760

(b) The table below provides data of nurses in their specialization per percentage of each category per Provinces in which they are employed

NB. Persal does not provide the breakdown percentage of each specialized category since they are all grouped under category specialty.

Age demographics: Specialized Nurses vs all filled Nursing posts.

Professional Nurse (Specialized) 2023
Province	25-34yrs	35-44yrs	45-54yrs	55-64yrs	*Above 65
	Total Specialized	% vs Total Nurse	Total Specialized	% vs Total Nurse	Total Specialized	% vs Total Nurse	Total Specialized	% vs Total Nurse	Total Specialized	% vs Total Nurse
Eastern Cape	67	1.6%	343	5.7%	703	10.7%	772	18.5%	2	22.2%
Free State	32	3.2%	89	4.8%	307	14.2%	397	21.9%	0	0.0%
Gauteng	162	2.6%	799	7.9%	1321	14.3%	1189	22.2%	7	29.2%
KwaZulu-Natal	107	2.2%	1047	8.9%	1776	15.6%	1284	24.3%	3	60.0%
Limpopo	67	3.9%	302	6.3%	535	9.4%	694	21.4%	0	0.0%
Northern Cape	6	0.3%	25	0.8%	63	1.9%	72	4.7%	0	0.0%
Mpumalanga	13	0.7%	157	6.1%	400	13.7%	355	22.5%	0	0.0%
North-West	23	5.3%	145	25.2%	364	45.3%	285	41.8%	0	0.0%
Western Cape	119	4.1%	469	12.0%	706	16.7%	464	19.2%	2	28.6%
Total	596	2.3%	3376	7.5%	6175	13.3%	5512	21.1%	14	12.2%

* Aged above 65 are regulated in accordance with the Public Service Regulation and Act- to employ professionals over the age of 65

(2) (a) Current vacancy rate for all the specified nursing specialties in each province and

Nursing Specialty Vacancy Rate
Province	Vacant (funded and unfunded)	Vacancy rate %
Eastern Cape	282	13.0%
Free State	419	34.4%
Gauteng	571	14.1%
KwaZulu Natal	1016	19.4%
Limpopo	214	11.8%
Mpumalanga	93	9.1%
North West	172	17.4%
Northern Cape	65	28.1%
Western Cape	224	11.3%
Grand Total	3056	16.3%

(b) The Department is unable to state the envisaged time frame to fill the vacant positions due to general budget cuts that negatively affects the Compensation of Employment (CoE) a specific date of when the specified challenges will be eradicated. However, it can confirm that measures are applied across Provinces to prioritize filling of vacant posts where the budgets permit.

END.

Reply:

(a) According to the Gauteng Department of Health, bodies were taken to both Hillbrow (Johannesburg) and Diepkloof Forensic mortuaries for the following reasons.

• The Diepkloof Forensic Mortuary was used for the postmortem examinations. It was also as a central storage for bodies so that families can access one central point for identification of family members.
• The Hillbrow (Johannesburg) Mortuary was used to conduct advanced scientific investigations such as DNA harvesting, Fingerprint Taking and use of the LODOX/ X-Ray services.

(b) The Gauteng Department of Health did not charge any family money for the release of the bodies. The following are free services provided by Forensic Pathology Services: Body Autopsy, DNA collection, Histology, Toxicology, and Anthropology examination.

(c) Table 1 below indicates responses to (i)(ii) and (c) and (d)

Mortuary name	(c)Capacity	(d) Bodies in the mortuary as of 1 September 2023
(i) Diepkloof	300	205
(ii) Hillbrow	200	160
(iii) Roodepoort	100	84

END.

Reply:

The Department of Home Affairs compiles a list of critical skills needed in the country as their reference for approving work permits. The current Home Affairs Critical list as published 2022 includes only Medical and Nursing Specialists for Health services.

The Department of Health provides essential services to the country. This is based on the nature of services being provided. It is imperative to note that ideally the Department of Health wishes to fill all health care worker posts in order to improve the health outcomes of the population.

(1)-(2) Due to current financial constrains that are also affecting human resources budgets, Provinces annually appoint Employment Recruitment Teams lead by Heads of Health Departments or delegated officials at senior positions to develop recruitment plans prioritising the filling of critical posts with a required skills mix to address the burden of diseases at all our levels of care guarding against overspending on provided/available budgets.

Annexure A as attached is provincial submission of prioritised posts per province with envisaged dates to fill the posts and total costs per province. Outstanding province Free is Gauteng.

END.

Reply:

1. (a) According to the KZN Department of Health, the two Security Officers implicated have since been suspended by the Private Security Company and are in the process of being subjected to a disciplinary inquiry. A case was opened (CAS No.586/9/2023) with South African Police Service following the incident and the Security Officers were arrested, detained, and thereafter released on bail. The Security Officers also appeared before Mental Health Review Board.

(b)-(c) The Kwa-Zulu Natal Department of Health has instituted an investigation into this matter to determine the role of the five nurses that were on duty on the night of the incident. The five nurses have been precautionarily suspended pending the outcome of the investigation.

2. (a) The patient in question was admitted under Mental Health Care Act for 72-hour observation, as he presented with a history of aggressive behavior, intimidating other children at the Morester Children’s home, threatening to stab them and he had numerous abscondments from the Centre. At the time of the incident, the patient was mechanically restrained with the restraining devices to subdue his movement for the primary purpose of behaviour control.

(b) The Kwa-Zulu Natal Department of Health has instituted an investigation into this matter to determine the role of the five nurses that were on duty on the night of the incident. The five nurses have been precautionarily suspended pending the outcome of the investigation.

(3)  (a) The patient was transferred and admitted to the Child and Adolescent unit at a King Dinuzulu Hospital in Durban.

(b) The patient was transferred to a more specialised psychiatric care.

END.

Reply:

a) Ambulances are allocated to EMS stations which are either stand-alone or co-located in hospitals, clinics, and other public facilities. Ambulances are therefore not allocated to each hospital.

b) The number of ambulances procured in 2023-24 financial year per province is as per table below:

Province	Number of Ambulances
Eastern Cape	58
Free State	20
Gauteng	170
KwaZulu-Natal	32
Limpopo	500
Mpumalanga	10
Northwest	3
Northern Cape	0
Western Cape	120
Total	913

END.

Reply:

According to the Health Professions Council of South Africa (HPCSA), 217 foreign trained applicants sat for theory examinations on the 25th of October 2023.

END.

Reply:

1. and (2) The table below reflects the details in this regard.

Province	Facility Name	No of psychiatrists	No of usable beds	Patient to psychiatrist ratio	Ratio compliant with the Norms and Standards (1:28 – 1:42 for acute beds and 1:50 for medium to long stay beds)
Eastern Cape	Elizabeth Donkin Specialised Psychiatric Hospital	2	163	1:82	No
	Fort England Specialised Psychiatric Hospital	2	313	1:156	No
	Komani Specialised Psychiatric Hospital	0	440	None	No
	Tower Specialised Psychiatric Hospital	0	352	None	No
	Dora Nginza Regional Hospital	1	35	1:35	Yes
	Cecilia Makiwane Regional Hospital	1	50	1:50	No
	Mthatha Regional Hospital	1	30	1: 30	Yes
Free State	Free State Psychiatric Complex	5	760	1: 152	No
	Mofuhadi Manapo Mopedi Regional Hospital	1	30	1:30	Yes
	Boitumelo Regional Hospital	1	34	1: 34	Yes
Gauteng	Sterkfontein Specialised Psychiatric Hospital	18	613	1:34	Yes
	Tara Specialised Psychiatric Hospital	8	137	1:17	Yes
	Weskoppies Specialised Psychiatric Hospital	16	780	1:49	Yes
	Cullinan Psychiatric Care and Rehabilitation Hospital	0.5 (sessional)	180	1: 360	No
	Dr George Mukhari Central Hospital	4	48	1: 12	Yes
	Charlotte Maxeke Central Hospital	7	65	1:9	Yes
	Chris Hani Baragwanath Central Hospital	10	165	1:17	Yes
	Kalafong Provincial Tertiary Hospital	1	45	1:45	No
	Steve Biko Central Hospital	2	18	1:9	Yes
	Helen Joseph Provincial Tertiary Hospital	3	60	1:20	Yes
	Thembisa Provincial Tertiary Hospital	0	30	None	No
	Leratong Regional Hospital	1	40	1: 40	No
	Mamelodi Regional Hospital	0	28	None	No
	Thelle Mogoerane Regional Hospital	1	20	1: 20	Yes
	Kopanong District Hospital	1	54	1:54	No
KZN	Ekuhlengeni Specialised Psychiatric Care and Rehabilitation Hospital	0	700	None	No
	Fort Napier Specialised Psychiatric Hospital	5	378	1:76	No
	Town Hill Specialised Psychiatric Hospital	7	242	1:35	Yes
	Umngeni Specialised Psychiatric Care and Rehabilitation Hospital	0	392	None	No
	Umzimkhulu Specialised Psychiatric Hospital	0	284	None	No
	King Dinuzulu Regional Hospital	4	78	1:20	Yes
	Madadeni Regional Hospital	1	250	1: 250	No
	Port Shepstone Regional Hospital	1	8	1: 8	Yes
	Ngwelezane Provincial Tertiary Hospital	2	30	1:15	Yes
	Prixley KaSeme Regional Hospital	3	28	1:9	Yes
	St Benedictine District Hospital	0	15	None	No
	Prince Mshiyeni Regional Hospital	3	25	1:8	Yes
	Addington Regional Hospital	2	18	1:9	Yes
	King Edward IV Central Hospital	3	20	1:7	Yes
	General Justice Gizenga Mpanza Regional Hospital	1	20	1:20	Yes
	RK Khan Regional Hospital	1	20	1:20	Yes
	Northdale District Hospital	0	10	None	No
	Ladysmith Regional Hospital	1	14	1:14	Yes
	Harry Gwala Regional Hospital	3	15	1:5	Yes
	Mahatma Ghandhi Regional Hospital	1	18	1:18	Yes
Limpopo	Evuxakeni Specialised Psychiatric Care and Rehabilitation Hospital	0	354	None	No
	Hayani Specialised Psychiatric Hospital	2	250	1:125	No
	Thabamoopo Specialised Psychiatric Hospital	2	500	1:250	No
	Mankweng Provincial Tertiary Hospital	1	20	1:20	Yes
	Donald Frazer District Hospital	0	40	None	No
	Elim District Hospital	0	36	None	No
	Letaba Regional Hospital	1	40	1:40	No
	Malamulele District Hospital	0	20	None	No
	Nkhensani District Hospital	0	14	None	No
	Siloam District Hospital	0	30	None	No
	Tshilidzini Regional Hospital	0	12	None	No
	Matlala District Hospital	0	12	None	No
Mpumalanga	Ermelo Regional Hospital	1	30	1:30	Yes
	Rob Ferreira Provincial Tertiary Hospital	1	30	1:30	Yes
	Tintswalo District Hospital	0	50	None	No
	Themba Regional Hospital	1	27	1:27	Yes
	Embhuleni District Hospital	20	0	None	No
Northern Cape	Kimberly Specialised Psychiatric Hospital	2	170	1:85	No
North West	Bophelong Specialised Psychiatric Hospital	1	314	1: 314	No
	Witrand Specialised Psychiatric Care and Rehabilitation Hospital	2	797	1: 399	No
	Mahikeng Provincial Regional Hospital	1	26	1: 26	Yes
	Job Shimankane Tabane Provincial Tertiary Hospital	1	60	1: 60	No
	Taung District Hospital	1	20	1:20	Yes
	Potchestroom Regional Hospital	1	11	1: 21	Yes
	Tshepong Provincial Tertiary Hospital		10
Western Cape	Alexandra Specialised Psychiatric Care and Rehabilitation Hospital	0	300	None	No
	Lentergeur Specialised Psychiatric Hospital	9	690	1:77	No
	Stikland Specialised Psychiatric Hospital	9	423	1:47	Yes Medium
	Valkenberg Specialised Psychiatric Hospital	8	391	1:49	Yes
	Worcester Regional Hospital	2	24	1: 12	Yes
	Paarl Regional Hospital	2	30	1:15	Yes
	George Regional Hospital	2	12	1:6	Yes
	Tygerberg Central Hospital	5	42	1:8	Yes
	Red Cross Provincial Tertiary Hospital	3	6	1: 2	Yes
	Groote Schuur Central Hospital	2	55	1: 28	Yes
	Mitchell’s Plain District Hospital	1	44	1: 44	No
	Khayelitsha District Hospital	0	55	None	No
	Eerste River	0	30	None	No
	New Somerset Hospital	0	32	None	No
	Victoria District Hospital	1	15	1: 7	Yes

• There is a limited number of psychiatrists in the country.
• Facilities that are in rural areas struggle to attract specialists
• In all provinces where the ratio is low, the psychiatrists do outreach (care and training) to areas where there are no psychiatrists.
• The academic hospitals have more psychiatrists because over and above caring for patients, they provide training at universities.
• In the Limpopo Province, hospitals without psychiatrists, have medical officers with diplomas in psychiatry.

END.

Reply:

The Department has introduced the Human Resources Training Grant (HRTG) to amongst other required speciality areas create a pool of trained specialists to enhance capacity in essential services that includes radiation oncology. The Grant is funding 52 Registrar posts of Radiation Oncology that are in various years of their training programme between first to fourth year.

END.

Reply:

The National Department of Health opened the Internship and Community Program (ICSP) online System application process on 4 October 2023 and closed the applications process on 20 October 2023.

1. (a)(i)(ii) Physiotherapists are not required to perform internship. Therefore, no Physiotherapists are allocated for internship in South Africa.
2. (a) The total projected number of Physiotherapist to be placed for community service (i) nationally is 460, and (ii) 423 are available posts for Physiotherapists confirmed by provinces as the table below. Provision will be made to cover the shortfall in the event that all 460 qualify at the same time.

2024 Annual Cycle - Physiotherapist
Provinces	Total Post
Eastern Cape	67
Free State	33
Gauteng	99
KwaZulu-Natal	74
Limpopo	17
Mpumalanga	33
Northern Cape	28
Nort-West	43
Western Cape	29
Grand Total	423

(b) The names of facilities that will be used per Province for this purpose are attached as Annexure A.

END.

Reply:

The National Department of Health opened the Internship and Community Program (ICSP) online System application process on 4 October 2023 and closed the applications process on 20 October 2023.

1. (a)(i)(ii) Professional Nurses are not required to perform internship. Therefore, no Professional Nurse is allocated for internship in South Africa.
2. (a) The total projected number of Professional Nurses to be placed for community service (i) nationally is 1 662, and (ii) 2 803 are available posts for Professional Nurses confirmed by provinces as follows in each province:

2024 Annual Cycle - Professional Nurse
Provinces	Total Post
Eastern Cape	614
Free State	46
Gauteng	565
KwaZulu-Natal	675
Limpopo	178
Mpumalanga	148
Northern Cape	27
Nort-West	250
Western Cape	300
Grand Total	2803

(b) The names of facilities that will be used per Province for this purpose are attached as Annexure A.

END.

Reply:

According to the Eastern Cape Department of Health,

1. The procurement of the 100 scooters with sidecars was cancelled in July 2020 and the scooters were not delivered. Nothing was paid to the company and there was therefore no irregular, wasteful and fruitless expenditure pertaining to this matter. Access to chronic medicines by patients is through the central chronic medicines dispensing and distribution (CCMDD) programme. In the month of September 2023, the department had 390 000 chronic patients accessing their medicines on the CCMDD programme at various pick-up points in the Province.

2. The delivery of chronic medicine is not considered as a wasteful expenditure as it is an important programme and a successful intervention to bring chronic medicines to the communities especially the elderly patients in the rural areas in the Eastern Cape, closer to where they live.

END.

Reply:

1. Yes, the department receives the repairs and maintenance reports on ambulances monthly from the National Treasury appointed service provider, Wesbank. These reports are being used to track the number of ambulances that are not operational due repairs and maintenance with the specific intention of reducing downtime and optimizing the operational fleet through specific interventions at provincial level.

2. This ambulance is in operation in Qunu at the OR Tambo District under the management of Emergency Medical Services.

a) Repairs have been undertaken four (4) times as follows: two (2) rear and front brake repairs, one (1) mirror replacement, and one (1) alternator repairs.

b) Maintenance of the ambulance has been undertaken twice at 15 000- and 30 000-kilometre service intervals and the next service will be at 45 000km.

END.

Reply:

According to the Office of Health Standards Compliance (OHSC),

1. Yes the leave for Dr S Mndaweni (CEO) was approved by Dr. Kenoshi (Board Chairperson) following the request made to the Board by Dr Mndaweni.

2. Dr Mndaweni is entitled to 26 days paid leave per annum as stipulated in her employment contract. Of the leave that was approved by the Board, a portion of the leave was part of her leave entitlement per her employment contract and the remaining portion was unpaid (13.56 days).

3. The leave entitlement is specified in the employment contract of the CEO and consists of 26 days paid leave per annum.

END.

Reply:

1. According to the Office of Health Standards Compliance (OHSC) (a) None of the staff members in the OHSC have been dismissed because of committing fraud and/or corruption.

(b) Not applicable;

(c) No amount was used for legal costs.

2. There has been no fraud or corruption identified in the OHSC supply chain management processes. (a) There was no fraud or corruption identified in any of the OHSC Departments and (b) There was no wasteful expenditure identified.

END.

Reply:

a) According to the Office of Health Standards Compliance (OHSC), the specified amount of R250,000 was paid to “Z Jojwana HR Consulting Company”.

b) The payment was for services rendered for an investigation into capacity issues within the Human Resources Unit at the OHSC. The report is titled “Department of Human Resources poor performance investigation report”.

END.

Reply:

1. (a) The scope of applicability for the Directives on nurses’ uniform:

• 1. only applies to nurses as defined in Section 30 of the Nursing Act, 2005 (Act 33 of 2005).
  2. applies to nurses that are employed in health establishments of the Departments of Health
  3. applies to nurses who are required to wear unform in the execution of their duties and
  4. to those eligible to receive the uniform allowance under PHSDSBC resolution 1 of 2005.

b) The directive on wearing of head scarves and adornments is informed by the regulatory framework of the nursing profession as reflected in the SA Nursing Council regulations. Chief amongst these is the imperative to uphold and portray professional identity and image, in addition to minimising any potential risk to patient safety. The NDOH directives address both these imperatives. Wearing headscarves was vetoed by the nursing stakeholders because it would prevent the standardization of uniform, which is one of the hallmarks of restoration of professional identity and image. The rationale against allowing traditional adornments to be visible while on duty was for Infection Prevention and Control reasons, as it would pose a risk in spreading infections.

(2) A report reflecting a record of these decisions is attached as Annexure A.

END.

Reply:

The National Department of Health opened the Internship and Community Program (ICSP) online System application process on 4 October 2023 and closed the applications process on 20 October 2023.

1. (a)(i)(ii) According to the information extracted from the Internship and Community Service Programme (ICSP) online System, (a) the projected numbers of medical interns for the 2024 Annual cycle nationally is 2 293 and 2 446 are available posts for internship confirmed by provinces:

2024 Annual Cycle - Medical Internship Posts
Provinces	Total Posts
Eastern Cape	216
Free State	93
Gauteng	791
KwaZulu-Natal	531
Limpopo	176
Mpumalanga	94
Northern Cape	40
Nort-West	194
Western Cape	311
Grand Total	2446

(b) The names of facilities that will be used per Province for this purpose are attached as Annexure A.

2. (a)(i)(ii) The total projected number of medical doctors to be placed for community service nationally is 2 530, and 2 530 are available posts for community service (2 073 as confirmed by provinces and additional 457 secured by NDoH) in each province as follows:

2024 Annual Cycle - Community Service Posts
Provinces	Provincial Posts	Additional posts	Total Posts
Eastern Cape	287	70	357
Free State	112	20	132
Gauteng	357	80	437
KwaZulu-Natal	248	75	323
Limpopo	267	41	308
Mpumalanga	285	41	326
Northern Cape	65	15	80
Nort-West	241	45	286
Western Cape	211	70	281
Grand Total	2073	457	2530

(b) The names of facilities that will be used per Province for this purpose are attached as Annexure A.

END.

Reply:

While it is customary for women of the Muslim faith to have their heads covered, not all Muslim women cover their heads. The nursing profession has members of the Muslim faith who currently do not wear head gear.

It is the employer’s responsibility to provide the uniform or give a cash allowance to its employees if the wearing of a uniform is a condition for their work. This is also aligned to the prescripts and regulatory framework of the nursing profession as reflected in the SA Nursing Council regulations. Chief amongst these is the imperative to uphold and portray professional identity and image, in addition to minimising any potential risk to patient safety. The regulations stipulate that the wearing of the uniform should enable all nurses to display the devices which distinguish a nurse providing care in line with her professional qualifications from others.

The dress code for nurses has always served as an administrative instrument to give effect to all these service obligations that are imposed by the profession on their members. However, since 2005 nurses were provided with an allowance to purchase own uniform. The unintended consequence has been a lack of standardisation in terms of colour, material composition and quality of garment. Thus, posing a threat to historic professional image of a nurse. Hence the recent circular intended to restore standardisation in wearing of uniform. In addition to affirming the historic position of the department regarding wearing of adornment while on duty

The National department of Health is aware of the objection raised by Muslims organisations. This is the first time that the decade old practice reading wearing of adornment while on duty is being challenged. The Department remains open to engage with any affected stakeholder in this regard.

END.

Reply:

In response to the question, all health facilities in both public and private sector were included. The total number of facilities was divided by population using the 2022 Mid-Year Population Estimates by Statistics South Africa. The South African Health Facilities are classified into three categories, Peri-urban, Rural and Urban.

The total number of health facilities that serve a population of 100 000:

 

(i) Province	Peri-Urban	(a) Rural	(b) Urban
Eastern Cape	2,10	9,95	14,75
Free State	1,81	8,35	24,64
Gauteng	0,35	0,16	15,05
KwaZulu-Natal	1,53	7,60	16,47
Limpopo	1,53	14,78	5,44
Mpumalanga	1,02	6,08	10,19
Northern Cape	4,66	17,57	28,73
North West	1,39	8,07	8,77
Western Cape	1,77	7,57	24,61
National	1,34	6,75	15,43

The Urban category has a higher facility density per 100 000 population followed by the Rural with Peri-Urban having the lowest density. This is comparable to the WHO density assessment which had the hospital density for South Africa per 100 000 population at 0,67 in 2013, Malasia at 0,47 and Sri Lanka at 0,099.

END.

Reply:

Employees are generally paid on time by means of the PERSAL system. Some delays in payments for newly appointed staff may be experienced at the end of December due to calendar year end processes or at the end of February due to tax year end processes, but this is not commonly experienced problem and delays would only be for one or two weeks, not 30 days or more.

When an employee who was previously dismissed for misconduct is reinstated/ re-appointed due to an Arbitration Award or Settlement Agreement, the unblocking of the previous service termination is implemented by National Treasury following the process required after the Head of Department has approved a submission for reinstatement/re-appointment.

The National Department of Health has requested information from the provinces in relation to the question.

Financial Year 2022 - 2023
Province	Category	Salaries	Overtime	Rural Allowance	PMDS related (Notch progression / bonuses)	Any Other (Please Specify)
EC	Doctors	8	8	4 (4 of 8)	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
FS	Doctors	0	0	0	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
GP	Doctors
	Nurses		Outstanding information
	Other Healthcare Workers
KZN	Doctors	0	0	0	0	13 DC outcomes: suspension without pay
	Nurses	0	0	0	0
	Other Healthcare Workers	0	0	0	0
LP	Doctors	0	0	0	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
MP	Doctors	0	0	0	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
NC	Doctors	0	0	0	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
NW	Doctors	0	0	0	0	0
	Nurses	0	0	0	0	0
	Other Healthcare Workers	0	0	0	0	0
WC	Doctors	0	0	0	0	0
	(b) Nurses	0	0	0	0	0
	(c) Other Healthcare Workers	0	0	0	0	0

The table above excludes employees that have been through disciplinary processes and received sanctions of suspension without remuneration.

Eastern Cape:

• Two Community Service Doctors assumed duties based on institutional appointment letters which still required approval by the delegated authority.
• Six Medical Officers who applied for renewal of work permits on time but were only issued with instruction letters from Home Affairs which are acceptable for them to continue their services under Government-to-Government agreement. However, treasury regulations on PERSAL appointments necessitates individual work permits.

 

Northern Cape:

• An update from the province indicates that all remuneration for the identified personnel were settled within the calendar month.

END.

Reply:

1. Applicants are required to submit safety data on vaccines before they are registered by regulatory authorities (SAHPRA in the case of South Africa). Once registered manufacturers and regulatory authorities are required by law to conduct post-marketing surveillance of adverse events following immunisation, and to update or amend registration and product information based on this surveillance.

In addition, health care workers and the public are encouraged to report adverse effects following immunization to SAHPRA. After notification, provincial authorities investigate each case in a systematic manner and provide results to the National Immunisation Safety Expert Committee (NISEC). Experts on this committee evaluate each case to determine causal associations with vaccines. Results of these case evaluations are reported on the SAHPRA website https://aefi-reporting.sahpra.org.za/.

2. No. There is no scientific reason nor evidence to support the notion that exposure to COVID vaccine through a blood transfusion can cause harm to the person who receives the blood. As a result, donated blood is not routinely tested to determine whether it contains COVID vaccine.

3. There are no reported cases of patients reacting negatively to blood as a result of the donor having received a COVID vaccine. Blood donated by vaccinated and unvaccinated persons is processed and made available to potential recipients using the same standardised safety and other procedures.

END.

Reply:

The responsibility for the payment of electricity bills resides with the respective provincial Departments of Health. Indicated below are the amounts owing as received from the provinces for various hospitals as appears in the tables:

a) The amounts owing to the various municipalities shown here are as the end of July 2023.

EASTERN CAPE

No.	Municipality	Outstanding Debt
	Sarah Baartman	R
1	Sarah Baartman DM	1 044 492,88
2	Blue Crane Route	1 047 910,64
3	Camdeboo	0,00
4	Kouga	1 363 996,64
5	Koukamma	564 841,14
6	Makana	1 902 886,27
7	Ndlambe	332 805,52
8	Sundays River Valley	628 719,94
9	Baviaans / Ikwezi / Dr Beyers Naude	1 215 075,41
Total	8 100 728,44
	Nelson Mandela
10	Nelson Mandela Metro	24 145 981,30
Total	24 145 981,30
	Amathole
11	Amathole DM	15 204 200,95
12	Amahlathi	1 004 040,50
13	Great Kei	128 909,13
14	Mbashe	75 952,00
15	Mnquma	29 136,00
16	Ngqushwa	76 581,50
17	Nkonkobe / Nxuba / Raymond Mhlaba	20 811 489,12
Total	37 330 309,20
	Buffalo City
18	Buffalo City Metro	6 600 804,35
Total	6 600 804,35
	Chris Hani
19	Chris Hani DM	20 986 174,81
20	Emalahleni	1 964 407,15
21	Engcobo	522,35
22	Sakhisizwe	2 478 085,35
23	Intsika Yethu	468 884,20
24	Inxuba Yethemba	844 200,73
25	Inkwanca / Lukhanji /Tsolwana / Enoch Mgijima LM	4 539 032,16
Total	26 742 274,59
	Joe Gqabi
26	Joe Gqabi DM	1 382 332,82
27	Elundini	103 544,30
28	Senqu	1 410 656,03
29	Garriep / Maletswai / Walter Sisulu	3 464 505,18
Total	6 361 038,33
	OR Tambo
30	OR Tambo	7 085 527,07
31	KSD	9 608 874,60
32	Mhlontlo	8 429,53
33	Nyandeni	844 423,00
34	Ingquza Hill	8 686,65
35	Port St Johns	2 120,31
Total	17 558 061,16
	Alfred Nzo
36	Alfred Nzo DM	18 052 297,74
37	Matatiele	6 987 581,43
38	Mbizana / Winnie Madikizela	4 828 870,90
39	Ntabankulu	3 900,69
40	Umzimvubu	69 166,84
Total	29 941 817,60
	Grand Total	161 320 047,13

a) Acknowledgement of debt has been made to the relevant municipalities. There are ongoing mechanisms in place to ensure disconnection by the municipalities is avoided. After Budget Adjustment Estimates the Department will further engage relevant municipalities again with a purpose of re-arranging payments terms for this financial year and negotiate the payment terms for the next financial year.

The Department has engaged Reonet (Pty) LTD through the EC Department of Public Works with the aim of verifying all outstanding debts and billings by certain municipalities are valid and accurate.

FREE STATE

a) The Free State Department of Public Works & Infrastructure is responsible for payment of all property rates, sanitation and refuse removal accounts for all Provincial Departments. The Department of Public Works & Infrastructure is also responsible for the electricity and water accounts excluding for the schools and leased out properties where the electricity and water is metered separately and paid for by the user.

The following table indicates hospitals in the Free State province with verified outstanding electricity accounts:

FACILITY NAME	MUN CODE	TOWN	SUBURB	VERIFIED OUTSTANDING ELECTRICITY
DIAMOND HOSPITAL	FS162	JAGERSFONTEIN	JAGERSFONTEIN	R356 083,95
TROMSBURG - ALBERT NZULA HOSPITAL	FS162	TROMPSBURG Farm	TROMPSBURG Farm	R905 032,78
SMITHFIELD HOSPITAL	FS163	SMITHFIELD	SMITHFIELD	R273 713,70
EMBEKWENI HOSPITAL	FS163	ZASTRON RD	ZASTRON RD	R322 470,39
WINBURG HOSPITAL	FS181	WINBURG RD	WINBURG RD	R548 546,84
THUSANONG DISTRICT HOSPITAL	FS184	ODENDAALSRUS	ODENDAALSRUS	R1 039 539,70
KATLEHO HOSPITAL	FS184	VIRGINIA	VIRGINIA	R1 098 783,50
BONGANI REGIONAL HOSPITAL	FS184	WELKOM RD	WELKOM RD	R6 456 031,14
NALA HOSPITAL	FS185	BOTHAVILLE	BOTHAVILLE	R235 524,37
MOHAU HOSPITAL	FS185	HOOPSTAD	HOOPSTAD	R771 548,09
JOHN DANIEL NEWBERRY HOSPITAL / CLINIC	FS191	CLOCOLAN	CLOCOLAN	R168 413,33
PHUTHULOHA DISTRICT HOSPITAL	FS191	FICKSBURG	FICKSBURG	R164 537,07
ITEMOHENG HOSPITAL - SENEKAL	FS191	SENEKAL	SENEKAL	R225 643,91
PHEKOLONG HOSPITAL	FS192	BETHLEHEM	BETHLEHEM	R10 854 908,76
DIHLABENG HOSPITAL	FS192	BETHLEHEM	BETHLEHEM	R5 061 231,19
NKETOANA HOSPITAL	FS193	REITZ RD	REITZ RD	R334 285,13
THEBE DISTRICT HOSPITAL	FS194	HARRISMITH	HARRISMITH	R0,00
ELIZABETH ROSS HOSPITAL	FS194	HARRISMITH RD	HARRISMITH RD	R0,00
MOFUMAHADI MANAPO MOPELI HOSPITAL	FS194	QWA-QWA	PHUTHADITJHABA-A	R0,00
PHUMELELA HOSPITAL/VREDE CLINIC	FS195	VREDE	VREDE	R0,00
SENORITA NHLABATHI HOSPITAL	FS196	LADYBRAND	LADYBRAND	R857 455,55
BOITUMELO HOSPITAL	FS201	KROONSTAD RD	KROONSTAD RD	R3 915 423,49
TOKOLLO HOSPITAL	FS203	HEILBRON	HEILBRON	R1 594 812,28
PARYS HOSPITAL	FS203	PARYS	PARYS	R1 131 364,09
Fezi Ngumbentombi Hospital	FS204	PARYS RD	PARYS RD	R12 565 856,06
MAFUBE HOSPITAL	FS205	FRANKFORT	FRANKFORT	R0,00
NATIONAL DISTRICT HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R20 785 268,98
PSYCHIATRIC COMPLEX	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R31 590 119,88
PELONOMI HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R43 334 465,10
UNIVERSITAS ACADEMIC HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R66 108 250,22
BOTSHABELO HOSPITAL	MAN	BOTSHABELO	BOTSHABELO-BA	R18 733 852,05
DR J S MOROKA HOSPITAL	MAN	THABA `NCHU	THABA 'NCHU	R0,00

b) The Free State Department of Public Works & Infrastructure continue to negotiate with service providers not to disconnect the electricity supply as it will hamper service delivery and may cause loss of lives if a hospital electricity is disconnected. The Province is continuously assisting the department in identifying savings which are then re-directed to augment the budget pressure in this regard.

GAUTENG

a) The total amount in outstanding electricity bills at each hospital in each province amount to R285,357,103.13, from the amount R102,478,398.20 already processed on the system for payments. The total outstanding electricity bill amount to R182, 878, 704.93 of which the institutions to conduct verification for payment.

Refer to the table as below mentioned:

Vendor details	Institution	Awaiting Payment Run	Institution to approve, before payment is done
City of Johannesburg Municipality	Charlotte Maxeke	-	114 174 074,96
City of Johannesburg Municipality	Chris Hani Baragwanath Hospital	19 202 124,74	966 713,30
City of Johannesburg Municipality	Edenvale Hosp	2 205 293,14	-
City of Johannesburg Municipality	Health Head Office	-	593,14
City of Johannesburg Municipality	Helen Joseph	7 329 585,56	12 245 916,03
City of Johannesburg Municipality	Johannesburg Metro District Health	-	176 929,11
City of Johannesburg Municipality	Rahima Moosa Hosp (Coronation Hosp)	1 812 301,43	17 542 309,44
City of Johannesburg Municipality	South Rand Hosp	-	6 896 388,53
City of Johannesburg Municipality	Tara Hosp	207 047,83	523 177,46
City of Tshwane	Forensic Pathology Services	-	342 328,32
City of Tshwane	Jubilee District Hosp	-	3 286 238,53
City of Tshwane	Kalafong Hosp	1 589 028,09	-
City of Tshwane	Lebone College of Emergency	-	448 876,27
City of Tshwane	Mamelodi Hosp	589 336,07	-
City of Tshwane	Masakhane Cookfreeze	49 675,80	-
City of Tshwane	ODI District Hospital	-	399 425,03
City of Tshwane	Pretoria West	-	2 497 959,24
City of Tshwane	Steve Biko Hosp (PTA Academic Hosp)	-	96 503,47
City of Tshwane	Tshwane District Health	229 719,49	19 406,52
City of Tshwane	Tshwane District Hosp	-	-
City of Tshwane	Tshwane Rehab	-	501 685,89
City of Tshwane	Weskoppies	-	1 797 203,68
Ekurhuleni Metropolitan Municipality	Dunswart Hosp	884 844,00	-
Ekurhuleni Metropolitan Municipality	Ekurhuleni District Health	53 751 000,00	-
Ekurhuleni Metropolitan Municipality	Far East Rand Hospital	-	2 002 165,09
Ekurhuleni Metropolitan Municipality	Tambo Memorial Hosp	6 126 127,08	45 473,62
Ekurhuleni Metropolitan Municipality	Tembisa Hosp	-	3 268 538,16
Ekurhuleni Metropolitan Municipality	Thelle Mogoerane	-	220 000,04
Emfuleni - GP Local Municipality	Kopanong Hosp	7 094,31	521 335,48
Emfuleni - GP Local Municipality	Sebokeng Hosp	62 501,63	2 831 029,82
Emfuleni - GP Local Municipality	Sedibeng District Health	-	-
Lesedi - GP Local Municipality	Forensic Pathology Services	-	47 196,14
Lesedi - GP Local Municipality	Heidelburg	73 551,13	733 037,29
Merafong City - GP Local Municipality	Carlton Vill Clinic	-	8 815,87
Mogale City - GP Local Municipality	Dr Yusuf Dadoo	-	809 736,78
Mogale City - GP Local Municipality	Leratong Hosp	3 022 440,53	-
Mogale City - GP Local Municipality	Sterkfontein Hosp	2 251 647,14	-
Mogale City - GP Local Municipality	West Rand District Office	168 332,38	-
Rand West City - GP Local Municipality	West Rand District Office	402 852,88	21 284,42
ESKOM	Charlotte Maxeke	-	97 313,13
ESKOM	Ekurhuleni District Health	4 348,81	-
ESKOM	EMS	-	13 876,81
ESKOM	Johannesburg Metro District Health	1 224 494,37	409 322,98
ESKOM	Jubilee District Hosp	-	7 298 418,97
ESKOM	ODI District Hospital	-	265 607,22
ESKOM	Pholosong Hosp	-	397 829,63
ESKOM	Sedibeng District Health	117 874,95	75 465,31
ESKOM	Tara Hosp	497 564,22	-
ESKOM	Thelle Mogoerane	-	1 607 620,72
ESKOM	Tshwane District Health	469 739,63	138 186,88
ESKOM	West Rand District Office	199 872,99	150 721,65
Grand Total		102 478 398,20	182 878 704,93

b) The department conduct weekly meetings with Eskom and bilateral meetings with Municipalities, which are arranged and attended to by Representatives from Gauteng Treasury, COGTA, Department of Health: Head Office and Health Institutions (Hospitals & Entities).

KWAZULU-NATAL

a) The Department’s electricity bill across the province is all current, sitting at just over R31million.

b) The Department prioritise the water and electricity on a month-to-month basis resulting to the total debt owed being current.

LIMPOPO

a) Yes, The department has as at 31 August 2023 municipal bills of hospitals amounting to R8 590 999,33, of which the balances were within 30 Days.

The breakdown of the total bills as per the tables below:

Capricorn district

Mopani district

Sekhukhune District

Vhembe District

Waterberg District

b) All bills listed above were settled during the month of September 2023. The department is paying the municipalities monthly, hence all transactions reported are within 30 days. The department will continue reconciling the accounts and settle the debts accordingly.

MPUMALANGA

a) The hospitals will be able to process the electricity bills soon as the outstanding invoices are received and when the system is back. Attached hereunder, please find table detailing the outstanding electricity bill per hospital and payment status.

Name of Facilities	Status	Amount in Arrears	Comments
GERT SIBANDE DISTRICT
Bethal Hospital	Paid until September	604 953,00	Emzinoni Clinic billing from 2018, new matter still under investigation. A meeting schedule for tomorrow with CFO Govan Mbeki
Evander Hospital	Paid until September	300 000,00	A shortfall on the committed order, a new order to be generated
Carolina Hospital	Paid until July	-	waiting for August and September invoices. The municipal has implemented a new system which causes the delay.
Embhuleni Hospital	Paid until August	-	Invoice received after the cut-off date, yet to be processed
Ermelo Hospital	Paid until August	-	Awaiting for September invoice, a dispute was lodged on the initial invoice.
Msukalingwa Clinic	Paid until August	-	Invoice received after the cut-off date, yet to be processed
Total		904 953,00
EHLANZENI DISTRICT
Tintswalo Hospital	Paid until August	234 770,70	Invoice received after cut-off date
Themba Hospital	Paid until August	-	Waiting for invoice
Barberton TB Hospital	Paid until August	300 980,00	Invoice received after cut-off date.
Barberton Hospital	Paid until August	-	Waiting for invoice
Sabie Hospital	Paid until August	219 970,43	Invoice received after the cut-off date.
Total		755 721,13
NKANGALA DISTRICT
Kwamhlanga Hospital	Paid until 31st August 2023	37 450,00	September invoice received in process
Benice Samuel Hospital	Paid until 31st August 2023		September invoice not yet received
Middleburg Hospital	Paid until 31st August 2023	650 323,18	September invoice received in process
Mmamethlake Hospital	Paid until 31st July 2023		August and September invoice not yet received
Impungwe Hospital	Paid until 31st August 2023	253 361,19	September invoice received in process
Waterval boven	Paid until 31st August 2023		September invoice not yet received
HA Grove Hospital	Paid until 31st August 2023		September invoice not yet received
TB Hospital	Paid until 31st August 2023	192 141,36	September invoice received in process
PHC Facilities	Paid until 31st August 2023		September invoice not yet received
Total		1 133 275,73
Grand Total		2 793 949,86

b) Outstanding invoices will be processed upon receipts and captured invoices will be paid soon as the system is back.

NORTHERN CAPE

No response, after several engagement and follow ups with the province.

NORTH WEST

a) The department owes electricity bills of R5 017 155,17 outstanding as of September 2023, However, the R631 134.69 is in dispute with ESKOM.

Name of the Hospital	Total outstanding electricity bills
Ventersdorp CHC (Hospital)	352 035.81
Mafikeng Provincial Hospital	631 134.69
JST Hospital	2 879 515.91
Taung Hospital	1 154 468.76
	1 506 504.57

b) The outstanding bills are current. The department conduct regular reconciliation of the accounts with facilities when a need arises for settlement.

WESTERN CAPE

a) As of 31 August 2023, 99% of our outstanding balances are current. Some have been settled and reflect as 0 and some in credit reflected in brackets:

Hospital	Current electricity bill
Alexandra Hospital	(R1 023,27) in credit
Beaufort West Hospital	R 406 456,64
Brewelskloof Hospital	R 380 534,96
Caledon Hospital	R 365 431,18
Ceres Hospital	R 287 907,87
Citrusdal Hospital	R 421 045,97
DP Marais Hospital (vacant land)	0
Eerste River Hospital	0
False Bay Hospital	0
George Hospital	R 1 219 583,28
Groote Schuur Hospital	R 5 986,75
Harry Comay	R 166 705,81
Helderberg Hospital	0
Hermanus Hospital	R 35 710,22
Karl Bremer Hospital	0
Khayelitsha Hospital	0
Knysna Hospital	R 391 993,44
Ladismith Hospital	R 78 459,00
Laingsburg Hospital	R 75 264,00
Lapa Munnik Hospital	R 150 800,53
Lentegeur Hospital	0
Metro TB Hospital	0
Mitchells Plain Hospital	0
Montagu Hospital	0
Mosselbay Hospital	R 151 655,87
Mowbray Hospital	0
Murraysburg Hospital	R 45 654,65
Nelspoort Hospital	R 12 777,66
Oudtshoorn Hospital	0
Paarl Hospital	R 1 107 137,61
Prince Albert Hospital	R 135 198,70
Radie Kotze Hospital	R 68 478,58
Red Cross Childrens Hospital	R 2 994 987,92
Riversdale Hospital	R 210 159,68
Robertson Hospital	0
Somerset Hospital	R 805 743,74
Stellenbosch Hospital	R 270 917,51
Stikland Hospital	R 6 822,08
Swartland Hospital	R 2 582,18
Swellendam Hospital	R 168 770,49
Tygerberg Hospital	0
Valkenberg Hospital	0
Victoria Hospital	(R 400,00) in credit
Vredenburg Hospital	R 418 976,96
Vredendal Hospital	R 170 159,95
Wesfleur Hospital	R 227 512,42
Worcester Hospital	0

b) Measures in place:

• Monthly reporting to Provincial Treasury (PT) Local Government Directorate on Rural debt, which manages outstanding Provincial municipal debt, based on identifying long outstanding debt. PT will engage with the said municipality and the Department to address the debt and identifying and resolving disputes,
• Receipt of month-end outstanding billing from the City of Cape Town (Metro) to ensure all payments processed in that month are allocated to the correct accounts and all Metro accounts are reflected as current.
• BAS reports are monitored monthly.

 

END.

Reply:

The National Department of Health has not received any report about the coal tender in Limpopo and therefore not privy to any report or allegation of coal tender fraud in the Limpopo Department of Health.

END.

Reply:

It was actually 81 medical doctors who were allocated/placed for community service at the Limpopo Department of Health by the National Department of Health on 15 June 2023. Their assumption of duty was delayed because the Limpopo Provincial Treasury requested that these 81 medical doctors, must first confirm whether they will be taking up this position prior to granting approval for the creation of the posts for their employment.

(a) Shortages in the public health sector especially in rural areas is due to budget constraints and lack of appetite by health professionals to work in rural areas,

(b) As mentioned above 81 medical doctors were placed and subsequently all of them have since assumed duty to date, and

(c) Placement for medical interns and community service doctors occurs twice in each year (i.e., 1 January and 1 July of each year).

END.

Reply:

There is no obligation on the Provincial Departments of Health to report to the National Department of Health matters that relate to discipline, fraud and/or corruption committed by the provincial staff members. The National Department of Health is not privy to any matter that relates to Mr Ntshane Lephoto as that matter has not been reported to the National Department of Health.

END.

Reply:

According to Limpopo Department of Health;

Cats in Siloam District Hospital, in Vhembe, Limpopo come from nearby households for the purpose of food. The cats increase in numbers due to reproduction. The hospital has an informal agreement with farmers from the area to periodically collect cats to assist them with rodents on their farms. The first collection already happened in September 2023. The NDoH is advising the Limpopo Department of Health to consult the Society for Prevention of Cruelty to Animals (SPCA) to arrive at a good solution to this problem.

END.

Reply:

a) To date from January 2023, a total of 3 974 posts of medical doctors were advertised and filled as compared to 2 053 medical doctors’ posts of the previous year (2022) for the same periods of employment. This means that an additional 1 921 posts for medical doctors were funded to accommodate unemployed medical doctors.

It is also acknowledged that not all unemployed medical doctors after completing community service, applied for these positions due to their different personal interests (e.g., Preference of urban areas rather than rural).

It remains the obligation for the Department of Health to ensure that sufficient platform is available for all eligible South African Citizens and Permanent Residents for medical internship and community service and after qualifying for independent practice, doctors are allowed to seek employment either in public or private sector.

The National Department of Health remains accessible/open to refer unemployed medical doctors, either individually or through their Associations, to Provinces for recruitment to available funded posts.

b) The National Department of Health has been working with the HPCSA throughout the process to ensure that all South African Citizens who studied abroad are eligible and given a fair opportunity to sit for the Medical Board examinations.

Following engagements with HPCSA, the Department can now confirm that the next schedule of exams will be held as follows:

• Theory Medical Board examinations: 25 October 2023.
• Practical/OSCE Medical Board examinations: Planned between 05 and 08 December 2023.
• HPCSA has since invited applicants who meet the requirements for these examinations.

END.

Reply:

1. (a)(i) is indicated in Table 1 below as received from Provincial Departments of Health.

Table 1: (i)Number of Forensic Mortuaries including holding Facilities.

Province	Number
Eastern Cape	22
Free State	11
KwaZulu Natal	33
Gauteng	11
Limpopo	12
Mpumalanga	21
Northern Cape	11
Northwest	7
Western Cape	16
Total	145

 

(1)(a)(ii)(iii) and (b) is indicated Table 3 below as received from the provincial departments of Health.

Table 2(ii): Number of Forensic Pathologists per Province

Province	Number
Eastern Cape	2
Free State	7
KwaZulu Natal	2
Gauteng
Limpopo	7
Mpumalanga	2
Northern Cape	1
Northwest	2
Western Cape	16

Tables below indicate (ii) Number of medical officers(iii) Bodies examined, (b) Backlog per facility.

EASTERN CAPE

	Facility	(ii)Number of Medical officers including pathologists	(iii)Bodies examined for month of August 2023	(b) Backlog as of 31 August 2023
1	Adelaide		Holding Facility	Not applicable
2	Aliwal North	1	25	None
3	Bizana	1	45	None
4	Butterworth	2	70	None
5	Bhisho	1	80	None
6	Dutywa		Holding Facility	Not applicable
7	Gelvandale	2	45	None
8	Grahamstown	1	35	None
9	Graaff-Reinet	1	15	None
10	Joubertina		Holding Facility	None
11	Lusikisiki	1	45	None
12	Mdantsane	1	70	None
13	Mount Fletcher	1	45	None
14	Mount Frere	1	45	None
15	Mount Road	3	35	None
16	Molteno		Holding Facility	Not applicable
17	Mthatha	4	200	None
18	New Brighton	2	65	None
19	Port Alfred		Holding Facility	Not applicable
20	Queenstown	2	80	None
21	Uitenhage	0	40	None
22	Woodbrook	1	80	20

 

FREE STATE PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Bethlehem	1	25	None
2	Bloemfontein	7	95	None
3	Botshabelo	1	26	Not applicable
4	Ficksburg	0	Holding facility	Not applicable
5	Jagersfontein	0	Holding facility	Not applicable
6	Harrismith	0	Holding facility	Not applicable
7	Kroonstad	1	30	None
8	Phuthaditjhaba	1	50	None
9	Sasolburg	1	20	None
10	Smithfield	1	Holding facility	Not applicable
11	Welkom	2	55	None

GAUTENG PROVINCE

No	Facility	(ii)Number of medical officers including pathologist	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Bronkhorspruit	01	29	None
2	Carletonville	02	46	None
3	Diepkloof	06	256	None
4	Ga-Rankuwa	08	121	None
5	Germiston	11	400	None
6	Heidelberg	01	27	None
7	Johannesburg	12	410	None
8	Pretoria	12	219	None
9	Roodepoort	04	161	None
10	Sebokeng	04	230	None
11	Springs	04	164	None

KWAZULU NATAL PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined Jan to Dec 2022 monthly average
1	Bulwer	Shares with Ixopo	Holding Facility
2	Dannhauser	Shares with Newcastle	Holding Facility
3	Dundee	1	20
4	Estcourt	Shares with Ladysmith	32
5	Eshowe	Shares with Richards Bay	26
6	Greytown	2	37
7	Harding	1	19
8	Howick	1	19
9	Ixopo	1	30
10	KwaDukuza	2	73
11	Kokstad	Shares with Ixopo	10
12	Ladysmith	1	60
13	Madadeni	1	44
14	Manguzi	Shares with Richards Bay	Holding Facility
15	Mkhuze	Shares with Richards Bay	Holding Facility
16	Mtubatuba	Shares with Richards Bay	Holding Facility
17	Mosvold	Shares with Richards Bay	Holding Facility
18	Newcastle	3	17
19	New Hanover	Shares with Greytown	10
20	Nkandla	Shares with Richards Bay	Holding Facility
21	Nongoma	1	43
22	Park Rynie	4	141
23	Paulpietersburg	Shares with Vryheid	Holding Facility
24	Pietermaritzburg	4	166
25	Pinetown	8	216
26	Phoenix	3	321
27	Pongola	Shares with Nongoma	Holding Facility
28	Port Shepstone	3	67
29	Richards Bay	3	141
30	Richmond	Shares with Pietermaritzburg	Holding Facility
31	Ulundi	Shares with Nongoma	Holding Facility
32	Umzimkulu	Shares with Ixopo	14
33	Vryheid	1	26

(b) The KwaZulu Department of Health indicates that there is a backlog of 52 bodies as of 31 August 2023.

LIMPOPO PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Polokwane	8	148	None
2	Lebokwakgomo	1	42	None
3	Bela Bela	1	45	None
4	Elim	1	38	None
5	Maphutha Malatjie, Phalaborwa	0	30	None
6	Nkhensani, Giyani	1 for Phutha Malatjie and Nkhensani	40	None
7	Kgapane, Tzaneen	1	35	None
8	Tshilidzini	2	21	None
9	Letaba, Tzaneen	2	24	None
10	St Ritas	1 for both St Ritas and Groblersdal	12	None
11	Mokopane	2	21	None
12	Groblersdal	0	17	None

MPUMALANGA PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Balfour	1	6	None
2	Barberton	1	12	None
3	Belfast	0	11	None
4	Bethal	1 for Bethal and Standerton	21	None
5	Carolina	1 for Carolina and Embhuleni	8	None
6	Delmas	1	8	None
7	Embhuleni	0	13	None
8	Ermelo	1	27	None
9	Evander	1	31	None
10	KwaMhlanga	2 for KwaMhlanga and Mmamethlake	36	None
11	Lydenburg	1 for Lydenburg and Mapulaneng	10	None
12	Mmamethlake	0	0	None
13	Mapulaneng	0	43	None
14	Middelburg	1 for Middleburg and Belfast	30	None
15	Piet Retief	1	14	None
16	Themba	2	65	None
17	Tintswalo	1	23	None
18	Tonga	1	26	None
19	Standerton	0	16	None
20	Volksrust	1	11	None
21	Witbank	2	56	None

 

Mpumalanga Department of Health has additional:

• Forensic Pathologist responsible for the whole province
• 1 Forensic Pathologist responsible for Nkangala District
• 1 Senior Medical officer responsible for Ehlanzeni District
• 1 Senior Medical office responsible for the Gert Sibande District.

NORTHERN CAPE PROVINCE

No	Facility	(ii)Number of medical officers including a pathologist	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Kimberley	2	50	None
2	Upington	1	33	None
3	De Aar	1	20	None
4	Kuruman	1	30	None
5	Calvinia	1	5	None
6	Springbok	1	15	None
7	Postmasburg		Holding facility	Not applicable
8	Hartswater		Holding facility	Not applicable
9	Douglas		Holding facility	Not applicable
10	Prieska		Holding facility	Not applicable
11	Victoria West		Holding facility	Not applicable

NORTHWEST PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined on the month of August 2023	(b) Backlog as of 31 August 2023
1	Phokeng	2	82	None
2	Vryburg	1	26	None
3	Klerksdorp	1	23	None
4	Lichtenburg	1	11	None
5	Brits	3	54	None
6	Potchefstroom	2	13	None
7	Mafikeng	1	17	None

WESTERN CAPE PROVINCE

No	Facility	(ii)Number medical officers including Pathologists	(iii)Average Bodies examined for the period April 2022/2023 financial year monthly average
Garden Route / Central Karoo	3
1	Beaufort West		7
2	George		24
3	Knysna		12
4	Laingsburg Mossel		2
5	Mossel Bay		10
6	Oudtshoorn		10
7	Riversdale		5
City of Cape Town
8	Salt River	15	355
9	Tygerberg	15	318
Westcoast/Cape Winelands	4(2 vacant)
10	Malmesbury		14
11	Vredenburg		11
12	Vredendal		16
13	Paarl		40
Winelands/Overberg	4
14	Hermanus		26
15	Ceres		17
16	Worcester		44

(b) The Western Cape Department of Health indicates that the number of outstanding postmortems as of 2023/09/28 is 202 with no mortuaries indicated.

(2) Tables below indicate Forensic pathology mortuary by name and location.

EASTERN CAPE

	Facility	Location
1	New Brighton	New Brighton
2	Mount Road	Mount Road
3	Gelvandale	Gelvandale
4	Grahamstown	Grahamstown
5	Graaff-Reinet	Graaff -Reinet
6	Woodbrook	Woodbrook
7	Mdantsane	Mdantsane
8	Bizana	Bizana
9	Butterworth	Butterworth
10	Bhisho	Bhisho
11	Queenstown	Queenstown
12	Adelaide	Adelaide
13	Aliwal North	Aliwal North
14	Middelburg	Middelburg
15	Mthatha	Mthatha
16	Mount Fletcher	Mount Fletcher
17	Mount Frere	Mount Frere
18	Molteno	Molteno
19	Lusikisiki	Lusikisiki
20	Port Alfred	Port Alfred
21	Uitenhage	Uitenhage
22	Joubertina	Joubertina

FREE STATE PROVINCE

No	Facility	Location
1	Bethlehem	Bethlehem
2	Bloemfontein	Bloemfontein
3	Botshabelo	Botshabelo
4	Ficksburg	Ficksburg
5	Jagersfontein	Jagersfontein
6	Harrismith	Harrismith
7	Kroonstad	Kroonstad
8	Phuthaditjhaba	Phuthaditjhaba
9	Sasolburg	Sasolburg
10	Smithfield	Smithfield
11	Welkom	Welkom

GAUTENG PROVINCE

No	Facility	Location
1	Johannesburg	Hillbrow Johannesburg
2	Roodepoort	Roodepoort
3	Germiston	Germiston
4	Carletonville	Carletonville
5	Springs	Springs
6	Heidelburg	Heidelburg
7	Diepkloof	Diepkloof, Soweto
8	Sebokeng	Sebokeng
9	Pretoria	Pretoria
10	Bronkhorspruit	Bronkhorspruit
11	Garankuwa	Ga- Rankuwa

 

KWAZULU NATAL PROVINCE

No	Facility	Location
1	Phoenix	Phoenix
2	Pinetown	Pinetown
3	Park Rynie	Park Rynie
4	Port Shepstone	Port Shepstone
5	Harding	Harding
6	KwaDukuza	KwaDukuza
7	Pietermaritzburg	Pietermaritzburg
8	New Hanover	New Hanover
9	Howick	Howick
10	Richmond	Richmond
11	Ladysmith	Ladysmith
12	Estcourt	Estcourt
13	Dundee	Dundee
14	Greytown	Greytown
15	Newcastle	Newcastle
16	Madadeni	Madadeni
17	Dannhauser	Dannhauser
18	Kokstad	Kokstad
19	Ixopo	Ixopo
20	Umzimkulu	Umzimkulu
21	Bulwer	Bulwer
22	Nongoma	Nongoma
23	Paulpietersburg	Paulpietersburg
24	Vryheid	Vryheid
25	Pongola	Pongola
26	Richards Bay	Richards Bay
27	Eshowe	Eshowe
28	Richards Bay	Richards Bay
29	Mkhuze	Mkhuze
30	Mosvold	Mosvold
31	Manguzi	Manguzi
32	Nkandla	Nkandla
33	Ulundi	Ulundi

LIMPOPO PROVINCE

No	Facility	Location
1	Polokwane	Polokwane Hospital
2	Lebokwakgomo	Lebowakgomo
3	Bela Bela	Bela Bela Hospital
4	Elim	Elim Hospital
5	Maphutha Malatjie	Maphutha Malatjie Hospital
6	Nkhensani	Nkhensani Hospital
7	Kgapane, Tzaneen	Kgapane Hospital
8	Tshilidzini	Tshilidzini Hospital
9	Letaba, Tzaneen	Letaba Hospital, Tzaneen
10	St Ritas	St Ritas Hospital
11	Mokopane	Mokopane Hospital
12	Groblersdal	Groblersdal Hospital

MPUMALANGA PROVINCE

No	Facility	Location
1	Balfour	Balfour Community Health Centre
2	Barberton	Barberton Hospital
3	Belfast	HA Grove Hospital
4	Bethal	Bethal SAPS
5	Carolina	Carolina Hospital
6	Delmas	Bernice Samuel Hospital
7	Embhuleni	Embhuleni Hospital
8	Ermelo	Ermelo Hospital
9	Evander	Evander Hospital
10	KwaMhlanga	KwaMhlanga Hospital
11	Lydenburg	Lydenburg Hospital
12	Mmamethlake	Mmametlhake Hospital
13	Mapulaneng	Mapulaneng Hospital
14	Middelburg	Middleburg Hospital
15	Piet Retief	Piet Retief Hospital
16	Themba	Themba Hospital
17	Tintswalo	Tintswalo Hospital
18	Tonga	Tonga Hospital
19	Standerton	Standerton Hospital
20	Volksrust	Amajuba Hospital
21	Witbank	Witbank SAPS

NORTHERN CAPE PROVINCE

No	Facility	Location
1	Kimberley	Kimberly
2	Upington	Upington
3	De Aar	De Aar
4	Kuruman	Kuruman
5	Calvinia	Calvinia
6	Springbok	Springbok
7	Postmasburg	Postmansburg
8	Hartswater	Hartswater
9	Douglas	Douglas
10	Prieska	Prieska
11	Victoria West	Victoria West

NORTHWEST PROVINCE

No	Facility	Location
1	Phokeng	Doves Private Mortuary, Rustenburg
2	Vryburg	Joe Morolong Memorial Hospital, Vryburg
3	Klerksdorp	Tshepong Hospital Complex, Joubert on, Klerksdorp
4	Lichtenburg	Lichtenburg SAPS Station Lichtenburg
5	Brits	427 Crocodile St, Primindia, Brits
6	Potchefstroom	25 OR Tambo Street, Potchefstroom
7	Mahikeng	Mahikeng Provincial Hospital

WESTERN CAPE PROVINCE

No	Facility	Location
1	Salt River	Salt River
2	Tygerberg	Tygerberg
3	Paarl	Paarl
4	Vredendal	Vredendal
5	Malmesbury	Malmesbury
6	Vredenburg	Vredenburg
7	Worcester	Worcester
8	Wolseley	Wolseley
9	Hermanus	Hermanus
10	George	George
11	Laingsburg	Laingsburg
12	Mossel Bay	Mossel Bay
13	Knysna	Knysna
14	Oudtshoorn	Oudtshoorn
15	Beaufort West	Beaufort West
16	Riversdale	Riversdale

3. (a) There are no specific regulations in place that regulate the period for post-mortems. The regulations regarding the rendering of Forensic Pathology Service (R359; 23 March 2018) in terms of section 90(1) of the National Health Act does not specifically state any such timelines.

The Forensic Pathology Service in each province does however set targets and measure the turn-around time of post-mortem examinations and most provinces set the 3 to 7 days turnaround time. This also is depended on the number of bodies received and capacity that is available to conduct post-mortems. However, most postmortems are conducted between (1) to (3) days in majority of facilities.

(b) There are regulations that govern mortuaries in terms of the National Health Act (Chapter 8). These are R363; 22 May 2013; Regulations regarding the management of human remains.

The National Code of Guidelines for Forensic Pathology Practice in South Africa, issued in relation to the Regulations of the National Health Act 61 of 2003 provide guidance on period for postmortem examinations and body storage temperatures. The Code of Guidelines stipulate only that postmortem examinations must be conducted as soon as possible. These Code of Guidelines and are currently being revised.

END.